Alharbi Sultan R
Radiology and Medical Imaging, King Saud University, Riyadh, SAU.
Cureus. 2025 Jan 2;17(1):e76822. doi: 10.7759/cureus.76822. eCollection 2025 Jan.
Transcatheter arterial chemoembolization (TACE) is a well-known standard treatment for hepatocellular carcinoma (HCC); however, the effectiveness of this treatment can vary among patients.
This study aimed to develop a novel imaging-based prediction score (Sultan's score) to predict complete response after treatment.
From January 2015 to 2021, 41 patients with solitary HCC, admitted at King Saud University Medical City, Riyadh, Saudi Arabia, were treated with drug-eluting TACE (DEBTACE). Clinical data, tumor details, treatment specifics, and outcomes were gathered retrospectively. Sultan's score incorporates five imaging-based elements, namely, well-defined tumor borders, presence of tumor capsule, tumor size, arterial hyper enhancement, and hypertrophic arterial feeder. The cut-off value of Sultan's score was determined by calculating the maximum Youden index using the receiver operating characteristic curve to accurately predict complete treatment response to DEBTACE.
Following two DEBTACE sessions, 28 (68.3%) and 13 (31.7%) patients showed complete and partial responses, respectively. The mean ± standard deviation and median (interquartile range) of the Sultan's score in patients with a complete treatment response were 3.93 ± 0.72 and 4 (4-4), and the corresponding values in patients with a partial response were 2.77 (0.93) and 3 (2-3.5), respectively. A cut-off value of 3.5 for the Sultan's score had a sensitivity and specificity of 78.6% and 76.9%, respectively, in predicting a complete treatment response. The area under the curve was 0.827 (95% confidence interval: 0.688-0.966).
We developed a novel imaging-based scoring system (Sultan's score) for predicting complete response in patients with HCC following DEBTACE.
经动脉化疗栓塞术（TACE）是肝细胞癌（HCC）一种广为人知的标准治疗方法；然而，这种治疗方法的有效性在患者之间可能存在差异。
本研究旨在开发一种基于影像学的新型预测评分（苏丹评分），以预测治疗后的完全缓解情况。
2015年1月至2021年，沙特阿拉伯利雅得国王沙特大学医学城收治的41例孤立性HCC患者接受了药物洗脱TACE（DEBTACE）治疗。回顾性收集临床数据、肿瘤细节、治疗细节及结果。苏丹评分纳入了五个基于影像学的要素，即肿瘤边界清晰、肿瘤包膜存在、肿瘤大小、动脉期强化及增粗的供血动脉。通过计算受试者工作特征曲线的最大约登指数来确定苏丹评分的临界值，以准确预测对DEBTACE的完全治疗反应。
经过两次DEBTACE治疗后，分别有28例（68.3%）和13例（31.7%）患者显示出完全缓解和部分缓解。完全治疗反应患者的苏丹评分的平均值±标准差及中位数（四分位间距）分别为3.93±0.72和4（4-4），部分反应患者的相应值分别为2.77（0.93）和3（2-3.5）。苏丹评分临界值为3.5时，预测完全治疗反应的敏感性和特异性分别为78.6%和76.9%。曲线下面积为0.827（95%置信区间：0.688-0.966）。
我们开发了一种基于影像学的新型评分系统（苏丹评分），用于预测HCC患者接受DEBTACE治疗后的完全缓解情况。
