Radiologic-pathologic correlation of hepatocellular carcinoma treated with chemoembolization

Ahsun Riaz, Robert J. Lewandowski, Laura Kulik, Robert K. Ryu, Mary F. Mulcahy, Talia Baker, Vanessa Gates, Ritu Nayar, Ed Wang, Frank H. Miller, Kent T. Sato, Reed A. Omary, Michael Abecassis, Riad Salem*

*Corresponding author for this work

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

To correlate posttreatment radiologic and pathologic findings in patients who underwent transarterial chemoembolization before transplantation or resection. Thirty-five patients with postchemoembolization follow-up imaging underwent liver transplantation/resection. Pre- and posttreatment contrast-enhanced magnetic resonance imaging were used to evaluate radiologic findings. Imaging characteristics using World Health Organization (WHO) and European Association for the Study of the Liver (EASL) criteria after treatment were evaluated. Treated lesions were examined by pathology (gold standard) for the assessment of necrosis. Radiologic findings on magnetic resonance imaging were correlated to pathologic findings to assess the predictability by imaging of actual necrosis. Kappa (κ) statistics were used to determine intermethod agreement between WHO and EASL criteria. Fourteen (40%) of 35 lesions had biopsy-proven hepatocellular carcinoma. Thirteen (37%) of 35 target lesions showed complete pathologic necrosis. Complete pathologic necrosis was seen in 35% of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 1 (100%) of 1, 6 (67%) of 9, 6 (33%) of 18, and 0 (0%) of 7 of the lesions that exhibited complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by WHO criteria, respectively. Complete pathologic necrosis was seen in 9 (82%) of 11, 4 (36%) of 11, 0 (0%) of 8, and 0 (0%) of 5 of the lesions that showed CR, PR, SD, or PD by EASL criteria, respectively. EASL CR and WHO response were shown to have ≥85% specificity for predicting complete pathologic necrosis. The κ coefficient for agreement between WHO and EASL was 0.29. EASL and WHO criteria had minimal intermethod agreement. EASL CR and WHO response were able to predict pathologic necrosis.

Original languageEnglish (US)
Pages (from-to)1143-1152
Number of pages10
JournalCardioVascular and Interventional Radiology
Volume33
Issue number6
DOIs
StatePublished - Dec 1 2010

Fingerprint

Hepatocellular Carcinoma
Necrosis
Liver
Magnetic Resonance Imaging
Liver Transplantation
Transplantation
Pathology
Biopsy

Keywords

  • Hepatocellular cancer
  • Imaging
  • Radiologic-pathologic correlation
  • Transarterial chemoembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{6a9c1fb762394948ad5f3c37af7bb587,
title = "Radiologic-pathologic correlation of hepatocellular carcinoma treated with chemoembolization",
abstract = "To correlate posttreatment radiologic and pathologic findings in patients who underwent transarterial chemoembolization before transplantation or resection. Thirty-five patients with postchemoembolization follow-up imaging underwent liver transplantation/resection. Pre- and posttreatment contrast-enhanced magnetic resonance imaging were used to evaluate radiologic findings. Imaging characteristics using World Health Organization (WHO) and European Association for the Study of the Liver (EASL) criteria after treatment were evaluated. Treated lesions were examined by pathology (gold standard) for the assessment of necrosis. Radiologic findings on magnetic resonance imaging were correlated to pathologic findings to assess the predictability by imaging of actual necrosis. Kappa (κ) statistics were used to determine intermethod agreement between WHO and EASL criteria. Fourteen (40{\%}) of 35 lesions had biopsy-proven hepatocellular carcinoma. Thirteen (37{\%}) of 35 target lesions showed complete pathologic necrosis. Complete pathologic necrosis was seen in 35{\%} of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 1 (100{\%}) of 1, 6 (67{\%}) of 9, 6 (33{\%}) of 18, and 0 (0{\%}) of 7 of the lesions that exhibited complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by WHO criteria, respectively. Complete pathologic necrosis was seen in 9 (82{\%}) of 11, 4 (36{\%}) of 11, 0 (0{\%}) of 8, and 0 (0{\%}) of 5 of the lesions that showed CR, PR, SD, or PD by EASL criteria, respectively. EASL CR and WHO response were shown to have ≥85{\%} specificity for predicting complete pathologic necrosis. The κ coefficient for agreement between WHO and EASL was 0.29. EASL and WHO criteria had minimal intermethod agreement. EASL CR and WHO response were able to predict pathologic necrosis.",
keywords = "Hepatocellular cancer, Imaging, Radiologic-pathologic correlation, Transarterial chemoembolization",
author = "Ahsun Riaz and Lewandowski, {Robert J.} and Laura Kulik and Ryu, {Robert K.} and Mulcahy, {Mary F.} and Talia Baker and Vanessa Gates and Ritu Nayar and Ed Wang and Miller, {Frank H.} and Sato, {Kent T.} and Omary, {Reed A.} and Michael Abecassis and Riad Salem",
year = "2010",
month = "12",
day = "1",
doi = "10.1007/s00270-009-9766-5",
language = "English (US)",
volume = "33",
pages = "1143--1152",
journal = "CardioVascular and Interventional Radiology",
issn = "7415-5101",
publisher = "Springer Verlag",
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T1 - Radiologic-pathologic correlation of hepatocellular carcinoma treated with chemoembolization

