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- Title
Imaging predictors of the response to transarterial chemoembolization in patients with hepatocellular carcinoma: a radiological-pathological correlation.
- Authors
Kwan, Sharon W; Fidelman, Nicholas; Ma, Elizabeth; Kerlan, Robert K, Jr; Yao, Francis Y
- Abstract
Transarterial chemoembolization (TACE) is one of the standard therapies for bridging patients with hepatocellular carcinoma (HCC) to transplantation. This study was designed to determine which features on pre- and post-TACE imaging are associated with tumor necrosis in pathological specimens. Records of 105 patients with 132 HCC lesions who underwent liver transplantation after TACE were retrospectively reviewed. In 70% of the nodules, >90% necrosis was achieved. The development of >90% lesion necrosis upon pathological analysis was associated with avid lesion enhancement (P = 0.03) and the presence of a feeding vessel larger than 0.9 mm in diameter on the pre-TACE visceral angiogram (P = 0.01). Near-complete lesion necrosis was also associated with an extensive accumulation of ethiodized oil within a lesion during TACE administration (P = 0.04). On post-TACE computed tomography imaging, a lack of residual contrast enhancement (P < 0.0001), a decrease in the lesion size (P = 0.04), a high lesion density due to an accumulation of ethiodized oil (P = 0.03), and a diffuse distribution of ethiodized oil throughout the lesion (P = 0.0001) were also correlated with near-complete lesion necrosis upon pathological analysis. In conclusion, this study found multiple pre- and post-TACE imaging characteristics of HCC that were associated with near-complete tumor necrosis upon histopathological analysis after TACE. These findings may help to guide the selection of an optimal treatment strategy for bridging patients with HCC to liver transplantation.
- Publication
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2012, Vol 18, Issue 6, p727
- ISSN
1527-6473
- Publication type
Journal Article
- DOI
10.1002/lt.23413