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The Efficacy of Cone-Beam CT–Based Liver Perfusion Mapping to Predict Initial Response of Hepatocellular Carcinoma to Transarterial Chemoembolization

Title
The Efficacy of Cone-Beam CT–Based Liver Perfusion Mapping to Predict Initial Response of Hepatocellular Carcinoma to Transarterial Chemoembolization
Authors
Kim K.A.Choi S.Y.Kim M.U.Baek S.Y.Park S.H.Yoo K.Kim T.H.Kim H.Y.
Ewha Authors
백승연유권김태헌최선영박상희김휘영김민욱
SCOPUS Author ID
백승연scopus; 유권scopus; 김태헌scopus; 최선영scopusscopus; 박상희scopus; 김휘영scopus
Issue Date
2019
Journal Title
Journal of Vascular and Interventional Radiology
ISSN
1051-0443JCR Link
Citation
Journal of Vascular and Interventional Radiology vol. 30, no. 3, pp. 358 - 369
Publisher
Elsevier Inc.
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Purpose: To evaluate efficacy of cone-beam CT–based liver perfusion mapping obtained immediately following conventional transarterial chemoembolization of hepatocellular carcinoma (HCC) for assessing tumor vascularity, technical success of chemoembolization, and treatment response. Materials and Methods: From July 2015 to June 2016, 35 patients with 57 HCCs who underwent cone-beam CT with post-processing software via conventional transarterial chemoembolization for HCC and follow-up examination were included. Three reviewers evaluated technical success on angiography, unenhanced cone-beam CT, contrast-enhanced cone-beam CT, and cone-beam CT–based liver perfusion mapping after transarterial chemoembolization per tumor and per patient. Parenchymal blood volume (PBV) was measured. Treatment response was determined on follow-up CT, MR imaging, or histopathology according to modified Response Evaluation Criteria In Solid Tumors. Diagnostic performance for detection of a viable tumor was evaluated using multiple logistic regression with C-statistics. Results: Treatment response was 38, 17, 2, and 0 for complete response, partial response, stable disease, and progressive disease per tumor and 18, 15, 2, and 0 per patient. In multiple logistic regression, unenhanced cone-beam CT, contrast-enhanced cone-beam CT, cone-beam CT–based liver perfusion mapping, mean value of PBV, and maximum value of PBV of tumor were significant in response assessment for per tumor and per patient (per tumor, all P <.001; per patient, P =.015, P =.001, P <.001, P =.020, and P =.032). Mean value of PBV of tumor was excellent for evaluating technical success with the highest C-statistic (0.880 and 0.920 for per tumor and per patient), followed by that of visual assessment of cone-beam CT–based liver perfusion mapping (0.864 and 0.908). Conclusions: Cone-beam CT–based liver perfusion mapping provided reliable images to evaluate technical success after transarterial chemoembolization of HCC by qualitative visual assessment and quantitative perfusion values. © 2018 SIR
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DOI
10.1016/j.jvir.2018.10.002
Appears in Collections:
의과대학 > 의학과 > Journal papers
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