title: Early survival prediction after intra-arterial therapies: a 3D quantitative MRI assessment of tumour response after TACE or radioembolization of colorectal cancer metastases to the liver.
abstract: OBJECTIVE
  This study evaluated the predictive role of 1D, 2D and 3D quantitative, enhancement-based MRI regarding overall survival (OS) in patients with colorectal liver metastases (CLM) following intra-arterial therapies (IAT).
  
  
  METHODS
  This retrospective analysis included 29 patients who underwent transarterial chemoembolization (TACE) or radioembolization and received MRI within 6 weeks after therapy. Tumour response was assessed using 1D and 2D criteria (such as European Association for the Study of the Liver guidelines [EASL] and modified Response Evaluation Criteria in Solid Tumors [mRECIST]). In addition, a segmentation-based 3D quantification of overall (volumetric [v] RECIST) and enhancing lesion volume (quantitative [q] EASL) was performed on portal venous phase MRI. Accordingly, patients were classified as responders (R) and non-responders (NR). Survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios (HR).
  
  
  RESULTS
  Only enhancement-based criteria identified patients as responders. EASL and mRECIST did not predict patient survival (P = 0.27 and P = 0.44, respectively). Using uni- and multivariate analysis, qEASL was identified as the sole predictor of patient survival (9.9 months for R, 6.9 months for NR; P = 0.038; HR 0.4).
  
  
  CONCLUSIONS
  The ability of qEASL to predict survival early after IAT provides evidence for potential advantages of 3D quantitative tumour analysis.
  
  
  CONCLUSIONS
  • Volumetric assessment of colorectal liver metastases after intra-arterial therapy is feasible. • Early 3D quantitative tumour analysis after intra-arterial therapy may predict patient survival. • Volumetric tumour response assessment shows advantages over 1D and 2D techniques. • Enhancement-based MR response assessment is preferable to size-based measurements.
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Ste 7203, 1800 Orleans St, Baltimore, MD, 21287, USA.
authors: Julius
authors: J
authors: Chapiro
authors: Rafael
authors: R
authors: Duran
authors: MingDe
authors: M
authors: Lin
authors: Rüdiger
authors: R
authors: Schernthaner
authors: David
authors: D
authors: Lesage
authors: Zhijun
authors: Z
authors: Wang
authors: Lynn Jeanette
authors: LJ
authors: Savic
authors: Jean-François
authors: JF
authors: Geschwind
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016461:Chemoembolization, Therapeutic / Q000379:methods / Q000401:mortality; D015179:Colorectal Neoplasms; D004621:Embolization, Therapeutic / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden
references: Int J Surg Oncol. 2011;2011:285840
references: 22312501
references: Lancet. 2010 Mar 20;375(9719):1030-47
references: 20304247
references: HPB Surg. 2013;2013:570808
references: 24285916
references: Radiology. 2013 Feb;266(2):502-13
references: 23192780
references: Radiographics. 2013 Oct;33(6):1781-800
references: 24108562
references: J Hepatol. 2011 Apr;54(4):695-704
references: 21147504
references: J Vasc Interv Radiol. 2014 Feb;25(2):256-65
references: 24461131
references: Acad Radiol. 2014 Mar;21(3):393-9
references: 24507426
references: World J Gastroenterol. 2012 Oct 7;18(37):5249-59
references: 23066320
references: Semin Liver Dis. 2010 Feb;30(1):52-60
references: 20175033
references: HPB (Oxford). 2014 Dec;16(12):1110-6
references: 25123597
references: J Natl Cancer Inst. 2000 Feb 2;92(3):205-16
references: 10655437
references: Clin Cancer Res. 2013 Mar 15;19(6):1503-11
references: 23225115
references: J Vasc Interv Radiol. 2012 Dec;23(12):1629-37
references: 23177109
references: Radiology. 2014 Dec;273(3):746-58
references: 25028783
references: J Vasc Interv Radiol. 2009 Mar;20(3):360-7
references: 19167245
references: J Vasc Interv Radiol. 2012 Feb;23(2):153-63
references: 22264550
references: J Hepatol. 2001 Sep;35(3):421-30
references: 11592607
references: World J Gastroenterol. 2013 Dec 14;19(46):8502-14
references: 24379567
references: J Clin Oncol. 2006 Mar 20;24(9):1395-403
references: 16505413
references: Cancer. 2009 May 1;115(9):1849-58
references: 19267416
references: Lancet. 2012 Dec 15;380(9859):2095-128
references: 23245604
references: Curr Treat Options Oncol. 2012 Sep;13(3):403-15
references: 22773276
references: J Magn Reson Imaging. 2010 Feb;31(2):348-55
references: 20099348
references: Eur J Radiol. 2014 Mar;83(3):487-96
references: 24387824
references: Acad Radiol. 2013 Apr;20(4):446-52
references: 23498985
references: Br J Radiol. 2013 Oct;86(1030):20130281
references: 23995873
references: Radiology. 2012 Aug;264(2):464-72
references: 22692032
references: Cardiovasc Intervent Radiol. 2014 Feb;37(1):154-64
references: 23670568
references: J Natl Compr Canc Netw. 2009 Sep;7(8):778-831
references: 19755046
references: J Am Coll Surg. 2013 Apr;216(4):845-56; discussion 856-7
references: 23415549
references: Eur J Cancer. 2009 Jan;45(2):248-60
references: 19095437
references: Eur Radiol. 2014 Jul;24(7):1521-8
references: 24816938
references: Anticancer Res. 2013 May;33(5):2077-83
references: 23645758
references: Eur Radiol. 2013 Mar;23(3):748-56
references: 23001604
references: J Vasc Interv Radiol. 2009 Dec;20(12):1564-9
references: 19846320
references: Radiology. 2013 Feb;266(2):407-30
references: 23362094
references: Cancer. 1981 Jan 1;47(1):207-14
references: 7459811
references: J Vasc Interv Radiol. 2008 Aug;19(8):1187-95
references: 18656012
references: J Nucl Med. 2013 Nov;54(11):1890-5
references: 24071510
references: Br J Cancer. 2010 Jul 27;103(3):324-31
references: 20628388
references: Magn Reson Imaging Clin N Am. 2014 Aug;22(3):337-52
references: 25086933
references: Br J Cancer. 2003 Aug 18;89(4):605-11
references: 12915864
references: Eur J Cancer. 2013 Oct;49(15):3122-30
references: 23777743
references: Anticancer Res. 2014 Feb;34(2):575-84
references: 24510986
references: Cancer. 2011 Jan 15;117(2):343-52
references: 20830766
references: AJR Am J Roentgenol. 2007 Feb;188(2):W154-61
references: 17242222
references: Acad Radiol. 2013 Jan;20(1):115-21
references: 22947274
references: Hepatology. 2015 Mar;61(3):1056-65
references: 25041904