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Parametric response mapping of dynamic CT: enhanced prediction of survival in hepatocellular carcinoma patients treated with transarterial chemoembolization

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Abstract

Purpose

The aim of this study was to evaluate the prognostic significance of parametric response mapping (PRM) analysis for hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE).

Methods

We recruited 65 HCC patients who underwent TACE. These patients underwent longitudinal multiphasic CT before and after TACE. We applied PRM analysis to the baseline CT before TACE and first/second follow-up CTs. The results of PRM analyses were used to stratify patients into responders and non-responders. Overall survival was compared between the two groups. An independent survival analysis using conventional radiological assessments was performed, and the results were compared with PRM results. Univariate and multivariate analyses were performed to identify clinical factors affecting survival.

Results

The PRM analyses demonstrated that the responding group had a median survival of 529 days, while the non-responding group had a median survival of 263 days [hazard ratio (HR) 12.9, p < 0.05 for differences in survival]. The manual analyses indicated median survivals of 491 and 329 days for the responding and non-responding groups, respectively (HR 2.7, p < 0.05). Tumor size, albumin level, and PRM values were found to be significantly related to overall survival after univariate and multivariate analyses.

Conclusions

The PRM analysis could be a better predictor of overall survival for patients with HCC undergoing TACE than conventional radiological assessments.

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Author notes

    Authors and Affiliations

    1. Department of Radiology, Gachon University Gil Hospital, Incheon, Korea

      Seung Joon Choi & Hyung Sik Kim

    2. Department of Electronic Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea

      Jonghoon Kim

    3. School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, 16419, Korea

      Hyunjin Park

    4. Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea

      Hyunjin Park

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    1. Seung Joon Choi
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    2. Jonghoon Kim
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    3. Hyung Sik Kim
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    Corresponding author

    Correspondence to Hyunjin Park.

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    Funding

    This study was funded by the Institute for Basic Science (Grant Number IBS-R015-D1) and also National Research Foundation of Korea (NRF) (Grant Number NRF-2016R1A2B4008545).

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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    Statement of informed consent was not applicable since the manuscript does not contain any patient data.

    Additional information

    Seung Joon Choi and Jonghoon Kim—equal contribution as co-first authors.

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    Choi, S.J., Kim, J., Kim, H.S. et al. Parametric response mapping of dynamic CT: enhanced prediction of survival in hepatocellular carcinoma patients treated with transarterial chemoembolization. Abdom Radiol 42, 1871–1879 (2017). https://doi.org/10.1007/s00261-017-1082-y

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    • DOI: https://doi.org/10.1007/s00261-017-1082-y

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