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A predictive model of incomplete response after transarterial chemoembolization for early or intermediate stage of hepatocellular carcinoma: consideration of hepatic angiographic and cross-sectional imaging

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objectives

The purpose of the present study is to develop a predictive model for incomplete response (IR) after conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC) based on hepatic angiographic and cross-sectional imaging.

Methods

Sixty patients with 139 target HCC lesions who underwent cTACE from February 2013 to March 2019 were included in this retrospective study. Hepatic angiographic features were identified: the number of feeding arteries, vascularity of the tumor, tumor staining on angiography, vascular lake phenomenon, and hepatic arterio-portal shunt. Cross-sectional imaging features were also identified: tumor extent, location, size, and enhancement pattern. Treatment response was assessed by the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Logistic regression analysis was performed to determine the potential predictive factors for treatment response. To validate the predictive value of potential factors, the means of a decision tree were also calculated by Classification and Regression Tree (CART). P < 0.05 was considered statistically significant.

Results

The IR rate was 43.2% (60/139) in the entire study population. Logistic regression analysis showed that a tumor size > 50 mm (P = 0.005; odds ratio, 7.25; 95% CI 1.79–29.33), central location (P = 0.007; odds ratio, 0.14; 95% CI 0.03–0.59), and nondense tumor staining (P < 0.001; odds ratio, 0.08; 95% CI 0.02–0.28) were predictors of IR after cTACE. Decision tree analysis showed a good ability to classify treatment response with an accuracy of 78.4%.

Conclusion

Tumor size > 50 mm, central tumor location, and nondense tumor staining were predictors of IR after cTACE. These factors should be taken into consideration when performing cTACE.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Project was supported by the National Natural Science Foundation of China (Grant No. 81801813).

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Authors and Affiliations

  1. Department of Radiology, The Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Road, Changsha, 410011, China

    Pei-Yao Tao, Zi-Shu Zhang, Tian-Cheng Wang, Meng-Qi Yu & Yu-Dong Xiao

Authors
  1. Pei-Yao Tao
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  2. Zi-Shu Zhang
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  3. Tian-Cheng Wang
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  4. Meng-Qi Yu
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  5. Yu-Dong Xiao
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Contributions

MQ Yu and PY Tao analyze and interpret the patients’ data and review the patients’ image. ZS Zhang and TC Wang collect the data and revise the manuscript. YD Xiao and PY Tao are major contributors in writing the manuscript. YD Xiao provide the concept, and is a major contributor in the manuscript editing. All authors read and approve the final manuscript.

Corresponding author

Correspondence to Yu-Dong Xiao.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethics approval

This single-institution retrospective study was approved by the Institutional Ethics Committee of Second Xiangya hospital and in accordance with the Declaration of Helsinki.

Informed consent

Consent to participate: Written informed consent was waived by the Institutional Ethics Committee due to the retrospective nature of the present study.

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Tao, PY., Zhang, ZS., Wang, TC. et al. A predictive model of incomplete response after transarterial chemoembolization for early or intermediate stage of hepatocellular carcinoma: consideration of hepatic angiographic and cross-sectional imaging. Abdom Radiol 46, 581–589 (2021). https://doi.org/10.1007/s00261-020-02701-5

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  • DOI: https://doi.org/10.1007/s00261-020-02701-5

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