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Related Concept Videos

Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Related Experiment Video

Updated: May 26, 2025

Predicting Treatment Response to Image-Guided Therapies Using Machine Learning: An Example for Trans-Arterial Treatment of Hepatocellular Carcinoma
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Comparative Radiologic Response Assessment after Transarterial Chemoembolization, Percutaneous Ablation, and

Wali Badar1, Eric G Cooper2, Christopher R Florido3

  • 1Department of Radiology, University of Illinois at Chicago, Chicago, Illinois.

Journal of Vascular and Interventional Radiology : JVIR
|February 22, 2025
PubMed
Summary
This summary is machine-generated.

Radiologic response criteria correlate with pathologic necrosis in hepatocellular carcinoma (HCC) after locoregional therapy (LRT). However, imaging imperfectly predicts complete necrosis, necessitating continued surveillance before liver transplantation.

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Area of Science:

  • Hepatobiliary oncology
  • Interventional radiology
  • Surgical pathology

Background:

  • Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality worldwide.
  • Locoregional therapies (LRT), including transarterial chemoembolization (TACE) and percutaneous ablation, are standard treatments for HCC.
  • Accurate assessment of treatment response is crucial for patient management and predicting outcomes, particularly for those undergoing liver transplantation.

Purpose of the Study:

  • To evaluate the concordance between radiologic and pathologic responses in HCC following LRT.
  • To compare the efficacy of different LRT modalities (TACE, ablation, combined) in achieving tumor necrosis.
  • To determine the predictive value of imaging-based response criteria for pathologic necrosis.

Main Methods:

  • Retrospective analysis of 56 patients with 81 HCC tumors treated with TACE, ablation, or both prior to liver transplantation.
  • Assessment of radiologic response using modified Response Evaluation Criteria in Solid Tumours (mRECIST) on pre-transplant imaging.
  • Quantification of percent pathologic necrosis (PN) from explant liver pathology.
  • Statistical correlation between imaging findings and pathologic outcomes.

Main Results:

  • A significant association was found between mRECIST response and percent pathologic necrosis (PN), with complete response (CR) correlating with higher PN.
  • Sixty percent of CR tumors demonstrated 100% complete PN (CPN), compared to 20% of partial response (PR) and 18% of stable disease (SD) tumors.
  • Radiologic CR showed 87% sensitivity and 49% specificity for predicting 100% PN, indicating imperfect prediction.

Conclusions:

  • Radiologic response criteria are associated with pathologic necrosis in HCC treated with LRT, with no significant differences between treatment modalities.
  • The imperfect accuracy of imaging in predicting complete tumor necrosis underscores the need for careful surveillance of treated HCC lesions before liver transplantation.