Arterial phase perfusion ratio for assessment of efficacy of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

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Author:
ZOU Ru-hai(Department of Ultrasoand Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou 510060, China)
HAN Feng(Department of Ultrasoand Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou 510060, China)
HUANG Wei()
WANG Jian-wei(Department of Ultrasoand Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou 510060, China)
YUAN Yun-fei()
LI An-hua(Department of Ultrasoand Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou 510060, China)
Journal Title:
Chinese Journal of Biomedical Engineering
Issue:
Volume 18, Issue 03, 2012
DOI:
10.3760/cma.j.issn.1674-1927.2012.03.017
Key Word:
Angiography,digital subtraction;Liver neoplame;Embolization,therapeutic;Efficacy

Abstract: Objective To predict the efficacy of transcatheter arterial chemoembolization(TACE) in patients with hepatocellular carcinoma (HCC) by using ultrasonographic perfusion paramctcrs.Methods Sixty-nine patients with primary diagnosis of HCC as having single tumor diameter of ≥5 cm and TACE as initial treatment were enrolled from Sun Yat- scn University Cancer Center between January 2008 and December 2010.Patients were divided into partial response group(PR,n=21 ),stable disease group(SD,n=17) and progressive disease group(PD,n=31 ),respectively,based on the RECIST standard and comparison of pre- and post-operative tumor size.Parameters of tumor ultrasonographic perfusion curve,including area under curve (AUC),mean transit time (mTT),perfusion index (PI),time to peak (TTP) and maximum intensity (IMX),were analyzed by using SonoLiver software,and the artcrial phase perfusion ratio was computed via Image Pro Plus software.Results Thc differences in AUC,mTT,PI,TTP and IMX did not reach statistical significance among groups (all P>0.05).Group PR and SD yielded higher perfusion ratio in arterial phasc than group PD [ (78.88± 12.19)%,(72.93± 15.68)% vs (38.97± 11.01 )%,P<0.05].Arterial phase perfusion ratio <50% as a predictor of patients with PD was associated with a diagnostic accuracy of 88.4%(61/69),sensitivity of 83.9%(26/31) and specificity of 92.1%(35/38).Conclusion Pcrfusion ratio in arterial phase may be a novel ultrasonographic perfusion parameter for the prediction of efficacy of TACE treatments in patients with HCC.

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