Radiologic-pathologic correlation of hepatocellular carcinoma treated with internal radiation using Yttrium-90 microspheres

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

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

We present the correlation between radiologic and pathologic findings in HCC patients who underwent radioembolization with yttrium-90 (90Y) microspheres prior to resection or transplantation. Thirty-five patients with a total of 38 lesions who underwent liver explantation after 90Y radioembolization were studied. Imaging surrogates following treatment were evaluated; the explants were examined for assessment of necrosis by pathology. The correlation betwen radiologic and histologic findings of the treated lesions was analyzed. Twenty-three of 38 (61%) target lesions showed complete pathologic necrosis. All target lesions demonstrated some degree of histologic necrosis at explant. Complete histologic necrosis was seen in 89% of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 100%, 78%, and 93% of the lesions that were shown to have complete response by European Association for the Study of the Liver (EASL) necrosis criteria, partial response by World Health Organizaton (WHO) criteria, or thin rim enhancement on post-treatment imaging, respectively. In contrast, complete pathologic necrosis was seen in only 52% and 38% of the lesions that showed partial response by EASL criteria and peripheral nodular enhancement, respectively. Conclusion: Post-radioembolization imaging findings of response by EASL and WHO criteria are predictive of the degree of pathologic necrosis. Rim enhancement was an imaging characteristic that correlated well with histologic necrosis.

Original languageEnglish (US)
Pages (from-to)1185-1193
Number of pages9
JournalHepatology
Volume49
Issue number4
DOIs
StatePublished - Jun 24 2009

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Yttrium
Microspheres
Hepatocellular Carcinoma
Necrosis
Radiation
Liver
Transplantation
Pathology

ASJC Scopus subject areas

  • Hepatology

Cite this

@article{9fa0ca0d3ab448388fdf0e0f2cced257,
title = "Radiologic-pathologic correlation of hepatocellular carcinoma treated with internal radiation using Yttrium-90 microspheres",
abstract = "We present the correlation between radiologic and pathologic findings in HCC patients who underwent radioembolization with yttrium-90 (90Y) microspheres prior to resection or transplantation. Thirty-five patients with a total of 38 lesions who underwent liver explantation after 90Y radioembolization were studied. Imaging surrogates following treatment were evaluated; the explants were examined for assessment of necrosis by pathology. The correlation betwen radiologic and histologic findings of the treated lesions was analyzed. Twenty-three of 38 (61{\%}) target lesions showed complete pathologic necrosis. All target lesions demonstrated some degree of histologic necrosis at explant. Complete histologic necrosis was seen in 89{\%} of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 100{\%}, 78{\%}, and 93{\%} of the lesions that were shown to have complete response by European Association for the Study of the Liver (EASL) necrosis criteria, partial response by World Health Organizaton (WHO) criteria, or thin rim enhancement on post-treatment imaging, respectively. In contrast, complete pathologic necrosis was seen in only 52{\%} and 38{\%} of the lesions that showed partial response by EASL criteria and peripheral nodular enhancement, respectively. Conclusion: Post-radioembolization imaging findings of response by EASL and WHO criteria are predictive of the degree of pathologic necrosis. Rim enhancement was an imaging characteristic that correlated well with histologic necrosis.",
author = "Ahsun Riaz and Laura Kulik and Lewandowski, {Robert J.} and Ryu, {Robert K.} and Spear, {Georgia Giakoumis} and Mulcahy, {Mary F.} and Michael Abecassis and Talia Baker and Vanessa Gates and Ritu Nayar and Miller, {Frank H.} and Sato, {Kent T.} and Omary, {Reed A.} and Riad Salem",
year = "2009",
month = "6",
day = "24",
doi = "10.1002/hep.22747",
language = "English (US)",
volume = "49",
pages = "1185--1193",
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Radiologic-pathologic correlation of hepatocellular carcinoma treated with internal radiation using Yttrium-90 microspheres. / Riaz, Ahsun; Kulik, Laura; Lewandowski, Robert J.; Ryu, Robert K.; Spear, Georgia Giakoumis; Mulcahy, Mary F.; Abecassis, Michael; Baker, Talia; Gates, Vanessa; Nayar, Ritu; Miller, Frank H.; Sato, Kent T.; Omary, Reed A.; Salem, Riad.

In: Hepatology, Vol. 49, No. 4, 24.06.2009, p. 1185-1193.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Radiologic-pathologic correlation of hepatocellular carcinoma treated with internal radiation using Yttrium-90 microspheres

AU - Riaz, Ahsun

AU - Kulik, Laura

AU - Lewandowski, Robert J.

AU - Ryu, Robert K.

AU - Spear, Georgia Giakoumis

AU - Mulcahy, Mary F.

AU - Abecassis, Michael

AU - Baker, Talia

AU - Gates, Vanessa

AU - Nayar, Ritu

AU - Miller, Frank H.

AU - Sato, Kent T.

AU - Omary, Reed A.

AU - Salem, Riad

PY - 2009/6/24

Y1 - 2009/6/24

N2 - We present the correlation between radiologic and pathologic findings in HCC patients who underwent radioembolization with yttrium-90 (90Y) microspheres prior to resection or transplantation. Thirty-five patients with a total of 38 lesions who underwent liver explantation after 90Y radioembolization were studied. Imaging surrogates following treatment were evaluated; the explants were examined for assessment of necrosis by pathology. The correlation betwen radiologic and histologic findings of the treated lesions was analyzed. Twenty-three of 38 (61%) target lesions showed complete pathologic necrosis. All target lesions demonstrated some degree of histologic necrosis at explant. Complete histologic necrosis was seen in 89% of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 100%, 78%, and 93% of the lesions that were shown to have complete response by European Association for the Study of the Liver (EASL) necrosis criteria, partial response by World Health Organizaton (WHO) criteria, or thin rim enhancement on post-treatment imaging, respectively. In contrast, complete pathologic necrosis was seen in only 52% and 38% of the lesions that showed partial response by EASL criteria and peripheral nodular enhancement, respectively. Conclusion: Post-radioembolization imaging findings of response by EASL and WHO criteria are predictive of the degree of pathologic necrosis. Rim enhancement was an imaging characteristic that correlated well with histologic necrosis.

AB - We present the correlation between radiologic and pathologic findings in HCC patients who underwent radioembolization with yttrium-90 (90Y) microspheres prior to resection or transplantation. Thirty-five patients with a total of 38 lesions who underwent liver explantation after 90Y radioembolization were studied. Imaging surrogates following treatment were evaluated; the explants were examined for assessment of necrosis by pathology. The correlation betwen radiologic and histologic findings of the treated lesions was analyzed. Twenty-three of 38 (61%) target lesions showed complete pathologic necrosis. All target lesions demonstrated some degree of histologic necrosis at explant. Complete histologic necrosis was seen in 89% of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 100%, 78%, and 93% of the lesions that were shown to have complete response by European Association for the Study of the Liver (EASL) necrosis criteria, partial response by World Health Organizaton (WHO) criteria, or thin rim enhancement on post-treatment imaging, respectively. In contrast, complete pathologic necrosis was seen in only 52% and 38% of the lesions that showed partial response by EASL criteria and peripheral nodular enhancement, respectively. Conclusion: Post-radioembolization imaging findings of response by EASL and WHO criteria are predictive of the degree of pathologic necrosis. Rim enhancement was an imaging characteristic that correlated well with histologic necrosis.

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