Computed tomography texture analysis to facilitate therapeutic decision making in hepatocellular carcinoma.

Meng Li,Sirui Fu,Zaiyi Liu,Changhong Liang,Ligong Lu,Shuting Chen,Yanjie Zhu

doi:10.18632/oncotarget.7467

Abstract

This study explored the potential of computed tomography (CT) textural feature analysis for the stratification of single large hepatocellular carcinomas (HCCs) > 5 cm, and the subsequent determination of patient suitability for liver resection (LR) or transcatheter arterial chemoembolization (TACE). Wavelet decomposition was performed on portal-phase CT images with three bandwidth responses (filter 0, 1.0, and 1.5). Nine textural features of each filter were extracted from regions of interest. Wavelet-2-H (filter 1.0) in LR and wavelet-2-V (filter 0 and 1.0) in TACE were related to survival. Subsequently, LR and TACE patients were divided based on the wavelet-2-H and wavelet-2-V median at filter 1.0 into two subgroups (+ or −). LR+ patients showed the best survival, followed by LR-, TACE+, and TACE-. We estimated that LR+ patients treated using TACE would exhibit a survival similar to TACE- patients and worse than TACE+ patients, with a severe compromise in overall survival. LR was recommended for TACE- patients, whereas TACE was preferred for LR- and TACE+ patients. Independent of tumor size, CT textural features showed positive and negative correlations with survival after LR and TACE, respectively. Although further validation is needed, texture analysis demonstrated the feasibility of using HCC patient stratification for determining the suitability of LR vs. TACE.

Highlights

Identification and quantification of tumor heterogeneity by computed tomography (CT) textural analysis shows promise in enhancing prognostic accuracy and facilitating therapeutic decision making
There were no significant differences in the patient baseline demographics and characteristics (Table 1)
For time to progression (TTP), univariate Cox regression showed that the presence of a capsule, corona and subgrouping had P-values < 0.10, and the multivariate Cox regression models confirmed that the capsule was the only factor that was significantly associated with the TTP (P = 0.021). These results indicate that liver resection (LR)+ was associated with the best survival, followed by LR- and transcatheter arterial chemoembolization (TACE)+

Summary

Introduction

Identification and quantification of tumor heterogeneity by computed tomography (CT) textural analysis shows promise in enhancing prognostic accuracy and facilitating therapeutic decision making. We explored texture analysis as a prognostic and patient stratification approach in the determination of the appropriate therapeutic option, LR or TACE, for patients with single large HCCs. two questions were raised: (1) are the textural parameters of the primary tumor, calculated from baseline CT, related to prognosis?

Results

Conclusion