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Intraprocedural 3D Quantification of Lipiodol Deposition on Cone-Beam CT Predicts Tumor Response After Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma

  • Clinical Investigation
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Abstract

Purpose

To evaluate whether intraprocedural 3D quantification of Lipiodol deposition on cone-beam computed tomography (CBCT) can predict tumor response on follow-up contrast-enhanced magnetic resonance imaging (CE-MRI) in patients with hepatocellular carcinoma (HCC) treated with conventional transarterial chemoembolization (cTACE).

Materials and Methods

This IRB approved, retrospective analysis included 36 patients with 51 HCC target lesions, who underwent cTACE with CBCT. CE-MRI was acquired at baseline and 1 month after cTACE. Overall tumor volumes as well as intratumoral Lipiodol volumes on CBCT were measured and compared with the overall and necrotic (non-enhancing) tumor volumes on CE-MRI using the paired student’s t test. Tumor response on CE-MRI was assessed using modified response evaluation criteria in solid tumors (mRECIST). A linear regression model was used to correlate tumor volumes, Lipiodol volumes, and the percentage of Lipiodol deposition on CBCT with the corresponding parameters on CE-MRI. Nonparametric spearman rank-order correlation and trend test were used to correlate the percentage of Lipiodol deposition in the tumor with tumor response.

Result

A strong correlation between overall tumor volumes on CBCT and CE-MRI was observed (R 2 = 0.986). In addition, a strong correlation was obtained between the volume of Lipiodol deposition on CBCT and tumor necrosis (in cm3) on CE-MRI (R 2 = 0.960), and between the percentage of Lipiodol deposition and tumor necrosis (R 2 = 0.979). Importantly, the extent of Lipiodol deposition (in percentage of total tumor volume) correlated strongly with tumor response on CE-MRI (Spearman rho = 0.84, p < 0.001).

Conclusions

Intraprocedural 3D quantification of Lipiodol deposition on CBCT can be used to predict tumor response on follow-up CE-MRI.

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Conflict of interest

MingDe Lin and Alessandro Radaelli are Philips employees. Jean-François Geschwind is a grant recipient of Philips. The control of the data and the information submitted for publication were maintained by the remaining authors (Zhijun Wang, Rongxin Chen, Rafael Duran, Yan Zhao, Gayane Yenokyan, Julius Chapiro, Rüdiger Schernthaner), who had no conflicts of interest.

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Statement of informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Sheikh Zayed Tower, Ste 7203, 1800 Orleans St, Baltimore, MD, 21287, USA

    Zhijun Wang, Rongxin Chen, Rafael Duran, Yan Zhao, Julius Chapiro, Rüdiger Schernthaner & Jean-François Geschwind

  2. Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Zhijun Wang

  3. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21287, USA

    Gayane Yenokyan

  4. iXR, Philips Healthcare, Best, The Netherlands

    Alessandro Radaelli

  5. Ultrasound Imaging and Interventions (UII), Philips Research North America, Briarcliff Manor, NY, USA

    MingDe Lin

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  1. Zhijun Wang
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Correspondence to Jean-François Geschwind.

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Wang, Z., Chen, R., Duran, R. et al. Intraprocedural 3D Quantification of Lipiodol Deposition on Cone-Beam CT Predicts Tumor Response After Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 38, 1548–1556 (2015). https://doi.org/10.1007/s00270-015-1129-9

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