Treatment Planning and Volumetric Response Assessment for Yttrium-90 Radioembolization: Semiautomated Determination of Liver Volume and Volume of Tumor Necrosis in Patients with Hepatic MalignancyReport as inadecuate




Treatment Planning and Volumetric Response Assessment for Yttrium-90 Radioembolization: Semiautomated Determination of Liver Volume and Volume of Tumor Necrosis in Patients with Hepatic Malignancy - Download this document for free, or read online. Document in PDF available to download.

CardioVascular and Interventional Radiology

, Volume 34, Issue 2, pp 306–318

First Online: 04 August 2010Received: 24 February 2010Accepted: 15 June 2010

Abstract

PurposeThe primary purpose of this study was to demonstrate intraobserver-interobserver reproducibility for novel semiautomated measurements of hepatic volume used for Yttrium-90 dose calculations as well as whole-liver and necrotic-liver hypodense-nonenhancing tumor volume after radioembolization. The secondary aim was to provide initial comparisons of tumor volumetric measurements with linear measurements, as defined by Response Evaluation Criteria in Solid Tumors criteria, and survival outcomes.

MethodsBetween 2006 and 2009, 23 consecutive radioembolization procedures were performed for 14 cases of hepatocellular carcinoma and 9 cases of hepatic metastases. Baseline and follow-up computed tomography obtained 1 month after treatment were retrospectively analyzed. Three observers measured liver, whole-tumor, and tumor-necrosis volumes twice using semiautomated software.

ResultsGood intraobserver-interobserver reproducibility was demonstrated intraclass correlation ICC > 0.9 for tumor and liver volumes. Semiautomated measurements of liver volumes were statistically similar to those obtained with manual tracing ICC = 0.868, but they required significantly less time to perform p < 0.0001, ICC = 0.088. There was a positive association between change in linear tumor measurements and whole-tumor volume p < 0.0001. However, linear measurements did not correlate with volume of necrosis p > 0.05. Dose, change in tumor diameters, tumor volume, and necrotic volume did not correlate with survival p > 0.05 in all instances. However, Kaplan–Meier curves suggest that a >10% increase in necrotic volume correlated with survival p = 0.0472.

ConclusionSemiautomated volumetric analysis of liver, whole-tumor, and tumor-necrosis volume can be performed with good intraobserver-interobserver reproducibility. In this small retrospective study, measurements of tumor necrosis were suggested to correlate with survival.

KeywordsRadioembolization CT Volume Tumor Response Necrosis  Download fulltext PDF



Author: Wayne L. Monsky - Armando S. Garza - Isaac Kim - Shaun Loh - Tzu-Chun Lin - Chin-Shang Li - Jerron Fisher - Parmbir Sand

Source: https://link.springer.com/







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