Ghosn M, Derbel H, Kharrat R, Oubaya N, Mulé S, Chalaye J, Regnault H, Amaddeo G, Itti E, Luciani A, Kobeiter H, Tacher V
Department of Medical Imaging, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
Department of Medical Imaging, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; Unité Inserm 955, équipe 18, IMRB, University of Paris Est Créteil, 94010 Créteil, France.
Diagn Interv Imaging. 2021 Jan;102(1):35-44. doi: 10.1016/j.diii.2020.09.004. Epub 2020 Oct 1.
To evaluate the potential of imaging criteria in predicting overall survival of patients with hepatocellular carcinoma (HCC) after a first transcatheter arterial yttrium-90 radioembolization (TARE) MATERIALS AND METHODS: From October 2013 to July 2017, 37 patients with HCC were retrospectively included. There were 34 men and 3 women with a mean age of 60.5±10.2 (SD) years (range: 32.7-78.9 years). Twenty-five patients (68%) were Barcelona Clinic Liver Cancer (BCLC) C and 12 (32%) were BCLC B. Twenty-four primary index tumors (65%) were>5cm. Three radiologists evaluated tumor response on pre- and 4-7 months post-TARE magnetic resonance imaging or computed tomography examinations, using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, modified RECIST (mRECIST), European Association for Study of the Liver (EASL), volumetric RECIST (vRECIST), quantitative EASL (qEASL) and the Liver Imaging Reporting and Data System treatment response algorithm. Kaplan-Meier survival curves were used to compare responders and non-responders for each criterion. Univariate and multivariate Cox proportional hazard ratio (HR) analysis were used to identify covariates associated with overall survival. Fleiss kappa test was used to assess interobserver agreement.
At multivariate analysis, RECIST 1.1 (HR: 0.26; 95% confidence interval [95% CI]: 0.09-0.75; P=0.01), mRECIST (HR: 0.22; 95% CI: 0.08-0.59; P=0.003), EASL (HR: 0.22; 95% CI: 0.07-0.63; P=0.005), and qEASL (HR: 0.30; 95% CI: 0.12-0.80; P=0.02) showed a significant difference in overall survival between responders and nonresponders. RECIST 1.1 had the highest interobserver reproducibility.
RECIST and mRECIST seem to be the best compromise between reproducibility and ability to predict overall survival in patients with HCC treated with TARE.
评估影像标准预测肝细胞癌（HCC）患者首次经导管动脉钇-90放射栓塞术（TARE）后总生存期的潜力。
回顾性纳入2013年10月至2017年7月期间的37例HCC患者。其中男性34例，女性3例，平均年龄60.5±10.2（标准差）岁（范围：32.7 - 78.9岁）。25例（68%）为巴塞罗那临床肝癌（BCLC）C期，12例（32%）为BCLC B期。24个主要指标肿瘤（65%）直径>5cm。三名放射科医生使用实体瘤疗效评价标准（RECIST）1.1、改良RECIST（mRECIST）、欧洲肝脏研究协会（EASL）标准、容积RECIST（vRECIST）、定量EASL（qEASL）以及肝脏影像报告和数据系统治疗反应算法，对TARE术前和术后4 - 7个月的磁共振成像或计算机断层扫描检查中的肿瘤反应进行评估。采用Kaplan-Meier生存曲线比较各标准下的反应者和无反应者。使用单因素和多因素Cox比例风险比（HR）分析确定与总生存期相关的协变量。采用Fleiss卡方检验评估观察者间的一致性。
多因素分析显示，RECIST 1.1（HR：0.26；95%置信区间[95%CI]：0.09 - 0.75；P = 0.01）、mRECIST（HR：0.22；95%CI：0.08 - 0.59；P = 0.003）、EASL（HR：0.22；95%CI：0.07 - 0.63；P = 0.005）和qEASL（HR：0.30；95%CI：0.12 - 0.80；P =
