Abstract No. 239: Magnetic resonance imaging biomarkers predicting survivals after doxorubicin drug eluting beads transarterial chemoembolization (DEB TACE) in patients with unresectable hepatocellular carcinoma (HCC)

Abstract

lesion was also segmented using a semi automatic segmentation software to provide 3D volumetric ADC and 3D volumetric enhancement in hepatic arterial (HAP) and portal venous phases (PVP). AFP levels (patients with baseline AFP 200ng/mL) were also utilized for assessing response. Overall patient Survival (OS) from the date of first treatment was used as primary endpoint. Statistical analysis include kaplan-Meier survival curves and Cox proportional hazards model. Results: Overall median survival for 141 patients with HCC was 20.7 months (76 deaths, 54%). Responders survived longer than nonresponders based on EASL (HR 0.39, p 0.008), 25% increase in volumetric ADC (HR 0.39, p 0.001), 50% decrease in volumetric enhancement in PVP (HR 0.35, p 0.001) and 15% decrease in AFP (HR 0.32, p 0.003), but not based on RECIST, mRECIST, decrease in tumor volume or HAP assessed 3-4 weeks after TACE. Decrease in AFP could only be analyzed in a subset of 55 (39%) patients, since the remaining 86 (61%) patients had normal AFP levels at baseline. In Multivariate analysis 25% increase in ADC and 50% decrease in PVP more consistently predicted survival times than EASL or AFP decrease. Conclusion: Treatment response by volumetric functional ADC and CE-MR in PVP consistently predicted patient survival early (3-4 weeks) post treatment and could be used as oncologic imaging biomarkers of early treatment response, progression and survival.