title: Semi-automatic Volumetric Measurement of Treatment Response in Hepatocellular Carcinoma After Trans-arterial Chemoembolization.
abstract: OBJECTIVE
  To perform a quantitative, volumetric analysis of therapeutic effects of trans-arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients.
  
  
  METHODS
  Entire tumor volume and a subset of hypervascular tumor portions were analyzed pre- and post-TACE in magnetic resonance imaging datasets of 22 HCC patients using a semi-automated segmentation and evaluation tool from the Medical Imaging Interaction Toolkit. Results were compared to mRECIST measurements and inter-reader variability was assessed.
  
  
  RESULTS
  Mean total tumor volume increased statistical significantly after TACE (84.6 ml pre- vs. 97.1 ml post-TACE, p=0.03) while hypervascular tumor volume decreased from 9.1 ml pre- to 3.7 ml post-TACE (p=0.0001). Likewise, mRECIST diameters decreased significantly after therapy (44.2 vs. 15.4 mm). In the inter-reader assessment, overlap errors were 12.3-17.7% for entire and 36.3-64.2% for the enhancing tumor volume.
  
  
  CONCLUSIONS
  Quantification of therapeutic changes after TACE therapy is feasible using a semi-automated segmentation and evaluation tool. Following TACE, hypervascular tumor volume decreases significantly.
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany johannes.budjan@umm.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Budjan
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Elke A
authors.initials: EA
authors.lastname: Sauter
authors.affiliation: St. John's Medical Center, Tulsa, OK, U.S.A.
authors.forename: John N
authors.initials: JN
authors.lastname: Morelli
authors.affiliation: Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Nolden
authors.affiliation: Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Fetzer
authors.affiliation: Department of Biostatistics, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim, Germany.
authors.forename: Lothar
authors.initials: L
authors.lastname: Pilz
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Reichert
authors.affiliation: Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany.
authors.forename: Theresa
authors.initials: T
authors.lastname: Brandt
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Hansmann
authors.affiliation: University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Haneder
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Rathmann
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Steffen J
authors.initials: SJ
authors.lastname: Diehl
authors.affiliation: Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Meinzer
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Schoenberg
authors.affiliation: Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Ulrike I
authors.initials: UI
authors.lastname: Attenberger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Trans-arterial chemoembolization; mRECIST; therapy assessment; volumetry