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Pattern of Retained Contrast on Immediate Postprocedure Computed tomography (CT) After Particle Embolization of Liver Tumors Predicts Subsequent Treatment Response

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Abstract

Purpose

To determine if the pattern of retained contrast on immediate postprocedure computed tomography (CT) after particle embolization of hepatic tumors predicts modified Response Evaluation Criteria in Solid Tumors (mRECIST) response.

Materials and Methods

This study was approved by the Institutional Review Board with a waiver of authorization. One hundred four liver tumors were embolized with spherical embolic agents (Embospheres, Bead Block, LC Bead) and polyvinyl alcohol. Noncontrast CT was performed immediately after embolization to assess contrast retention in the targeted tumors, and treatment response was assessed by mRECIST criteria on follow-up CT (average time 9.0 ± 7.7 weeks after embolization). Tumor contrast retention (TCR) was determined based on change in Hounsfield units (HUs) of the index tumors between the preprocedure and immediate postprocedure scans; vascular contrast retention (VCR) was rated; and defects in contrast retention (DCR) were also documented. The morphology of residual enhancing tumor on follow-up CT was described as partial, circumferential, or total. Association between TCR variables and tumor response were assessed using multivariate logistic regression.

Results

Of 104 hepatic tumors, 51 (49 %) tumors had complete response (CR) by mRECIST criteria; 23 (22.1 %) had partial response (PR); 21 (20.2 %) had stable disease (SD); and 9 (8.7 %) had progressive disease (PD). By multivariate analysis, TCR, VCR, and tumor size are independent predictors of CR (p = 0.02, 0.05, and 0.005 respectively). In 75 tumors, DCR was found to be an independent predictor of failure to achieve complete response (p < 0.0001) by imaging criteria.

Conclusion

TCR, VCR, and DCR on immediate posttreatment CT are independent predictors of CR by mRECIST criteria.

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Conflict of interest

Stephen B. Solomon received a research grant from GE Healthcare (Milwaukee, WI).

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Authors and Affiliations

  1. Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room H118, New York, NY, 10065, USA

    Xiaodong Wang, Joseph P. Erinjeri, Karen T. Brown, Constantinos T. Sofocleous, George I. Getrajdman, Lynn A. Brody, Raymond H. Thornton, Majid Maybody, Ann M. Covey, Robert H. Siegelbaum, William Alago & Stephen B. Solomon

  2. Department of Interventional Radiology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, 100142, China

    Xiaodong Wang

  3. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Xiaoyu Jia & Mithat Gonen

Authors
  1. Xiaodong Wang
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  2. Joseph P. Erinjeri
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  3. Xiaoyu Jia
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  4. Mithat Gonen
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  6. Constantinos T. Sofocleous
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  7. George I. Getrajdman
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  8. Lynn A. Brody
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  9. Raymond H. Thornton
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  10. Majid Maybody
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  11. Ann M. Covey
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  12. Robert H. Siegelbaum
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  13. William Alago
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  14. Stephen B. Solomon
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Corresponding author

Correspondence to Stephen B. Solomon.

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Wang, X., Erinjeri, J.P., Jia, X. et al. Pattern of Retained Contrast on Immediate Postprocedure Computed tomography (CT) After Particle Embolization of Liver Tumors Predicts Subsequent Treatment Response. Cardiovasc Intervent Radiol 36, 1030–1038 (2013). https://doi.org/10.1007/s00270-012-0506-x

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  • DOI: https://doi.org/10.1007/s00270-012-0506-x

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