Evaluation of early response to treatment of hepatocellular carcinoma with yttrium-90 radioembolization using quantitative computed tomography analysis

Sungwon Kim, Do Young Kim, Chansik An, Kyunghwa Han, Jong Yun Won, Gyoung Min Kim, Myeong Jin Kim, Jin Young Choi

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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.

Original languageEnglish
Pages (from-to)449-458
Number of pages10
JournalKorean journal of radiology
Issue number3
Publication statusPublished - 2019 Mar

Bibliographical note

Funding Information:
Received July 19, 2018; accepted after revision December 10, 2018. This study was supported by a faculty research grant of Yonsei University College of Medicine for 6-2011-0219. *These authors contributed equally to this work. Corresponding author: Jin-Young Choi, MD, PhD, Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. • Tel: (822) 2228-7400 • Fax: (822) 393-3035 • E-mail: gafield2@yuhs.ac This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright:
© 2019, The Korean Society of Radiology.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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