title: Advanced Hepatocellular Carcinoma: Perfusion Computed Tomography-Based Kinetic Parameter as a Prognostic Biomarker for Prediction of Patient Survival.
abstract: OBJECTIVE
  The aim of this study was to find prognostic biomarkers in perfusion computed tomography (PCT)-based kinetic parameters for advanced hepatocellular carcinoma (HCC) treated with antiangiogenic chemotherapy.
  
  
  METHODS
  Twenty-two patients with advanced HCC underwent PCT imaging and subsequently received bevacizumab in combination with gemcitabine and oxaliplatin. Pretreatment PCT data within advanced HCC were analyzed using the Tofts-Kety, 2-compartment exchange, adiabatic approximation to the tissue homogeneity (AATH), and distributed parameter models. Blood flow, blood volume, extraction fraction (E), and other 3 parameters were calculated. Kinetic parameters in each model were evaluated with 1-year survival discrimination using Kaplan-Meier analysis and with overall survival using univariate Cox regression analysis.
  
  
  RESULTS
  Only the AATH model-derived E was statistically significantly prognostic for 1-year survival. The increased AATH model-derived E was significantly associated with longer overall survival (P = 0.005).
  
  
  CONCLUSIONS
  The AATH model-derived E was an effective prognostic biomarker for advanced HCC.
authors.affiliation: From the *3D Imaging Research, Department of Radiology, Massachusetts General Hospital and Harvard Medical School; †Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital; and ‡Massachusetts General Hospital Cancer Center, Boston, MA.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Koichi
authors.initials: K
authors.lastname: Hayano
authors.forename: Andrew X
authors.initials: AX
authors.lastname: Zhu
authors.forename: Dushyant V
authors.initials: DV
authors.lastname: Sahani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*