Baseline tumor Lipiodol uptake after transarterial chemoembolization for hepatocellular carcinoma: identification of a threshold value predicting tumor recurrence

  • Yusuke Matsui Department of Radiology, Okayama University Medical School
  • Masahiro Horikawa Dotter Interventional Institute, Oregon Health and Science University
  • Younes Jahangiri Noudeh Dotter Interventional Institute, Oregon Health and Science University
  • John A Kaufman Dotter Interventional Institute, Oregon Health and Science University
  • Kenneth J Kolbeck Dotter Interventional Institute, Oregon Health and Science University
  • Khashayar Farsad Dotter Interventional Institute, Oregon Health and Science University

Abstract

Purpose: To evaluate the association between baseline Lipiodol uptake in hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with early tumor recurrence, and to identify a threshold baseline uptake value predicting tumor response. Methods: A single-institution retrospective database of HCC treated with Lipiodol-TACE was reviewed. 46 tumors in 30 patients treated with a Lipiodol-chemotherapy emulsion and no additional particle embolization were included. Baseline Lipiodol uptake was measured as the mean Hounsfield units (HU) on a CT within one week after TACE. Washout rate was calculated dividing the difference in HU between the baseline CT and follow-up CT by time (HU/month). Cox proportional hazard models were used to correlate baseline Lipiodol uptake and other variables with tumor response. A receiver operating characteristic (ROC) curve was used to identify the optimal threshold for baseline Lipiodol uptake predicting tumor response. Results: During the follow-up period (mean 5.6 months), 19 (41.3%) tumors recurred (mean time to recurrence = 3.6 months). In a multivariate model, low baseline Lipiodol uptake and higher washout rate were significant predictors of early tumor recurrence (P = 0.001 and < 0.0001, respectively). On ROC analysis, a threshold Lipiodol uptake of 270.2 HU was significantly associated with tumor response (95% sensitivity, 93% specificity). Conclusion: Baseline Lipiodol uptake and washout rate on follow-up were independent predictors of early tumor recurrence. A threshold value of baseline Lipiodol uptake > 270.2 HU was highly sensitive and specific for tumor response. These findings may prove useful for determining subsequent treatment strategies after Lipiodol TACE.
Published
2017-11-27
How to Cite
Matsui, Y., Horikawa, M., Jahangiri Noudeh, Y., Kaufman, J. A., Kolbeck, K. J., & Farsad, K. (2017). Baseline tumor Lipiodol uptake after transarterial chemoembolization for hepatocellular carcinoma: identification of a threshold value predicting tumor recurrence. Radiology and Oncology, 51(4). Retrieved from https://radioloncol.com/index.php/ro/article/view/2810
Section
Radiology