title: Parametric response mapping of dynamic CT: enhanced prediction of survival in hepatocellular carcinoma patients treated with transarterial chemoembolization.
abstract: The aim of this study was to evaluate the prognostic significance of parametric response mapping (PRM) analysis for hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE).
  
  
  
  We recruited 65 HCC patients who underwent TACE. These patients underwent longitudinal multiphasic CT before and after TACE. We applied PRM analysis to the baseline CT before TACE and first/second follow-up CTs. The results of PRM analyses were used to stratify patients into responders and non-responders. Overall survival was compared between the two groups. An independent survival analysis using conventional radiological assessments was performed, and the results were compared with PRM results. Univariate and multivariate analyses were performed to identify clinical factors affecting survival.
  
  
  
  The PRM analyses demonstrated that the responding group had a median survival of 529 days, while the non-responding group had a median survival of 263 days [hazard ratio (HR) 12.9, p < 0.05 for differences in survival]. The manual analyses indicated median survivals of 491 and 329 days for the responding and non-responding groups, respectively (HR 2.7, p < 0.05). Tumor size, albumin level, and PRM values were found to be significantly related to overall survival after univariate and multivariate analyses.
  
  
  
  The PRM analysis could be a better predictor of overall survival for patients with HCC undergoing TACE than conventional radiological assessments.
authors.affiliation: Department of Radiology, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Electronic Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea.
authors.forename: Jonghoon
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Radiology, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Hyung Sik
authors.initials: HS
authors.lastname: Kim
authors.affiliation: School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, 16419, Korea. hyunjinp@skku.edu.|Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea. hyunjinp@skku.edu.
authors.forename: Hyunjin
authors.identifier: 0000-0001-5681-8918
authors.initials: H
authors.lastname: Park
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Algorithms; Hepatocellular carcinoma; Longitudinal studies; Survival analysis; Therapeutic chemoembolization