The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response

Abstract Background Hepatocellular carcinoma (HCC) is classified as the sixth commonest cancer over the world and the fourth common in Egypt, representing the third leading cause of cancer-related mortality. Trans-arterial chemoembolization (TACE) is considered as one of the most effective treatment...

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Main Authors: Marie Nader Grace, Bahaa Eldin Mahmoud, Asmaa Mohamed Hussein Abdel-Latif, Shaima Fattouh Elkholy, Mahmoud Mohamed Saleh
Format: Article
Language:English
Published: SpringerOpen 2024-03-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43055-024-01242-x
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author Marie Nader Grace
Bahaa Eldin Mahmoud
Asmaa Mohamed Hussein Abdel-Latif
Shaima Fattouh Elkholy
Mahmoud Mohamed Saleh
author_facet Marie Nader Grace
Bahaa Eldin Mahmoud
Asmaa Mohamed Hussein Abdel-Latif
Shaima Fattouh Elkholy
Mahmoud Mohamed Saleh
author_sort Marie Nader Grace
collection DOAJ
description Abstract Background Hepatocellular carcinoma (HCC) is classified as the sixth commonest cancer over the world and the fourth common in Egypt, representing the third leading cause of cancer-related mortality. Trans-arterial chemoembolization (TACE) is considered as one of the most effective treatment option for intermediate stage HCC. Lesions showing complete response (CR) after TACE can be classified according to their lipiodol retention pattern into complete (C-Lip, covering the entire tumor volume) or incomplete (I-Lip). The purpose of this study was to assess the prediction value of post-TACE lipiodol retention pattern on the local disease progression after complete response and thus to decide which patient should be carefully observed and considered to be incompletely treated. Results The study included 45 HCC lesions treated with TACE and showed complete response in the first follow-up CT performed 4–6 weeks after the procedure; 23 cases showed incomplete lipiodol retention pattern and 22 with complete lipiodol retention pattern which was carefully assessed on non-contrast CT images done 4 to 6 weeks after treatment. Follow-up CT was then performed every 3 months for at least 12 months or until local progression occurred. On the follow-up CT studies, 20 out of the 45 lesions showed persistent complete response (i.e., no local progression), while 25 of them showed local progression. Among the 25 cases with disease progression upon correlation with their lipiodol retention pattern, it was found that local progression occurred in 31.8% of tumors showed CR with complete lipiodol retention, as opposed to 78.2% of tumors showed CR with incomplete lipiodol retention with significant statistical difference and p value 0.010. Conclusions Lipiodol retention pattern of HCC after TACE can predict the potential tumor local outcome. Lesions with incomplete lipiodol retention are at a higher risk of local tumor progression and therefore should probably observed and can be retreated; on the other hand, tumors with complete lipiodol retention have a much lower risk of local disease tumor progression.
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spelling doaj.art-fa0600fde2c2480081028e77a6b4bfea2024-03-31T11:13:32ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622024-03-015511810.1186/s43055-024-01242-xThe prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete responseMarie Nader Grace0Bahaa Eldin Mahmoud1Asmaa Mohamed Hussein Abdel-Latif2Shaima Fattouh Elkholy3Mahmoud Mohamed Saleh4Diagnostic and Interventional Radiology, Cairo UniversityDiagnostic and Interventional Radiology, Cairo UniversitySpecialist of Diagnostic Radiology, Cairo University Student HospitalDiagnostic and Interventional Radiology, Cairo UniversityDiagnostic and Interventional Radiology, National Cancer Institute, Cairo UniversityAbstract Background Hepatocellular carcinoma (HCC) is classified as the sixth commonest cancer over the world and the fourth common in Egypt, representing the third leading cause of cancer-related mortality. Trans-arterial chemoembolization (TACE) is considered as one of the most effective treatment option for intermediate stage HCC. Lesions showing complete response (CR) after TACE can be classified according to their lipiodol retention pattern into complete (C-Lip, covering the entire tumor volume) or incomplete (I-Lip). The purpose of this study was to assess the prediction value of post-TACE lipiodol retention pattern on the local disease progression after complete response and thus to decide which patient should be carefully observed and considered to be incompletely treated. Results The study included 45 HCC lesions treated with TACE and showed complete response in the first follow-up CT performed 4–6 weeks after the procedure; 23 cases showed incomplete lipiodol retention pattern and 22 with complete lipiodol retention pattern which was carefully assessed on non-contrast CT images done 4 to 6 weeks after treatment. Follow-up CT was then performed every 3 months for at least 12 months or until local progression occurred. On the follow-up CT studies, 20 out of the 45 lesions showed persistent complete response (i.e., no local progression), while 25 of them showed local progression. Among the 25 cases with disease progression upon correlation with their lipiodol retention pattern, it was found that local progression occurred in 31.8% of tumors showed CR with complete lipiodol retention, as opposed to 78.2% of tumors showed CR with incomplete lipiodol retention with significant statistical difference and p value 0.010. Conclusions Lipiodol retention pattern of HCC after TACE can predict the potential tumor local outcome. Lesions with incomplete lipiodol retention are at a higher risk of local tumor progression and therefore should probably observed and can be retreated; on the other hand, tumors with complete lipiodol retention have a much lower risk of local disease tumor progression.https://doi.org/10.1186/s43055-024-01242-xHepatocellular carcinomaTACELipiodol retentionPredictionClinical outcome
spellingShingle Marie Nader Grace
Bahaa Eldin Mahmoud
Asmaa Mohamed Hussein Abdel-Latif
Shaima Fattouh Elkholy
Mahmoud Mohamed Saleh
The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response
The Egyptian Journal of Radiology and Nuclear Medicine
Hepatocellular carcinoma
TACE
Lipiodol retention
Prediction
Clinical outcome
title The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response
title_full The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response
title_fullStr The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response
title_full_unstemmed The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response
title_short The prediction value of lipiodol retention pattern on post-TACE CT scan for local progression of HCC after complete response
title_sort prediction value of lipiodol retention pattern on post tace ct scan for local progression of hcc after complete response
topic Hepatocellular carcinoma
TACE
Lipiodol retention
Prediction
Clinical outcome
url https://doi.org/10.1186/s43055-024-01242-x
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