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CardioVascular and Interventional Radiology

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05.06.2018 | Clinical Investigation

Transarterial Radioembolization Following Chemoembolization for Unresectable Hepatocellular Carcinoma: Response Based on Apparent Diffusion Coefficient Change is an Independent Predictor for Survival

verfasst von: Elisabeth G. Klompenhouwer, Raphaëla C. Dresen, Chris Verslype, Annouschka Laenen, Lawrence Bonne, Vincent Vandecaveye, Geert Maleux

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 11/2018

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Abstract

Purpose

To evaluate whether response based on contrast-enhanced magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) change at diffusion-weighted MRI after transarterial radioembolization (TARE) can predict survival, in patients with prior transarterial chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma (HCC).

Methods

We identified all patients who received DEB-TACE prior to TARE for HCC between 2007 and 2016. Response on MRI was determined by modified RECIST (mRECIST) and ADC change relative to pre-TARE imaging (ADCratio). Kaplan–Meier and log-rank tests were used to correlate the response/disease and treatment variables to overall survival. Multivariable Cox regression models were used to correct for confounders.

Results

A total of 29 consecutive patients were included. Univariable analysis showed that response determined by mRECIST was a nonsignificant predictor of survival (p = 0.057), and response determined by ADCratio was a significant predictor of survival (p = 0.011). Number of prior DEB-TACE procedures (p = 0.037), female gender (p < 0.001) and BCLC C (p = 0.03) were related to worse survival. The number of prior DEB-TACE procedure was significantly higher in non-responders determined by ADCratio (p = 0.028). Multivariable analyses showed that response based on ADCratio was an independent predictor of survival (p = 0.041).

Conclusion

ADCratio following TARE is an independent predictor for survival in patients who previously underwent DEB-TACE for HCC.

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Titel: Transarterial Radioembolization Following Chemoembolization for Unresectable Hepatocellular Carcinoma: Response Based on Apparent Diffusion Coefficient Change is an Independent Predictor for Survival
verfasst von: Elisabeth G. Klompenhouwer
Raphaëla C. Dresen
Chris Verslype
Annouschka Laenen
Lawrence Bonne
Vincent Vandecaveye
Geert Maleux
Publikationsdatum: 05.06.2018
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 11/2018
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-018-1991-3

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Transarterial Radioembolization Following Chemoembolization for Unresectable Hepatocellular Carcinoma: Response Based on Apparent Diffusion Coefficient Change is an Independent Predictor for Survival

Abstract

Purpose

Methods

Results

Conclusion

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