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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 10/2018

01-10-2018 | Clinical Investigation

Assessment of Therapy Response to Transarterial Radioembolization for Liver Metastases by Means of Post-treatment MRI-Based Texture Analysis

Authors: Robert P. Reimer, Peter Reimer, Andreas H. Mahnken

Published in: CardioVascular and Interventional Radiology | Issue 10/2018

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Abstract

Introduction

To determine whether post-treatment magnetic resonance imaging (MRI)-based texture analysis of liver metastases (LM) may be suited predicting therapy response to transarterial radioembolization (TARE) during follow-up.

Materials and Methods

Thirty-seven patients with LM treated by TARE (mean age 63.4 years) between January 2006 and December 2014 were identified in this retrospective feasibility study. They underwent dynamic contrast-enhanced and hepatocellular phase MRI after TARE (mean 2.2 days). Response was evaluated on follow-up imaging scheduled in intervals of 3 months (median follow-up, 7.3 months) based on response evaluation criteria in solid tumors 1.1 (RECIST 1.1). Results of texture analysis [mean, standard deviation, skewness (s), kurtosis (k), entropy and uniformity] were compared between patients with progressive disease (PD) and patients with stable disease (SD), partial or complete response (PR/CR). Receiver operating characteristics including the area under the curve (AUC) and cutoff values including the sensitivity and specificity were calculated.

Results

According to RECIST 1.1, 24 patients (64.9%) had PD, 8 SD (21.6%) and 5 PR (13.5%). MRI-based texture analysis showed an earlier differentiation between patients with and without PD when compared with RECIST 1.1. Median k (2.88 vs. 2.35) in arterial phase MRI and median s (0.48 vs. 0.25) and k (2.85 vs. 2.25) in venous phase MRI were significantly different (p < 0.05). The AUC for k derived from arterial phase MRI was 0.73 (cutoff = 2.55, sensitivity = 0.83, specificity = 0.62) (p < 0.05). The AUC for s and k in venous phase MRI was 0.76 (cutoff = 0.35, sensitivity = 0.71, specificity = 0.85) (p > 0.05) and 0.83 (cutoff = 2.50, sensitivity = 0.75, specificity = 0.85) (p < 0.05).

Conclusion

This study indicates the potential of MRI-based texture analysis at arterial and venous phase MRI for the early prediction of PD after TARE.

Level of Evidence

IV.
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Metadata
Title
Assessment of Therapy Response to Transarterial Radioembolization for Liver Metastases by Means of Post-treatment MRI-Based Texture Analysis
Authors
Robert P. Reimer
Peter Reimer
Andreas H. Mahnken
Publication date
01-10-2018
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 10/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-018-2004-2

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