Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Cancer Imaging. 2022 Jul 30;22(1):38. doi: 10.1186/s40644-022-00477-z.
Arterial enhancement fraction (AEF), derived from triphasic CT scans, is considered to indirectly reflect the ratio of hepatic arterial perfusion to total perfusion. The purpose of this study was to retrospectively investigate the relationship between AEF and treatment response and survival in hepatocellular carcinoma (HCC) patients treated with drug-eluting bead (DEB) TACE.
AEF of primary lesion (AEF) and residual tumor (AEF) in 158 HCC patients were obtained from triphasic liver CT examinations pre- and post-treatment. Wilcoxon-signed rank test was used to compare the AEF and AEF for different response groups. Survival curves for overall survival (OS) in patients with different AEF were created by using Kaplan-Meier method. Cox regression analyses were used to determine the association between AEF and OS.
There was no correlation between AEF and treatment response. After DEB-TACE, AEF was significantly lower than AEF either in the partial response group (38.9% vs. 52.7%, p < 0.001) or in the stable disease group (49.3% vs. 52.1%, p = 0.029). In the progression disease group, AEF was numerically higher than AEF (55.5% vs. 53.0%, p = 0.604). Cox regression analyses showed that risk of death increased in patients with AEF > 57.95% (HR = 1.66, p = 0.019) or AEF > 54.85% (HR = 2.47, p < 0.001), and the risk reduced in patients with any reduction in tumor AEF (decrease ratio ≥ 0) and with increased AEF but not exceeding the ratio of 0.102 (increase ratio < 0.102) (HR = 0.32, p < 0.001).
The change in AEF of viable tumor is correlated with response of HCC to DEB-TACE. In addition, the AEF could be a helpful predictor in future studies on the embolization treatment for HCC.
动脉增强分数（AEF）来源于三期 CT 扫描，被认为可以间接反映肝动脉灌注与总灌注的比值。本研究旨在回顾性研究载药微球栓塞化疗（DEB-TACE）治疗肝细胞癌（HCC）患者时，AEF 与治疗反应和生存之间的关系。
从治疗前后三期肝脏 CT 检查中获得 158 例 HCC 患者的原发病灶（AEF）和残留肿瘤（AEF）的 AEF。采用 Wilcoxon 符号秩检验比较不同反应组之间的 AEF 和 AEF。采用 Kaplan-Meier 法绘制不同 AEF 患者的总生存（OS）生存曲线。采用 Cox 回归分析确定 AEF 与 OS 之间的关系。
AEF 与治疗反应之间无相关性。DEB-TACE 后，部分缓解组（38.9% vs. 52.7%，p<0.001）和稳定疾病组（49.3% vs. 52.1%，p=0.029）AEF 明显低于 AEF。在进展性疾病组中，AEF 略高于 AEF（55.5% vs. 53.0%，p=0.604）。Cox 回归分析显示，AEF>57.95%（HR=1.66，p=0.019）或 AEF>54.85%（HR=2.47，p<0.001）患者死亡风险增加，而肿瘤 AEF 任何减少（减少比例≥0）和 AEF 增加但不超过 0.102（增加比例<0.102）的患者风险降低（HR=0.32，p<0.001）。
存活肿瘤的 AEF 变化与 HCC 对 DEB-TACE 的反应相关。此外，AEF 可能是 HCC 栓塞治疗未来研究的一个有帮助的预测指标。