AU - Riaz, Ahsun

AU - Lewandowski, Robert J.

AU - Kulik, Laura

AU - Ryu, Robert K.

AU - Mulcahy, Mary F.

AU - Baker, Talia

AU - Gates, Vanessa

AU - Nayar, Ritu

AU - Wang, Ed

AU - Miller, Frank H.

AU - Sato, Kent T.

AU - Omary, Reed A.

AU - Abecassis, Michael

AU - Salem, Riad

PY - 2010/12/1

Y1 - 2010/12/1

N2 - To correlate posttreatment radiologic and pathologic findings in patients who underwent transarterial chemoembolization before transplantation or resection. Thirty-five patients with postchemoembolization follow-up imaging underwent liver transplantation/resection. Pre- and posttreatment contrast-enhanced magnetic resonance imaging were used to evaluate radiologic findings. Imaging characteristics using World Health Organization (WHO) and European Association for the Study of the Liver (EASL) criteria after treatment were evaluated. Treated lesions were examined by pathology (gold standard) for the assessment of necrosis. Radiologic findings on magnetic resonance imaging were correlated to pathologic findings to assess the predictability by imaging of actual necrosis. Kappa (κ) statistics were used to determine intermethod agreement between WHO and EASL criteria. Fourteen (40%) of 35 lesions had biopsy-proven hepatocellular carcinoma. Thirteen (37%) of 35 target lesions showed complete pathologic necrosis. Complete pathologic necrosis was seen in 35% of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 1 (100%) of 1, 6 (67%) of 9, 6 (33%) of 18, and 0 (0%) of 7 of the lesions that exhibited complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by WHO criteria, respectively. Complete pathologic necrosis was seen in 9 (82%) of 11, 4 (36%) of 11, 0 (0%) of 8, and 0 (0%) of 5 of the lesions that showed CR, PR, SD, or PD by EASL criteria, respectively. EASL CR and WHO response were shown to have ≥85% specificity for predicting complete pathologic necrosis. The κ coefficient for agreement between WHO and EASL was 0.29. EASL and WHO criteria had minimal intermethod agreement. EASL CR and WHO response were able to predict pathologic necrosis.

AB - To correlate posttreatment radiologic and pathologic findings in patients who underwent transarterial chemoembolization before transplantation or resection. Thirty-five patients with postchemoembolization follow-up imaging underwent liver transplantation/resection. Pre- and posttreatment contrast-enhanced magnetic resonance imaging were used to evaluate radiologic findings. Imaging characteristics using World Health Organization (WHO) and European Association for the Study of the Liver (EASL) criteria after treatment were evaluated. Treated lesions were examined by pathology (gold standard) for the assessment of necrosis. Radiologic findings on magnetic resonance imaging were correlated to pathologic findings to assess the predictability by imaging of actual necrosis. Kappa (κ) statistics were used to determine intermethod agreement between WHO and EASL criteria. Fourteen (40%) of 35 lesions had biopsy-proven hepatocellular carcinoma. Thirteen (37%) of 35 target lesions showed complete pathologic necrosis. Complete pathologic necrosis was seen in 35% of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 1 (100%) of 1, 6 (67%) of 9, 6 (33%) of 18, and 0 (0%) of 7 of the lesions that exhibited complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by WHO criteria, respectively. Complete pathologic necrosis was seen in 9 (82%) of 11, 4 (36%) of 11, 0 (0%) of 8, and 0 (0%) of 5 of the lesions that showed CR, PR, SD, or PD by EASL criteria, respectively. EASL CR and WHO response were shown to have ≥85% specificity for predicting complete pathologic necrosis. The κ coefficient for agreement between WHO and EASL was 0.29. EASL and WHO criteria had minimal intermethod agreement. EASL CR and WHO response were able to predict pathologic necrosis.

KW - Hepatocellular cancer

KW - Imaging

KW - Radiologic-pathologic correlation

KW - Transarterial chemoembolization

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