Parenchymal Blood Volume Assessed by C-Arm-Based Computed Tomography in Immediate Posttreatment Evaluation of Drug-Eluting Bead Transarterial Chemoembolization in Hepatocellular Carcinoma.

Authors:
Roland Syha
Roland Syha
University Hospital Tuebingen
Germany
Ulrich Grosse
Ulrich Grosse
University Hospital Tuebingen
Germany
Michael Maurer
Michael Maurer
Institute of Applied Microbiology
Austria
Lars Zender
Lars Zender
Medical School Hannover
Germany
Marius Horger
Marius Horger
Eberhard-Karls-University
Germany
Konstantin Nikolaou
Konstantin Nikolaou
Eberhard Karls University
Tübingen | Germany
Dominik Ketelsen
Dominik Ketelsen
Eberhard-Karls-University
Germany

Invest Radiol 2016 Feb;51(2):121-6

From the *Diagnostic and Interventional Radiology, Department of Radiology, Eberhard-Karls University; and †Division of Translational Gastrointestinal Oncology, Department of Internal Medicine I, University of Tübingen, Tübingen, Germany.

Objectives: The aim of this study was to assess clinical utility of the quantitative perfusion parameter called parenchymal blood volume (PBV), as derived from C-arm-based computed tomography (CT), for immediate posttreatment assessment of drug-eluting bead (DEB) transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC).

Materials And Methods: Twenty-four patients with early- or intermediate-stage HCC received DEB-TACE. A total of 52 HCC lesions were treated and assessed by C-arm CT before and after intervention. C-arm CT consisted of nonenhanced and contrast-enhanced acquisitions; from these, PBV maps were reconstructed. Lesion diameter, maximum PBV, and unenhanced parenchyma density were assessed before and after treatment. Diameter of visible contrast media deposits as well as residual vascularization was assessed after delivery of DEB. All patients underwent follow-up using cross-sectional imaging. All assessed lesions were evaluated concerning modified Response Evaluation Criteria in Solid Tumors for HCC.

Results: All treated lesions showed significant decrease in PBV after DEB-TACE (mean difference, -15.61 mL/100 mL, P < 0.0001). Eleven lesions showed residual tumoral perfusion in PBV maps associated with an unfavorable outcome compared with completely treated lesions in terms of a lower tumor shrinkage over time (-0.02 ± 0.49 vs -0.76 ± 0.38; P < 0.0001). A contrast media deposit was seen in 78% of treated HCC lesions with a tendency toward better visibility in encapsulated lesions. Nonenhanced parenchyma density was significantly higher in all treated segments (149.69 ± 58.6 vs 68.42 ± 18.04, P < 0.0001).

Conclusions: Parenchymal blood volume values as derived from C-arm CT acquisitions in combination with nonenhanced and contrast-enhanced C-arm CT images are useful in posttreatment assessment of DEB-TACE in HCC. Residual tumor perfusion in PBV maps have predictive potential for mid-term tumor response in HCC and could allow a more individualized treatment schedule for DEB-TACE in HCC patients.

Download full-text PDF

Source
http://pdfs.journals.lww.com/investigativeradiology/2016/020
Web Search
http://dx.doi.org/10.1097/RLI.0000000000000215DOI Listing

Still can't find the full text of the article?

We can help you send a request to the authors directly.
February 2016
210 Reads

Publication Analysis

Top Keywords

pbv maps
12
blood volume
12
parenchymal blood
12
hepatocellular carcinoma
8
deb-tace hcc
8
transarterial chemoembolization
8
drug-eluting bead
8
hcc lesions
8
perfusion pbv
8
posttreatment assessment
8
tomography posttreatment
8
treated lesions
8
nonenhanced contrast-enhanced
8
c-arm-based computed
8
parenchyma density
8
computed tomography
8
contrast media
8
lesions
7
pbv
6
hcc
6

Similar Publications