Baseline parameters of spectral CT could predict tumor response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients

Wei Zheng,Peng Yang,Bingqin Huang,Jian Lv,Xin Li,Ronghua Mu,Fuzhen Liu,Xiaoyan Qin,Xiqi Zhu

doi:10.1016/j.jimed.2023.12.005

Abstract

ObjectiveThe present study aimed to assess the diagnostic efficacy of baseline spectral computed tomography (CT) parameters in predicting tumor response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). MethodsData were collected from 91 consecutive patients with HCC between June 2020 and July 2023. An independent samples t-test was performed to compare the demographic and spectral CT variables between the groups. Predictors were screened using binary logistic regression, and the diagnostic efficacy of the baseline parameters for predicting the response to TACE in patients with HCC was analyzed using receiver operating characteristic (ROC) curves. ResultsA total of 91 patients with HCC were included in the present study, categorized into response (n = 52; men, 48 (92.3 %); age, 58.72 ± 11.16 years) and non-response (n = 39; men, 36 (92.31 %); age, 59.50 ± 10.10 years) groups based on the evaluation criteria. There was a statistically significant difference in both iodine concentration (IC) and normalized IC (NIC) between the two groups (P < 0.05), and we found that the mean values of the three IC and NIC phases in the non-response group were significantly lower than those in the response group. The arterial, portal, and delayed phase ICs and NICs had significant positive effects on the response to TACE in patients with HCC (P < 0.05). Baseline spectral CT parameters, including IC and NIC, had satisfactory diagnostic efficacy for predicting tumor response to TACE (area under the curve [AUC] of baseline spectral parameters ranged from 0.698 to 0.879). The results of the DeLong test indicated no statistical differences between the AUC of all the parameters and models. ConclusionThe present study found that the baseline spectral CT parameters could be surrogate imaging markers for predicting tumor response to TACE.

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