Aims and objectives
To assess the impact of CT scan-based volumetric analysis on radiologic and clinical outcomes of patients with hepatocellular carcinoma treated with transarterial chemoembolization (TACE).
The aims of this electronic presentation are:
• Reflect the technical considerations about CT-based volumetric analysis;
• Understand HCC lesions behavior on dynamic multi-phase CT scans;
• Assess outcomes of percutaneous treatment of HCC using TACE technique.
• Assess the impact of pre-operative CT-based volumetric analysis predicting outcomes of TACE on patients with HCC;
• Transfer the practical hints...
Methods and materials
Over a 41-month period,
65 TACE procedures were performed in 38 patients.
Baseline dynamic CT-based volumetric analysis was performed in 15 patients.
CT-based Volumetric Analysis details:
Portal venous phase series of images from the preoperative dynamic multi-phase CT scans were used for total liver volumetry.
Set of axial images with a slice thickness of 3-5 mm was used for the analysis.
Three observers (JG,
DT and JQ,
respectively) performed liver volumetry for allpatients on an iMac using OsiriX®/...
Baseline median total hepatic volume was 1444 ml (IQR,
1240-2034 ml) with a median tumor volume of 623 ml (IQR,
41-1019 ml) and a median residual hepatic volume of 965 ml (IQR,
779-1365 ml) (Figure 6).
All procedures were performed using doxorubicin-polyvinyl alcohol (PVA) microspheres conjugates.
Patients with liver-related adverse events (3[20%]) were found to have lower baseline residual hepatic volumes (174 ml [IQR,
36-312 ml] versus 1219 ml [IQR,
847-1400 ml]) (p=0.05) (Figure 7).
Residual volume was found to be correlated with ALT serum...
Baseline residual hepatic volume was associated with higher incidence of liver-related adverse outcomes and liver function impairment.
Baseline tumor volume,
failed to predict adverse radiological outcomes.
The role of CT-based volumetric analysis needs further investigation on the prediction of outcomes after TACE.
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