Prediction of transarterial chemoembolization (TACE) outcome by pre- and postinterventional 13C-methacetin breath test

Senk, Karin; Wilcke, Juliane; Haimerl, Michael; Verloh, Niklas; Bártulos, Carolina Río; Bäumler, Wolf; Stroszczynski, Christian; Wiggermann, Philipp

doi:10.3233/ch-219118

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…In this context, it is important to assess the liver function of the remnant before surgery to avoid postoperative liver failure (PHLF). These scoring systems are also used in locoregional therapies to assess liver function 27 , 28 . In addition, the MELD and CP scores are part of the strategies for prognosis prediction and treatment recommendation for HCC, such as the BCLC strategy or that of the Japan Society of Hepatology (JSH).…”

Section: Discussionmentioning

confidence: 99%

Using AI and Gd-EOB-DTPA-enhanced MR imaging to assess liver function, comparing the MELIF score with the ALBI score

Río Bártulos,

Senk,

Bade

et al. 2023

Sci Rep

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Monitoring disease progression is particularly important for determining the optimal treatment strategy in patients with liver disease. Especially for patients with diseases that have a reversible course, there is a lack of suitable tools for monitoring liver function. The development and establishment of such tools is very important, especially in view of the expected increase in such diseases in the future. Image-based liver function parameters, such as the T1 relaxometry-based MELIF score, are ideally suited for this purpose. The determination of this new liver function score is fully automated by software developed with AI technology. In this study, the MELIF score is compared with the widely used ALBI score. The ALBI score was used as a benchmark, as it has been shown to better capture the progression of less severe liver disease than the MELD and Child‒Pugh scores. In this study, we retrospectively determined the ALBI and MELIF scores for 150 patients, compared these scores with the corresponding MELD and Child‒Pugh scores (Pearson correlation), and examined the ability of these scores to discriminate between good and impaired liver function (AUC: MELIF 0.8; ALBI 0.77) and to distinguish between patients with and without cirrhosis (AUC: MELIF 0.83, ALBI 0.79). The MELIF score performed more favourably than the ALBI score and may also be suitable for monitoring mild disease progression. Thus, the MELIF score is promising for closing the gap in the available early-stage liver disease monitoring tools (i.e., identification of liver disease at a potentially reversible stage before chronic liver disease develops).

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Section: Discussionmentioning

confidence: 99%

Using AI and Gd-EOB-DTPA-enhanced MR imaging to assess liver function, comparing the MELIF score with the ALBI score

Río Bártulos,

Senk,

Bade

et al. 2023

Sci Rep

Self Cite

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“…Three recent studies evaluated the value of 13 C-MBT in TACE-treated patients with HCC ( 21 – 23 ). However, none of these studies investigated the association of baseline and longitudinal 13 C-MBT values with prognosis and mortality prediction.…”

Section: Discussionmentioning

confidence: 99%

“…Senk et al performed 13 C-MBT 1 day before and after TACE in 20 patients with HCC. Patients with an objective response or disease control according to modified response evaluation criteria in solid tumors (mRECIST) 6 weeks after TACE showed significantly higher baseline 13 C-MBT values, respectively ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

13C-methacetin breath test predicts survival in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Gairing

Kuchen

Müller

et al. 2022

Clin Transl Gastroenterol

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INTRODUCTION: The 13 C-methacetin breath test ( 13 C-MBT) is a dynamic method for assessing liver function. This proof-of-concept study aimed to investigate the association between 13 C-MBT values and outcomes in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). METHODS: A total of 30 patients with HCC were prospectively recruited. Of these, 25 were included in baseline and 20 in longitudinal analysis. 13 C-MBTs were performed before the first and second TACE session. Patients were followed for at least 1 year. RESULTS: At baseline, the median 13 C-MBT value was 261 μg/kg/hr (interquartile range 159–387). 13 C-MBT, albumin-bilirubin, Child-Pugh, and Model for End-Stage Liver Disease scores were associated with overall survival in extended univariable Cox regression ( 13 C-MBT: standardized hazard ratio [sHR] 0.297, 95% confidence interval [CI] 0.111–0.796; albumin-bilirubin score: sHR 4.051, 95% CI 1.813–9.052; Child-Pugh score: sHR 2.616, 95% CI 1.450–4.719; Model for End-Stage Liver Disease score: sHR 2.781, 95% CI 1.356–5.703). Using a cutoff of 140 μg/kg/hr at baseline, 13 C-MBT was associated with prognosis (median overall survival 28.5 months [95% CI 0.0–57.1] vs 3.5 months [95% CI 0.0–8.1], log-rank P < 0.001). Regarding prediction of 90-day mortality after second 13 C-MBT, the relative change in 13 C-MBT values yielded an area under the receiver-operating characteristic curve of 1.000 ( P = 0.007). DISCUSSION: Baseline and longitudinal 13 C-MBT values predict survival of patients with HCC undergoing TACE. The relative change in 13 C-MBT values predicts short-term mortality and may assist in identifying patients who will not benefit from further TACE treatment.

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“…This tool is potentially suitable to select candidates for liver surgery or liver transplantation and to predict the post-operative outcome [ 29 , 30 , 31 ]. Recent studies in small patient populations also showed that LiMAx might be an appropriate monitoring tool to predict the risk of liver failure after TACE [ 32 , 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

The Liver Maximum Capacity Test (LiMAx) Is Associated with Short-Term Survival in Patients with Early Stage HCC Undergoing Transarterial Treatment

Fischer

Wellhöner

Ebel

et al. 2022

Cancers

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Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are recommended to treat patients with early or intermediate hepatocellular carcinoma (HCC). The liver maximum capacity test (LiMAx) has been supposed to predict the risk of post-interventional liver failure. We investigated the correlation of LiMAx with short-term survival as primary endpoint and the occurrence of adverse events after therapy as secondary endpoint. Our study cohort prospectively included 69 patients receiving TACE (n = 57) or TARE (n = 12). LiMAx test and serological analyses were performed on the day before and 4 weeks after treatment. Hepatic and extrahepatic complications were monitored for 4 weeks. The LiMAx results were not associated with altered liver function and the occurrence of adverse events. The survival rates of patients with BCLC A with LiMAx ≤ 150 μg/kg/h were lower after 30 days (75.0 ± 15.3% vs. 100%, p = 0.011), 90 days (62.5 ± 17.7% vs. 95.8 ± 4.1%, p = 0.011) and 180 days (50.0 ± 17.7% vs. 95.8 ± 4.1%, p = 0.001) compared to those with higher LiMAx levels. The LiMAx test is not suitable to predict liver function abnormalities or the occurrence of complications 4 weeks after therapy but enables the identification of patients with early stage HCC and reduced short-term survival after treatment.

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Prediction of transarterial chemoembolization (TACE) outcome by pre- and postinterventional 13C-methacetin breath test

Cited by 6 publications

References 22 publications

Using AI and Gd-EOB-DTPA-enhanced MR imaging to assess liver function, comparing the MELIF score with the ALBI score

Using AI and Gd-EOB-DTPA-enhanced MR imaging to assess liver function, comparing the MELIF score with the ALBI score

13C-methacetin breath test predicts survival in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

The Liver Maximum Capacity Test (LiMAx) Is Associated with Short-Term Survival in Patients with Early Stage HCC Undergoing Transarterial Treatment

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