The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE)
The purpose of this study was to evaluate the efficacy of unenhanced cone-beam computed tomography (CBCT) performed at the end of drug-eluting bead transarterial chemoembolization (DEB-TACE) in predicting HCC nodules’ early radiologic response to treatment, assessed using mRECIST criteria with a 30–...
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| Format: | Article |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/23/7089 |
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| author | Marco Fronda Francesco Mistretta Marco Calandri Fernanda Ciferri Floriana Nardelli Laura Bergamasco Paolo Fonio Andrea Doriguzzi Breatta |
| author_facet | Marco Fronda Francesco Mistretta Marco Calandri Fernanda Ciferri Floriana Nardelli Laura Bergamasco Paolo Fonio Andrea Doriguzzi Breatta |
| author_sort | Marco Fronda |
| collection | DOAJ |
| description | The purpose of this study was to evaluate the efficacy of unenhanced cone-beam computed tomography (CBCT) performed at the end of drug-eluting bead transarterial chemoembolization (DEB-TACE) in predicting HCC nodules’ early radiologic response to treatment, assessed using mRECIST criteria with a 30–60 day four-phase contrast-enhanced CT follow-up. Fifty-nine patients (81 lesions) subjected to DEB-TACE as exclusive treatment for HCC lesions (naive/relapse) between February 2020 and October 2021 were prospectively enrolled. In a post-interventional unenhanced CBCT procedure, two experienced radiologists evaluated for each lesion the overall intensity of the contrast media deposit, the homogeneity of the enhancement, and the presence of smooth and complete margins. The univariate analysis found that lesions with complete response (CR+) had a significantly higher incidence of clear and complete margins than CR− lesions (76.9% vs. 17.2%, <i>p</i> = 0.003) and a higher intensity score (67.3% vs. 27.6%, <i>p</i> = 0.0009). A Dmax <30 mm was significantly more common among CR+ than CR− lesions (92.3% vs. 69%, <i>p</i> = 0.01). These features were confirmed as significant predictors for CR+ by multivariate binary logistic regression. The homogeneity of the enhancement did not affect the DEB-TACE outcome. Post-interventional unenhanced CBCT is effective in predicting early radiological response to DEB-TACE, since the presence of an intense contrast media deposit with clear and complete margins in treated HCC lesions is associated with CR. |
| first_indexed | 2024-03-09T17:43:15Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:43:15Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-1d708de6518a41db9e64a443cf20066f2023-11-24T11:22:44ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011123708910.3390/jcm11237089The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE)Marco Fronda0Francesco Mistretta1Marco Calandri2Fernanda Ciferri3Floriana Nardelli4Laura Bergamasco5Paolo Fonio6Andrea Doriguzzi Breatta7Radiology Unit, Department of Diagnostic Imaging and Interventional Radiology, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126 Turin, ItalyRadiology Unit, Department of Surgical Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126 Turin, ItalyRadiology Unit, Department of Surgical Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126 Turin, ItalyRadiology Unit, Department of Surgical Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126 Turin, ItalyRadiology Unit, Department of Surgical Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126 Turin, ItalyDepartment of Surgical Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, C.so Bramante 88, 10126 Turin, ItalyRadiology Unit, Department of Surgical Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126 Turin, ItalyRadiology Unit, Department of Diagnostic Imaging and Interventional Radiology, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126 Turin, ItalyThe purpose of this study was to evaluate the efficacy of unenhanced cone-beam computed tomography (CBCT) performed at the end of drug-eluting bead transarterial chemoembolization (DEB-TACE) in predicting HCC nodules’ early radiologic response to treatment, assessed using mRECIST criteria with a 30–60 day four-phase contrast-enhanced CT follow-up. Fifty-nine patients (81 lesions) subjected to DEB-TACE as exclusive treatment for HCC lesions (naive/relapse) between February 2020 and October 2021 were prospectively enrolled. In a post-interventional unenhanced CBCT procedure, two experienced radiologists evaluated for each lesion the overall intensity of the contrast media deposit, the homogeneity of the enhancement, and the presence of smooth and complete margins. The univariate analysis found that lesions with complete response (CR+) had a significantly higher incidence of clear and complete margins than CR− lesions (76.9% vs. 17.2%, <i>p</i> = 0.003) and a higher intensity score (67.3% vs. 27.6%, <i>p</i> = 0.0009). A Dmax <30 mm was significantly more common among CR+ than CR− lesions (92.3% vs. 69%, <i>p</i> = 0.01). These features were confirmed as significant predictors for CR+ by multivariate binary logistic regression. The homogeneity of the enhancement did not affect the DEB-TACE outcome. Post-interventional unenhanced CBCT is effective in predicting early radiological response to DEB-TACE, since the presence of an intense contrast media deposit with clear and complete margins in treated HCC lesions is associated with CR.https://www.mdpi.com/2077-0383/11/23/7089cone-beam computed tomographyhepatocellular carcinoma (HCC)DEB-TACEtransarterial chemoembolization |
| spellingShingle | Marco Fronda Francesco Mistretta Marco Calandri Fernanda Ciferri Floriana Nardelli Laura Bergamasco Paolo Fonio Andrea Doriguzzi Breatta The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) Journal of Clinical Medicine cone-beam computed tomography hepatocellular carcinoma (HCC) DEB-TACE transarterial chemoembolization |
| title | The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) |
| title_full | The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) |
| title_fullStr | The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) |
| title_full_unstemmed | The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) |
| title_short | The Role of Immediate Post-Procedural Cone-Beam Computed Tomography (CBCT) in Predicting the Early Radiologic Response of Hepatocellular Carcinoma (HCC) Nodules to Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) |
| title_sort | role of immediate post procedural cone beam computed tomography cbct in predicting the early radiologic response of hepatocellular carcinoma hcc nodules to drug eluting bead transarterial chemoembolization deb tace |
| topic | cone-beam computed tomography hepatocellular carcinoma (HCC) DEB-TACE transarterial chemoembolization |
| url | https://www.mdpi.com/2077-0383/11/23/7089 |
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