E-ISSN: 1305-3612
mRECIST criteria and contrast-enhanced US for the assessment of the response of hepatocellular carcinoma to transarterial chemoembolization
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Interventional Radiology - Original Article
VOLUME: 20 ISSUE: 2
P: 136-142
March 2014

mRECIST criteria and contrast-enhanced US for the assessment of the response of hepatocellular carcinoma to transarterial chemoembolization

Diagn Interv Radiol 2014;20(2):136-142
DOI: 10.5152/dir.2013.13282
Hippocrates Moschouris 1
Katerina Malagari 2
Marina G. Papadaki 1
Ioannis Kornezos 3
Konstantinos Stamatiou 1
Antonios Anagnostopoulos, 4
Katerina Chatzimichael 1
Nikolaos Kelekis 2
1. From the Departments of Radiology General Hospital Tzanio, Piraeus, Greece
2. From the 2nd Department of Radiology Liverpool Women’s Hospital Crown Street, Liverpool, UK.
3. the Department of Gynecology, Liverpool Women’s Hospital Crown Street, Liverpool, UK.
4. From the 2nd Department of Radiology Liverpool Women’s Hospital Crown Street, Liverpool, UK.
No information available.
No information available
Received Date: 10.06.2013
Accepted Date: 31.07.2013
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ABSTRACT

PURPOSE

We aimed to evaluate the combination of the modified Response Evaluation Criteria In Solid Tumors (mRECIST) and contrast-enhanced ultrasonography (CEUS) as a tool for the assessment of hepatocellular carcinoma treated with transarterial chemoembolization.

MATERIALS AND METHODS

Forty-seven hepatocellular carcinoma patients (80 target tumors suitable for mRECIST measurements) were studied. They were treated with scheduled transarterial chemoembolization with doxorubicin-eluting microspheres every 5–7 weeks. Imaging follow-up (performed one month after each transarterial chemoembolization) included a standard, contrast-enhanced modality (computed tomography [CT] in 12 patients or magnetic resonance imaging [MRI] in 35 patients) and CEUS. The study focused on response evaluation after the third transarterial chemoembolization. CEUS required a bolus injection of an echo-enhancer and imaging with a dedicated, low mechanical index technique. The longest diameters of the enhancing target tumors were measured on the CEUS or CT/MRI, and mRECIST criteria were applied. Radiologic responses were correlated with overall survival and time to progression.

RESULTS

The measurements of longest diameters of the enhancing target tumors were easily performed in all patients. According to mRECIST-CEUS and mRECIST-CT/MRI, complete response was recorded in five and six patients, partial response in 22 and 21 patients, stable disease in 16 and 14 patients, and progressive disease in four and six patients, respectively. There was a high degree of concordance between CEUS and CT/MRI (kappa coefficient=0.84, P < 0.001). Responders (complete+partial response) according to mRECIST-CEUS had a significantly longer mean overall survival and time to progression compared to nonresponders (37.1 vs. 11.0 months, P < 0.001 and 24.6 vs. 10.9 months, P = 0.007, respectively).

CONCLUSION

The mRECIST-CEUS combination is feasible and has prognostic value in the assessment of hepatocellular carcinoma following transarterial chemoembolization.