title: Follow-up of multicentric HCC according to the mRECIST criteria: role of 320-Row CT with semi-automatic 3D analysis software for evaluating the response to systemic therapy.
abstract: OBJECTIVE
  To evaluate the role of 320-detector row computed tomography (MDCT) with 3D analysis software in follow up of patients affected by multicentric hepatocellular carcinoma (HCC) treated with systemic therapy by using modified response evaluation criteria in solid tumors (mRECIST).
  
  
  METHODS
  38 patients affected by multicentric HCC underwent MDCT. All exams were performed before and after iodinate contrast material intravenous injection by using a 320-detection row CT device. CT images were analyzed by two radiologists using multi-planar reconstructions (MPR) in order to assess the response to systemic therapy according to mRECIST criteria: complete response (CR), partial response (PR), progressive disease (PD), stable disease (SD). 30 days later, the same two radiologists evaluated target lesion response to systemic therapy according to mRECIST criteria by using 3D analysis software. The difference between the two systems in assessing HCC response to therapy was assessed by the analysis of the variance (Anova Test). Interobserver agreement between the two radiologists by using MPR images and 3D analysis software was calculated by using Cohen's Kappa test.
  
  
  RESULTS
  PR occurred in 10/38 cases (26%), PD in 6/38 (16%), SD in 22/38 (58%). Anova Test showed no statistically significant difference between the two systems for assessing target lesion response to therapy (p >0.05). Inter-observer agreement (k) was respectively of 0.62 for MPR images measurements and 0.86 for 3D analysis ones.
  
  
  CONCLUSIONS
  3D Analysis software provides a semiautomatic system for assessing target lesion response to therapy according to mRECIST criteria in patient affected by multifocal HCC treated with systemic therapy. The reliability of 3D analysis software makes it useful in the clinical practice.
authors.forename: M
authors.initials: M
authors.lastname: Telegrafo
authors.forename: G
authors.initials: G
authors.lastname: Dilorenzo
authors.forename: G
authors.initials: G
authors.lastname: Di Giovanni
authors.forename: I
authors.initials: I
authors.lastname: Cornacchia
authors.forename: A A
authors.initials: AA
authors.lastname: Stabile Ianora
authors.forename: I
authors.initials: I
authors.lastname: Cornacchia
authors.forename: A A
authors.initials: AA
authors.lastname: Stabile Ianora
authors.forename: G
authors.initials: G
authors.lastname: Angelelli
authors.forename: M
authors.initials: M
authors.lastname: Moschetta
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods