nach oben

Erschienen in:

01.09.2015 | Hepatobiliary-Pancreas

Interreader and inter-test agreement in assessing treatment response following transarterial embolization for hepatocellular carcinoma

verfasst von: Olivio F. Donati, Richard Kinh Gian Do, Andreas M. Hötker, Seth S. Katz, Junting Zheng, Chaya S. Moskowitz, Christopher Beattie, Karen T. Brown

Erschienen in: European Radiology | Ausgabe 9/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate interreader and inter-test agreement in applying size- and necrosis-based response assessment criteria after transarterial embolization (TAE) for hepatocellular carcinoma (HCC), applying two different methods of European Association for the Study of the Liver (EASL) criteria.

Methods

Seventy-four patients (median age, 67 years) from a prospectively accrued study population were included in this retrospective study. Four radiologists independently evaluated CT data at 2–3 (1st follow-up, FU) and 10–12 (2nd FU) weeks after TAE and assessed treatment response using size-based (WHO, RECIST) and necrosis-based (mRECIST, EASL) criteria. Enhancing tissue was bidimensionally measured (EASL_meas) and also visually estimated (EASL_est). Interreader and inter-test agreements were assessed using intraclass correlation coefficient (ICC) and κ statistics.

Results

Interreader agreement for all response assessment methods ranged from moderate to substantial (κ = 0.578–0.700) at 1st FU and was substantial (κ = 0.716–0.780) at 2nd FU. Inter-test agreement was substantial between WHO and RECIST (κ = 0.610–0.799, 1st FU; κ = 0.655–0.782, 2nd FU) and excellent between EASL_meas and EASL_est (κ = 0.899–0.918, 1st FU; κ = 0.843–0.877, 2nd FU).

Conclusion

Size- and necrosis-based criteria both show moderate to excellent interreader agreement in evaluating treatment response after TAE for HCC. Inter-test agreement regarding EASL_meas and EASL_est was excellent, suggesting that either may be used.

Key points

• Applying EASL criteria, visual estimation and bidimensional measurements show comparable interreader agreement.

• EASL _meas and EASL _est show substantial interreader agreement for treatment response in HCC.

• Agreement was excellent for EASL _meas and EASL _est after TAE of HCC.

• Visual estimation of enhancement is adequate to assess treatment response of HCC.

Nur mit Berechtigung zugänglich

Llovet JM, Real MI, Montana X et al (2002) Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 359:1734–1739PubMedCrossRef

Lo CM, Ngan H, Tso WK et al (2002) Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 35:1164–1171PubMedCrossRef

Dhanasekaran R, Kooby DA, Staley CA, Kauh JS, Khanna V, Kim HS (2010) Comparison of conventional transarterial chemoembolization (TACE) and chemoembolization with doxorubicin drug eluting beads (DEB) for unresectable hepatocelluar carcinoma (HCC). J Surgical Oncol 101:476–480

Maluccio MA, Covey AM, Porat LB et al (2008) Transcatheter arterial embolization with only particles for the treatment of unresectable hepatocellular carcinoma. J Vasc Interv Radiol 19:862–869PubMedCrossRef

Salem R, Lewandowski RJ, Mulcahy MF et al (2010) Radioembolization for hepatocellular carcinoma using yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 138:52–64PubMedCrossRef

Sacco R, Bargellini I, Bertini M et al (2011) Conventional versus doxorubicin-eluting bead transarterial chemoembolization for hepatocellular carcinoma. J Vasc Interv Radiol 22:1545–1552PubMedCrossRef

Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35:421–430PubMedCrossRef

World Health Organization (1979) WHO handbook for reporting results of cancer treatment. WHO, Geneva

Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef

10.

Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30:52–60PubMedCrossRef

11.

Shim JH, Lee HC, Kim SO et al (2012) Which response criteria best help predict survival of patients with hepatocellular carcinoma following chemoembolization? A validation study of old and new models. Radiology 262:708–718PubMedCrossRef

12.

Riaz A, Miller FH, Kulik LM et al (2010) Imaging response in the primary index lesion and clinical outcomes following transarterial locoregional therapy for hepatocellular carcinoma. JAMA 303:1062–1069PubMedCentralPubMedCrossRef

13.

Prajapati HJ, Spivey JR, Hanish SI et al (2013) mRECIST and EASL responses at early time point by contrast-enhanced dynamic MRI predict survival in patients with unresectable hepatocellular carcinoma (HCC) treated by doxorubicin drug-eluting beads transarterial chemoembolization (DEB TACE). Ann Oncol 24:965–973PubMedCrossRef

14.

Forner A, Ayuso C, Varela M et al (2009) Evaluation of tumor response after locoregional therapies in hepatocellular carcinoma: are response evaluation criteria in solid tumors reliable? Cancer 115:616–623PubMedCrossRef

15.

Kamel IR, Liapi E, Reyes DK, Zahurak M, Bluemke DA, Geschwind JF (2009) Unresectable hepatocellular carcinoma: serial early vascular and cellular changes after transarterial chemoembolization as detected with MR imaging. Radiology 250:466–473PubMedCrossRef

16.

Malagari K, Alexopoulou E, Chatzimichail K et al (2008) Transcatheter chemoembolization in the treatment of HCC in patients not eligible for curative treatments: midterm results of doxorubicin-loaded DC bead. Abdom Imaging 33:512–519PubMedCrossRef

17.

Malagari K, Pomoni M, Kelekis A et al (2010) Prospective randomized comparison of chemoembolization with doxorubicin-eluting beads and bland embolization with BeadBlock for hepatocellular carcinoma. Cardiovasc Intervent Radiol 33:541–551PubMedCrossRef

18.

Lin M, Pellerin O, Bhagat N et al (2012) Quantitative and volumetric European Association for the Study of the Liver and Response Evaluation Criteria in Solid Tumors measurements: feasibility of a semiautomated software method to assess tumor response after transcatheter arterial chemoembolization. J Vasc Interv Radiol 23:1629–1637PubMedCentralPubMedCrossRef

19.

Bonekamp S, Jolepalem P, Lazo M, Gulsun MA, Kiraly AP, Kamel IR (2011) Hepatocellular carcinoma: response to TACE assessed with semiautomated volumetric and functional analysis of diffusion-weighted and contrast-enhanced MR imaging data. Radiology 260:752–761PubMedCrossRef

20.

Galizia MS, Tore HG, Chalian H, McCarthy R, Salem R, Yaghmai V (2012) MDCT necrosis quantification in the assessment of hepatocellular carcinoma response to yttrium 90 radioembolization therapy: comparison of two-dimensional and volumetric techniques. Acad Radiol 19:48–54PubMedCrossRef

21.

Corona-Villalobos CP, Halappa VG, Geschwind JF et al (2015) Volumetric assessment of tumour response using functional MR imaging in patients with hepatocellular carcinoma treated with a combination of doxorubicin-eluting beads and sorafenib. Eur Radiol 25:380–390PubMedCentralPubMedCrossRef

22.

Bankier AA, Levine D, Halpern EF, Kressel HY (2010) Consensus interpretation in imaging research: is there a better way? Radiology 257:14–17PubMedCrossRef

23.

Deodhar A, Brody LA, Covey AM, Brown KT, Getrajdman GI (2011) Bland embolization in the treatment of hepatic adenomas: preliminary experience. J Vasc Interv Radiol 22:795–799, quiz 800PubMedCrossRef

24.

Shim JH, Lee HC, Won HJ et al (2012) Maximum number of target lesions required to measure responses to transarterial chemoembolization using the enhancement criteria in patients with intrahepatic hepatocellular carcinoma. J Hepatol 56:406–411PubMedCrossRef

25.

Fleiss JL, Cohen J (1973) The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educ Psychol Measurement 33:613–619CrossRef

26.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef

27.

Memon K, Kulik L, Lewandowski RJ et al (2011) Radiographic response to locoregional therapy in hepatocellular carcinoma predicts patient survival times. Gastroenterology 141:526–535, 535 e521–522PubMedCentralPubMedCrossRef

28.

Riaz A, Memon K, Miller FH et al (2011) Role of the EASL, RECIST, and WHO response guidelines alone or in combination for hepatocellular carcinoma: radiologic-pathologic correlation. J Hepatol 54:695–704PubMedCentralPubMedCrossRef

29.

Bargellini I, Vignali C, Cioni R et al (2010) Hepatocellular carcinoma: CT for tumor response after transarterial chemoembolization in patients exceeding Milan criteria–selection parameter for liver transplantation. Radiology 255:289–300PubMedCrossRef

30.

Riaz A, Kulik L, Lewandowski RJ et al (2009) Radiologic-pathologic correlation of hepatocellular carcinoma treated with internal radiation using yttrium-90 microspheres. Hepatology 49:1185–1193PubMedCrossRef

31.

Kim BK, Kim KA, Park JY et al (2013) Prospective comparison of prognostic values of modified Response Evaluation Criteria in Solid Tumours with European Association for the Study of the Liver criteria in hepatocellular carcinoma following chemoembolisation. Eur J Cancer 49:826–834PubMedCrossRef

32.

Suzuki C, Torkzad MR, Jacobsson H et al (2010) Interobserver and intraobserver variability in the response evaluation of cancer therapy according to RECIST and WHO-criteria. Acta Oncol 49:509–514PubMedCrossRef

33.

Kubota K, Hisa N, Nishikawa T et al (2001) Evaluation of hepatocellular carcinoma after treatment with transcatheter arterial chemoembolization: comparison of Lipiodol-CT, power Doppler sonography, and dynamic MRI. Abdom Imaging 26:184–190PubMedCrossRef

34.

Loffroy R, Lin M, Yenokyan G et al (2013) Intraprocedural C-arm dual-phase cone-beam CT: can it be used to predict short-term response to TACE with drug-eluting beads in patients with hepatocellular carcinoma? Radiology 266:636–648PubMedCentralPubMedCrossRef

Titel: Interreader and inter-test agreement in assessing treatment response following transarterial embolization for hepatocellular carcinoma
verfasst von: Olivio F. Donati
Richard Kinh Gian Do
Andreas M. Hötker
Seth S. Katz
Junting Zheng
Chaya S. Moskowitz
Christopher Beattie
Karen T. Brown
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3677-4

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Interreader and inter-test agreement in assessing treatment response following transarterial embolization for hepatocellular carcinoma