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01-12-2021 | Metastasis | Oncology

Identifying enhancement-based staging markers on baseline MRI in patients with colorectal cancer liver metastases undergoing intra-arterial tumor therapy

Authors: Mansur A. Ghani, Arash Fereydooni, Evan Chen, Brian Letzen, Fabian Laage-Gaupp, Nariman Nezami, Yanhong Deng, Geliang Gan, Vinayak Thakur, MingDe Lin, Xenophon Papademetris, Ruediger E. Schernthaner, Steffen Huber, Julius Chapiro, Kelvin Hong, Christos Georgiades

Published in: European Radiology | Issue 12/2021

Abstract

Objectives

To determine if three-dimensional whole liver and baseline tumor enhancement features on MRI can serve as staging biomarkers and help predict survival of patients with colorectal cancer liver metastases (CRCLM) more accurately than one-dimensional and non-enhancement-based features.

Methods

This retrospective study included 88 patients with CRCLM, treated with transarterial chemoembolization or Y90 transarterial radioembolization between 2001 and 2014. Semi-automated segmentations of up to three dominant lesions were performed on pre-treatment MRI to calculate total tumor volume (TTV) and total liver volumes (TLV). Quantitative 3D analysis was performed to calculate enhancing tumor volume (ETV), enhancing tumor burden (ETB, calculated as ETV/TLV), enhancing liver volume (ELV), and enhancing liver burden (ELB, calculated as ELV/TLV). Overall and enhancing tumor diameters were also measured. A modified Kaplan-Meier method was used to determine appropriate cutoff values for each metric. The predictive value of each parameter was assessed by Kaplan-Meier survival curves and univariable and multivariable cox proportional hazard models.

Results

All methods except whole liver (ELB, ELV) and one-dimensional/non-enhancement-based methods were independent predictors of survival. Multivariable analysis showed a HR of 2.1 (95% CI 1.3–3.4, p = 0.004) for enhancing tumor diameter, HR 1.7 (95% CI 1.1–2.8, p = 0.04) for TTV, HR 2.3 (95% CI 1.4–3.9, p < 0.001) for ETV, and HR 2.4 (95% CI 1.4–4.0, p = 0.001) for ETB.

Conclusions

Tumor enhancement of CRCLM on baseline MRI is strongly associated with patient survival after intra-arterial therapy, suggesting that enhancing tumor volume and enhancing tumor burden are better prognostic indicators than non-enhancement-based and one-dimensional-based markers.

Key Points

• Tumor enhancement of colorectal cancer liver metastases on MRI prior to treatment with intra-arterial therapies is strongly associated with patient survival.

• Three-dimensional, enhancement-based imaging biomarkers such as enhancing tumor volume and enhancing tumor burden may serve as the basis of a novel prognostic staging system for patients with liver-dominant colorectal cancer metastases.

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Title: Identifying enhancement-based staging markers on baseline MRI in patients with colorectal cancer liver metastases undergoing intra-arterial tumor therapy
Authors: Mansur A. Ghani
Arash Fereydooni
Evan Chen
Brian Letzen
Fabian Laage-Gaupp
Nariman Nezami
Yanhong Deng
Geliang Gan
Vinayak Thakur
MingDe Lin
Xenophon Papademetris
Ruediger E. Schernthaner
Steffen Huber
Julius Chapiro
Kelvin Hong
Christos Georgiades
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Colorectal Cancer
Colorectal Cancer
Published in: European Radiology / Issue 12/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-08058-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Identifying enhancement-based staging markers on baseline MRI in patients with colorectal cancer liver metastases undergoing intra-arterial tumor therapy

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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