Baseline tumor Lipiodol uptake after transarterial chemoembolization for hepatocellular carcinoma: Identification of a threshold value predicting tumor recurrence

Yusuke Matsui, Masahiro Horikawa, Younes Jahangiri Noudeh, John Kaufman, Kenneth Kolbeck, Khashayar Farsad

Research output: Contribution to journalArticle

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Abstract

The aim of the study was to evaluate the association between baseline Lipiodol uptake in hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with early tumor recurrence, and to identify a threshold baseline uptake value predicting tumor response. A single-institution retrospective database of HCC treated with Lipiodol-TACE was reviewed. Forty-six tumors in 30 patients treated with a Lipiodol-chemotherapy emulsion and no additional particle embolization were included. Baseline Lipiodol uptake was measured as the mean Hounsfield units (HU) on a CT within one week after TACE. Washout rate was calculated dividing the difference in HU between the baseline CT and follow-up CT by time (HU/month). Cox proportional hazard models were used to correlate baseline Lipiodol uptake and other variables with tumor response. A receiver operating characteristic (ROC) curve was used to identify the optimal threshold for baseline Lipiodol uptake predicting tumor response. During the follow-up period (mean 5.6 months), 19 (41.3%) tumors recurred (mean time to recurrence = 3.6 months). In a multivariate model, low baseline Lipiodol uptake and higher washout rate were significant predictors of early tumor recurrence (P = 0.001 and < 0.0001, respectively). On ROC analysis, a threshold Lipiodol uptake of 270.2 HU was significantly associated with tumor response (95% sensitivity, 93% specificity). Baseline Lipiodol uptake and washout rate on follow-up were independent predictors of early tumor recurrence. A threshold value of baseline Lipiodol uptake > 270.2 HU was highly sensitive and specific for tumor response. These findings may prove useful for determining subsequent treatment strategies after Lipiodol TACE.

Original languageEnglish (US)
Pages (from-to)393-400
Number of pages8
JournalRadiology and Oncology
Volume51
Issue number4
DOIs
StatePublished - Jan 1 2017

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Ethiodized Oil
Hepatocellular Carcinoma
Recurrence
Neoplasms
Emulsions
Proportional Hazards Models
ROC Curve
Databases
Drug Therapy

Keywords

  • hepatocellular carcinoma
  • Lipiodol
  • threshold
  • transarterial chemoembolization
  • tumor response

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Baseline tumor Lipiodol uptake after transarterial chemoembolization for hepatocellular carcinoma : Identification of a threshold value predicting tumor recurrence. / Matsui, Yusuke; Horikawa, Masahiro; Jahangiri Noudeh, Younes; Kaufman, John; Kolbeck, Kenneth; Farsad, Khashayar.

In: Radiology and Oncology, Vol. 51, No. 4, 01.01.2017, p. 393-400.

Research output: Contribution to journalArticle

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