Universität zu Köln

Mueller, Lukas, Hahn, Felix, Jungmann, Florian, Maehringer-Kunz, Aline, Stoehr, Fabian, Halfmann, Moritz C., dos Santos, Daniel Pinto, Hinrichs, Jan, Auer, Timo A., Dueber, Christoph and Kloeckner, Roman (2022). Quantitative washout in patients with hepatocellular carcinoma undergoing TACE: an imaging biomarker for predicting prognosis? Cancer Imaging, 22 (1). LONDON: BMC. ISSN 1470-7330

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Abstract

Background The delayed percentage attenuation ratio (DPAR) was recently identified as a novel predictor of an early complete response in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). In this study, we aimed to validate the role of DPAR as a predictive biomarker for short-, mid-, and long-term outcomes after TACE. Methods We retrospectively reviewed laboratory and imaging data for 103 treatment-naive patients undergoing initial TACE treatment at our tertiary care center between January 2016 and November 2020. DPAR and other washin and washout indices were quantified in the triphasic computed tomography performed before the initial TACE. The correlation of DPAR and radiologic response was investigated. Furthermore, the influence of DPAR on the 6-, 12-, 18-, and 24-month survival rates and the median overall survival (OS) was compared to other established washout indices and estimates of tumor burden and remnant liver function. Results The DPAR was significantly of the target lesions (TLs) with objective response to TACE after the initial TACE session was significantly higher compared to patients with stable disease (SD) or progressive disease (PD) (125 (IQR 118-134) vs 110 (IQR 103-116), p < 0.001). Furthermore, the DPAR was significantly higher in patients who survived the first 6 months after TACE (122 vs. 115, p = 0.04). In addition, the number of patients with a DPAR > 120 was significantly higher in this group (n = 38 vs. n = 8; p = 0.03). However, no significant differences were observed in the 12-, 18-, and 24-month survival rates after the initial TACE. Regarding the median OS, no significant difference was observed for patients with a high DPAR compared to those with a low DPAR (18.7 months vs. 12.7 months, p = 0.260). Conclusions Our results confirm DPAR as the most relevant washout index for predicting the short-term outcome of patients with HCC undergoing TACE. However, DPAR and the other washout indices were not predictive of mid- and long-term outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Jungmann, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Maehringer-Kunz, Aline UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoehr, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Halfmann, Moritz C. UNSPECIFIED UNSPECIFIED UNSPECIFIED dos Santos, Daniel Pinto UNSPECIFIED UNSPECIFIED UNSPECIFIED Hinrichs, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Auer, Timo A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dueber, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloeckner, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-686564
DOI:	10.1186/s40644-022-00446-6
Journal or Publication Title:	Cancer Imaging
Volume:	22
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1470-7330
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSARTERIAL CHEMOEMBOLIZATION; DELAYED PHASE; VALIDATION; CT; RETREATMENT; SMALLER; SCORE; ABCR; ART Multiple languages Oncology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68656