Messmer Florian, Zgraggen Juliana, Kobe Adrian, Chaykovska Lyubov, Puippe Gilbert, Reiner Caecilia S, Pfammatter Thomas
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Aorten- und Gefässzentrum, Klinik Hirslanden, Zurich, Switzerland.
Res Diagn Interv Imaging. 2022 Apr 5;1:100005. doi: 10.1016/j.redii.2022.100005. eCollection 2022 Mar.
To investigate, by quantitative and qualitative enhancement measurements, the correlation between tumor enhancement on cone beam computed tomography (CBCT) images and treatment response at 6 months in patients undergoing transarterial radioembolization (TARE) for liver metastases.
36 patients (56% male; median age 62.5 years) with 104 metastases were retrospectively included. Quantitative and qualitative enhancement of liver metastases were evaluated on CBCT images before TARE. Quantitative analysis consisted of lesion enhancement measurements (ROI HU lesion - ROI HU relative to inferior vena cava). Qualitative analysis consisted of subjective enhancement pattern analysis (diffuse, sparse, rim-like or non-enhancing). Morphologic tumor response was evaluated according to RECIST 1.1 criteria on follow-up CT or MR imaging.
At a mean follow up of 6.5 ± 3.7 months, progressive disease (PD) was found in 4 patients, partial response (PR) in 11 and stable disease (SD) in 21. Relative lesion enhancement was significantly different between these groups (-37.5±154.2 HU vs. 103.8±93.4 vs. 181±144 HU in PD vs. SD vs. PR group, respectively; p<0.01). ROC analysis of relative lesion enhancement to predict progressive disease showed an area under the curve of 0.86 (p<0.01). For qualitative lesion enhancement analysis, no difference between groups was found.
Quantitative enhancement measurements derived from intraprocedural contrast enhanced CBCT may identify responders to TARE in patients with liver metastases.
通过定量和定性增强测量，研究接受经动脉放射性栓塞（TARE）治疗肝转移瘤的患者在锥束计算机断层扫描（CBCT）图像上的肿瘤增强与6个月时治疗反应之间的相关性。
回顾性纳入36例患者（男性占56%；中位年龄62.5岁），共104个转移灶。在TARE治疗前，对CBCT图像上肝转移瘤的定量和定性增强进行评估。定量分析包括病变增强测量（感兴趣区病灶的HU值减去相对于下腔静脉的感兴趣区HU值）。定性分析包括主观增强模式分析（弥漫性、稀疏性、边缘样或无增强）。根据实体瘤疗效评价标准（RECIST）1.1版，在随访CT或MR成像上评估肿瘤形态学反应。
平均随访6.5±3.7个月，4例患者出现疾病进展（PD），11例部分缓解（PR），21例病情稳定（SD）。这些组之间的相对病变增强有显著差异（PD组、SD组和PR组分别为-37.5±154.2 HU、103.8±93.4 HU和181±144 HU；p<0.01）。相对病变增强预测疾病进展的受试者工作特征（ROC）分析显示曲线下面积为0.86（p<0.01）。对于定性病变增强分析，各组之间未发现差异。
术中对比增强CBCT获得的定量增强测量可以识别肝转移瘤患者中TARE治疗的反应者。
