title: MRI Findings and Prediction of Time to Progression of Patients with Hepatocellular Carcinoma Treated with Drug-eluting Bead Transcatheter Arterial Chemoembolization.
abstract: The purpose of this study was to investigate the utility of MRI findings after drug-eluting beads (DEB) - transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma in predicting time to progression (TTP). This study included 48 patients with 60 lesions who underwent liver MRI within 3 months after DEB-TACE. MRI was assessed for arterial enhancement pattern, late washout, arterioportal shunt, signal intensity on T2-weighted image, intratumoral septa, enhancing tissue on subtraction images, and treatment response. Cox-regression analysis was performed to identify independent factors to predict TTP. TTP was calculated using the Kaplan-Meier method with the log-rank test. Per lesion, 30 achieved complete remission, 22 had a partial response, and the remaining 8 lesions displayed stable disease on MRI. Arterial enhancement pattern, washout and enhancing tissue on subtraction images from MRI were associated with viable tumor on the last follow-up computerized tomography. Arterial enhancement, washout and enhancing tissue on subtraction images were significant predictors of TTP, but only enhancing tissue on subtraction images remained a significant predictor of TTP (P=0.018) in the multivariate analysis. TTP was longer in the group without enhancing tissue on subtraction images compared to the group with enhancing tissue (601 days vs. 287 days, P<0.001). Enhancing tissue on subtraction images from MRI after DEB-TACE is predictive for longer TTP.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: Seungsoo
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyung Ah
authors.initials: KA
authors.lastname: Kim
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Radiology and Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D016461:Chemoembolization, Therapeutic; D018450:Disease Progression; D004337:Drug Carriers / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004337:Drug Carriers
keywords: Carcinoma, Hepatocellular; Drug-eluting Beads; Magnetic Resonance Imaging; Subtraction Image; Transcatheter Arterial Chemoembolization