Scholarlink

Objectives <p>To assess the temporal evolution and interobserver agreement of the early categories per the liver imaging reporting and data system (LI-RADS) radiation treatment response assessment (TRA) algorithm in patients receiving selective internal radiation therapy (SIRT) with Yttrium-90 for hepatocellular carcinoma (HCC).</p> Materials and methods <p>This single-center retrospective study included consecutive patients with treatment-naïve HCC who underwent serial contrast-enhanced CT/MRI before and after SIRT. Three masked radiologists independently evaluated response at 3–6 months. Another senior radiologist assessed response at 9, 12, 15, 18, 21, 24, and &gt; 24 months after comprehensive review of available clinical-radiological information.</p> Results <p>65 patients (mean age, 66.7 ± 11.2 years; 48 men) were included. At 3–6 months after SIRT, 47.7% (31/65) of lesions were assigned to the nonprogressing category, and the remaining 52.3% (34/65) to the nonviable category. Among early nonprogressing lesions, 64.5% (20/31) regressed to the nonviable category, 25.8% (8/31) remained nonprogressing, and 9.7% (3/31) evolved into the viable category at ≥ 12 months. The nonprogressing category decreased in number over time, with 61.3% (19/31) conversion to the nonviable category at 9 months. Among the early nonviable lesions, 91.2% (31/34) remained nonviable at ≥ 12 months, and 8.8% (3/34) evolved into the viable category. Agreement for the 3–6 months LR-TR category assignment was moderate (kappa = 0.46) with CT but almost perfect (kappa = 0.85) with MRI.</p> Conclusions <p>SIRT induced a delayed and sustained response in the majority of HCC patients after ≥ 12 months. MRI demonstrated superior agreement over CT in assessing response at 3–6 months.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Tumor response to SIRT can change; there is limited evidence on the evolution of the imaging appearance of HCC following SIRT</i>.</p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>Sixty-four and five-tenths of early nonprogressing lesions regressed to nonviable, and 91.2% of early nonviable lesions remained free of viability. LR-TR category assignment agreement was moderate with CT but almost perfect with MRI</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>SIRT induced a delayed and sustained response in HCC, underscoring the necessity of dynamic evaluation of long-term changes in treated lesions. MRI with subtraction imaging may be preferred over CT for long-term monitoring, which may help prevent premature retreatment decisions</i>.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Temporal evolution of the LI-RADS radiation treatment response assessment on multiphase CT/MRI in patients undergoing selective internal radiation therapy for hepatocellular carcinoma

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月17日

查看全文
  • Hong Wei,
  • Hanyu Jiang,
  • Jeongin Yoo,
  • Jae Hyun Kim,
  • Hyo-Jin Kang,
  • Yuanan Wu,
  • Rongbo Liu,
  • Hyo-Cheol Kim,
  • Jeong Min Lee

摘要

Objectives

To assess the temporal evolution and interobserver agreement of the early categories per the liver imaging reporting and data system (LI-RADS) radiation treatment response assessment (TRA) algorithm in patients receiving selective internal radiation therapy (SIRT) with Yttrium-90 for hepatocellular carcinoma (HCC).

Materials and methods

This single-center retrospective study included consecutive patients with treatment-naïve HCC who underwent serial contrast-enhanced CT/MRI before and after SIRT. Three masked radiologists independently evaluated response at 3–6 months. Another senior radiologist assessed response at 9, 12, 15, 18, 21, 24, and > 24 months after comprehensive review of available clinical-radiological information.

Results

65 patients (mean age, 66.7 ± 11.2 years; 48 men) were included. At 3–6 months after SIRT, 47.7% (31/65) of lesions were assigned to the nonprogressing category, and the remaining 52.3% (34/65) to the nonviable category. Among early nonprogressing lesions, 64.5% (20/31) regressed to the nonviable category, 25.8% (8/31) remained nonprogressing, and 9.7% (3/31) evolved into the viable category at ≥ 12 months. The nonprogressing category decreased in number over time, with 61.3% (19/31) conversion to the nonviable category at 9 months. Among the early nonviable lesions, 91.2% (31/34) remained nonviable at ≥ 12 months, and 8.8% (3/34) evolved into the viable category. Agreement for the 3–6 months LR-TR category assignment was moderate (kappa = 0.46) with CT but almost perfect (kappa = 0.85) with MRI.

Conclusions

SIRT induced a delayed and sustained response in the majority of HCC patients after ≥ 12 months. MRI demonstrated superior agreement over CT in assessing response at 3–6 months.

Key Points

Question Tumor response to SIRT can change; there is limited evidence on the evolution of the imaging appearance of HCC following SIRT.

Findings Sixty-four and five-tenths of early nonprogressing lesions regressed to nonviable, and 91.2% of early nonviable lesions remained free of viability. LR-TR category assignment agreement was moderate with CT but almost perfect with MRI.

Clinical relevance SIRT induced a delayed and sustained response in HCC, underscoring the necessity of dynamic evaluation of long-term changes in treated lesions. MRI with subtraction imaging may be preferred over CT for long-term monitoring, which may help prevent premature retreatment decisions.

Graphical Abstract