3:09 PMAbstract No. 140 - Predicting HCC treatment response to Y-90 radioembolization by quantitative perfusion using contrast-enhanced magnetic resonance angiography

Abstract

PurposeTo predict hepatocellular carcinoma (HCC) treatment response to Y-90 radioembolization (RAE) by quantitatively evaluating target lesion perfusion using contrast-enhanced MR angiography (MRA).MaterialsQuantitative MR perfusion was performed to evaluate 13 HCC target lesions in 10 patients (avg 67 yrs, 6 men), before and immediately (1hr) after Y-90 RAE. The peak slopes of the signal intensity curves were recorded to determine perfusion of target lesions and were normalized to the arterial input function. Target lesion perfusion was further adjusted by subtracting remote liver parenchyma perfusion. Target lesion response to therapy was assessed using WHO and EASL criteria on routine MR imaging; responses were defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Two-sample t-tests were performed to compare perfusion between lesions.ResultsFollow-up was available for an average of 6.9 (1-17) months. Target lesions averaged 3.1±1.2 cm, treated with an average dose of 191±118 Gy. Target lesions showing response (CR/PR) at 1 and 3 months were: 6/13 (46%) and 6/10 (60%) using EASL, and 0/13 (0%) and 2/10 (20%) using WHO criteria. EASL was used for subsequent analysis as it provided earlier and granular response detail. Average pre-RAE target lesion perfusion was 0.161, increasing post-RAE to 0.211. When the lesions were stratified into responders (CR/PR) and non-responders (SD/PD), responders had significantly lower pre-RAE perfusion compared to non-responders, both at 1 and 3 months (P<0.05, see table). No significant differences were seen for post-RAE perfusion.ConclusionsTabled 1*P<0.051 Month3 MonthsResponderNon-responderResponderNon-responderPre-RAE0.049*0.258*0.041*0.369*Post-RAE0.0570.3390.0580.453 Open table in a new tab PurposeTo predict hepatocellular carcinoma (HCC) treatment response to Y-90 radioembolization (RAE) by quantitatively evaluating target lesion perfusion using contrast-enhanced MR angiography (MRA). To predict hepatocellular carcinoma (HCC) treatment response to Y-90 radioembolization (RAE) by quantitatively evaluating target lesion perfusion using contrast-enhanced MR angiography (MRA). MaterialsQuantitative MR perfusion was performed to evaluate 13 HCC target lesions in 10 patients (avg 67 yrs, 6 men), before and immediately (1hr) after Y-90 RAE. The peak slopes of the signal intensity curves were recorded to determine perfusion of target lesions and were normalized to the arterial input function. Target lesion perfusion was further adjusted by subtracting remote liver parenchyma perfusion. Target lesion response to therapy was assessed using WHO and EASL criteria on routine MR imaging; responses were defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Two-sample t-tests were performed to compare perfusion between lesions. Quantitative MR perfusion was performed to evaluate 13 HCC target lesions in 10 patients (avg 67 yrs, 6 men), before and immediately (1hr) after Y-90 RAE. The peak slopes of the signal intensity curves were recorded to determine perfusion of target lesions and were normalized to the arterial input function. Target lesion perfusion was further adjusted by subtracting remote liver parenchyma perfusion. Target lesion response to therapy was assessed using WHO and EASL criteria on routine MR imaging; responses were defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Two-sample t-tests were performed to compare perfusion between lesions. ResultsFollow-up was available for an average of 6.9 (1-17) months. Target lesions averaged 3.1±1.2 cm, treated with an average dose of 191±118 Gy. Target lesions showing response (CR/PR) at 1 and 3 months were: 6/13 (46%) and 6/10 (60%) using EASL, and 0/13 (0%) and 2/10 (20%) using WHO criteria. EASL was used for subsequent analysis as it provided earlier and granular response detail. Average pre-RAE target lesion perfusion was 0.161, increasing post-RAE to 0.211. When the lesions were stratified into responders (CR/PR) and non-responders (SD/PD), responders had significantly lower pre-RAE perfusion compared to non-responders, both at 1 and 3 months (P<0.05, see table). No significant differences were seen for post-RAE perfusion. Follow-up was available for an average of 6.9 (1-17) months. Target lesions averaged 3.1±1.2 cm, treated with an average dose of 191±118 Gy. Target lesions showing response (CR/PR) at 1 and 3 months were: 6/13 (46%) and 6/10 (60%) using EASL, and 0/13 (0%) and 2/10 (20%) using WHO criteria. EASL was used for subsequent analysis as it provided earlier and granular response detail. Average pre-RAE target lesion perfusion was 0.161, increasing post-RAE to 0.211. When the lesions were stratified into responders (CR/PR) and non-responders (SD/PD), responders had significantly lower pre-RAE perfusion compared to non-responders, both at 1 and 3 months (P<0.05, see table). No significant differences were seen for post-RAE perfusion. ConclusionsTabled 1*P<0.051 Month3 MonthsResponderNon-responderResponderNon-responderPre-RAE0.049*0.258*0.041*0.369*Post-RAE0.0570.3390.0580.453 Open table in a new tab