Prediction Model for Intermediate-Stage Hepatocellular Carcinoma Response to Transarterial Chemoembolization.

Abstract

BACKGROUND:

The outcome of intermediate-stage hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) is greatly heterogeneous. Current means for predicting HCC response to TACE are lacking.

PURPOSE:

To investigate whether the combination of parameters derived from amide proton transfer (APT) and intravoxel incoherent motion (IVIM) imaging, and morphological characteristics of tumor can establish a better prediction model than the univariant model for HCC response to TACE.

STUDY TYPE:

Prospective.

SUBJECTS:

56 patients with intermediate-stage HCC (50 males and six females).

FIELD STRENGTH/SEQUENCES:

3.0T; T2 -weighted-fast spin echo, 3D liver acquisition with volume flex, single-shot fast spin echo-planar imaging (EPI), spin echo-EPI.

ASSESSMENT:

Pretreatment APT signal intensities (SIs), apparent diffusion coefficient (ADC), true molecular diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) for tumor, peritumoral, and normal tissues were measured. Follow-up MRI scanning was performed, and the patients were classified as responders or nonresponders based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria.

STATISTICAL TESTS:

The imaging parameters were compared among the three tissues and between the two groups using analysis of variance (ANOVA) or two-sample t-test. The prediction model's variables were derived from univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curve analysis was used to explore the predictive performance.

RESULTS:

Based on the logistic regression analysis results, we established a prediction model that integrated the APT SI and D values in the tumor tissue and the tumor size. ROC analyses revealed that the model was better able to predict tumor response to TACE (area under the ROC curve = 0.851) than the individual parameters on their own.

DATA CONCLUSION:

A prediction model incorporating pretreatment APT SI, D in the tumor tissue and tumor size may be useful for predicting the response of intermediate-stage HCC to TACE.

LEVEL OF EVIDENCE:

1 TECHNICAL EFFICACY: Stage 1 J. MAGN. RESON. IMAGING 2020;52:1657-1667.

• Authors: Fei Jia, Baolin Wu, Ruifang Yan, Lei Li, Kaiyu Wang, Dongming Han
• Journal: Journal of magnetic resonance imaging : JMRI (J Magn Reson Imaging) Vol. 52 Issue 6 Pg. 1657-1667 (12 2020) ISSN: 1522-2586 [Electronic] United States
• PMID: 32424881 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 International Society for Magnetic Resonance in Medicine.

Topics

• Carcinoma, Hepatocellular (diagnostic imaging, therapy)
• Chemoembolization, Therapeutic
• Diffusion Magnetic Resonance Imaging
• Female
• Humans
• Liver Neoplasms (diagnostic imaging, therapy)
• Male
• Prospective Studies