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Published on: August 31, 2022
Advanced Hepatocellular Carcinoma: Perfusion Computed Tomography-Based Kinetic Parameter as a Prognostic Biomarker
Sang Ho Lee1, Koichi Hayano, Andrew X Zhu
1From the *3D Imaging Research, Department of Radiology, Massachusetts General Hospital and Harvard Medical School; †Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital; and ‡Massachusetts General Hospital Cancer Center, Boston, MA.
Objective:
The aim of this study was to find prognostic biomarkers in perfusion computed tomography (PCT)-based kinetic parameters for advanced hepatocellular carcinoma (HCC) treated with antiangiogenic chemotherapy.
Methods:
Twenty-two patients with advanced HCC underwent PCT imaging and subsequently received bevacizumab in combination with gemcitabine and oxaliplatin. Pretreatment PCT data within advanced HCC were analyzed using the Tofts-Kety, 2-compartment exchange, adiabatic approximation to the tissue homogeneity (AATH), and distributed parameter models. Blood flow, blood volume, extraction fraction (E), and other 3 parameters were calculated. Kinetic parameters in each model were evaluated with 1-year survival discrimination using Kaplan-Meier analysis and with overall survival using univariate Cox regression analysis.
Results:
Only the AATH model-derived E was statistically significantly prognostic for 1-year survival. The increased AATH model-derived E was significantly associated with longer overall survival (P = 0.005).
Conclusions:
The AATH model-derived E was an effective prognostic biomarker for advanced HCC.
