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CardioVascular and Interventional Radiology

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01-08-2013 | Clinical Investigation

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

Authors: Xiaodong Wang, Joseph P. Erinjeri, Xiaoyu Jia, Mithat Gonen, 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

Published in: CardioVascular and Interventional Radiology | Issue 4/2013

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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Title: Pattern of Retained Contrast on Immediate Postprocedure Computed tomography (CT) After Particle Embolization of Liver Tumors Predicts Subsequent Treatment Response
Authors: Xiaodong Wang
Joseph P. Erinjeri
Xiaoyu Jia
Mithat Gonen
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
Publication date: 01-08-2013
Publisher: Springer New York
Published in: CardioVascular and Interventional Radiology / Issue 4/2013
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-012-0506-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Purpose

Materials and Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

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