title: Intra-arterial therapies for liver cancer: assessing tumor response.
abstract: Intra-arterial therapies (IATs) play an integral role in the management of unresectable hepatocellular carcinoma and liver metastases. The ability to accurately assess tumor response to intra-arterial therapies is crucial for clinical management. Several one- and two-dimensional manual imaging-based response assessment techniques, based both on tumor size or enhancement, have shown to be highly subjective and merely surrogate for the actual tumor as a whole. Areas covered: Given the currently existing literature, we will discuss all available tumor assessment techniques and criteria for liver cancer with a strong emphasis on 3D quantitative imaging biomarkers of tumor response in this review. Expert commentary: The growing role of information technology in medicine has brought about the advent of software-assisted, segmentation-based assessment techniques that address the outstanding issues of a subjective reader and provide for more accurate assessment techniques for the locally treated lesions. Three-dimensional quantitative tumor assessment techniques are superior to one- and two-dimensional measurements. This allows for treatment alterations and more precise targeting, potentially resulting in improved patient outcome.
authors.affiliation: a Department of Diagnostic and Interventional Radiology , Charité , Berlin , Germany.|b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Yasmin W
authors.initials: YW
authors.lastname: Stroehl
authors.affiliation: b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Letzen
authors.affiliation: b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Johanna M M
authors.initials: JM
authors.lastname: van Breugel
authors.affiliation: b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Geschwind
authors.affiliation: b Department of Radiology and Biomedical Imaging , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Julius
authors.initials: J
authors.lastname: Chapiro
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: 3D; ADC; RECIST; intraarterial therapy; liver cancer; qEASL; tumor response; tumor staging