Threshold for Enhancement in Treated Hepatocellular Carcinoma on MDCT: Effect on Necrosis Quantification

Arslanoğlu, Atilla; Chalian, Hamid; Sodagari, Faezeh; Seyal, Adeel R.; Töre, Hüseyin Gürkan; Salem, Riad; Yaghmai, Vahid

doi:10.2214/ajr.15.15339

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…This category is reserved for observations that do not clearly fall into the LR-TR nonviable or LR-TR viable category. With some treatments-for example, transarterial radioembolization-early posttreatment enhancement of the tumor may not reliably differentiate viable from nonviable tumor (48). Both incompletely necrotic tumor and granulation tissue may show mild early enhancement that is increased on delayed phase images.…”

Section: Lr-tr Equivocalmentioning

confidence: 99%

2017 Version of LI-RADS for CT and MR Imaging: An Update

Elsayes¹,

Hooker²,

Agrons³

et al. 2017

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The Liver Imaging Reporting and Data System (LI-RADS) is a reporting system created for the standardized interpretation of liver imaging findings in patients who are at risk for hepatocellular carcinoma (HCC). This system was developed with the cooperative and ongoing efforts of an American College of Radiology-supported committee of diagnostic radiologists with expertise in liver imaging and valuable input from hepatobiliary surgeons, hepatologists, hepatopathologists, and interventional radiologists. In this article, the 2017 version of LI-RADS for computed tomography and magnetic resonance imaging is reviewed. Specific topics include the appropriate population for application of LI-RADS; technical recommendations for image optimization, including definitions of dynamic enhancement phases; diagnostic and treatment response categories; definitions of major and ancillary imaging features; criteria for distinguishing definite HCC from a malignancy that might be non-HCC; management options following LI-RADS categorization; and reporting. RSNA, 2017.

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Section: Lr-tr Equivocalmentioning

confidence: 99%

2017 Version of LI-RADS for CT and MR Imaging: An Update

Elsayes¹,

Hooker²,

Agrons³

et al. 2017

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201

159

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“…In clinical studies, the bin sizes of 15, 20 and 25 HU may be reasonable since the proportions of reproducible features were relatively higher in these bin sizes than in other bin sizes, and 10 to 20 HU are commonly used as the threshold of enhancement or measurement error because the CT numbers are affected by many factors such as X-ray beam hardening, X-ray scatter, partial volume effects, etc. (19,21,22). Although the proportion of reproducible features was the highest in the bin size of 50 HU, the image resolution is inadequate to distinguish different composition in tissues and lesions.…”

Section: Discussionmentioning

confidence: 99%

Influence of feature calculating parameters on the reproducibility of CT radiomic features: a thoracic phantom study

Liu¹,

Tan²,

Vangel³

et al. 2020

Quant Imaging Med Surg

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Background: Existing studies have demonstrated that imaging parameters may affect radiomic features.However, the influence of feature calculating parameters has been overlooked. The purpose of this study is to investigate the influence of feature calculating parameters (gray-level range and bin size) on the reproducibility of CT radiomic features.Methods: Thirty-six CT scans from an anthropomorphic thoracic phantom were acquired with different imaging parameters including effective dose, pitch, slice thicknesses and reconstruction kernels. The influence of feature calculating parameters was investigated in terms of three gray-level ranges and eleven gray-level bin sizes. Feature reproducibility was assessed by the intraclass correlation coefficient (ICC) with the cutoff value of 0.8 and the coefficient of variation (CV) with the cutoff value of 20%. The agreements of reproducible features in different ranges and bin sizes were analyzed by Kendall's W test and Kappa test.The proportions of reproducible features, in terms of two calculating, four imaging and two segmentation parameters, were evaluated using Cochran's Q test and Dunn's test.Results: For the three gray-level ranges, 50% (44/88) of features were reproducible with a perfect agreement (Kendall's W coefficient 0.844, P<0.001). Of the 72 features that may be influenced by graylevel bin size, 33.3% (24/72) were reproducible for 11 bin sizes with a perfect agreement (Kendall's W coefficient 0.879, P<0.001). For the proportions of reproducible features, there was no statistically significant difference among three ranges (P=0.420), but there was among eleven bin sizes (P=0.013). The proportions of reproducible features in feature calculating parameters were statistically significantly lower than those in imaging parameters (adjusted P<0.05).Conclusions: Feature calculating parameters may have a greater influence than imaging parameters on the reproducibility of CT radiomic features, which should be given special attention in clinical applications.

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“…Previously, an enhancement of 10 HU or more had been generally used as the threshold that defines viability in hepatic tumors (24). However, a recent study suggested that the threshold of 17.1 HU was the best threshold for the detection of pseudoenhancement of the hepatic cyst and that 17.1 HU could be used as the cutoff for nonenhancement in necrotic HCCs (25). Therefore, in the present study, we used 20 HU as the threshold.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Early Response to Treatment of Hepatocellular Carcinoma with Yttrium-90 Radioembolization Using Quantitative Computed Tomography Analysis

Kim

et al. 2019

Korean J Radiol

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Objective To identify an imaging predictor for the assessment of early treatment response to yttrium-90 transarterial radioembolization (TARE) in patients with hepatocellular carcinoma (HCC), using a quantitative assessment of dynamic computed tomography (CT) images. Materials and Methods Dynamic contrast-enhanced CT was obtained pre- and 4 weeks post-TARE in 44 patients (34 men, 10 women; mean age, 60 years) with HCC. Computer software was developed for measuring the percentage increase in the combined delayed-enhancing area and necrotic area (pD + N) and the percentage increase in the necrotic area (pNI) in the tumor-containing segments pre- and post-TARE. Local progression-free survival (PFS) was compared between patient groups using Cox regression and Kaplan-Meier analyses. Results Post-TARE HCC with pD + N ≥ 35.5% showed significantly longer PFS than those with pD + N < 35.5% ( p = 0.001). The local tumor progression hazard ratio was 17.3 ( p = 0.009) for pD + N < 35.5% versus pD + N ≥ 35.5% groups. HCCs with a high pNI tended to have longer PFS, although this difference did not reach statistical significance. Conclusion HCCs with a larger pD + N are less likely to develop local progression after TARE.

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Threshold for Enhancement in Treated Hepatocellular Carcinoma on MDCT: Effect on Necrosis Quantification

Abstract: The threshold of 17.1 HU may be the appropriate cutoff for nonenhancement in a necrotic HCC. Use of this threshold may potentially affect how response to therapy is quantified and categorized.

Cited by 8 publications

References 24 publications

2017 Version of LI-RADS for CT and MR Imaging: An Update

2017 Version of LI-RADS for CT and MR Imaging: An Update

Influence of feature calculating parameters on the reproducibility of CT radiomic features: a thoracic phantom study

Evaluation of Early Response to Treatment of Hepatocellular Carcinoma with Yttrium-90 Radioembolization Using Quantitative Computed Tomography Analysis

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