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


All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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