The Role of Tumor Vascularity in Predicting Survival after Yttrium-90 Radioembolization for Liver Metastases

Kent T Sato*, Reed A. Omary, Christopher Takehana, Saad Ibrahim, Robert J Lewandowski, Robert K. Ryu, Riad Salem

*Corresponding author for this work

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Purpose: It is unclear what role pretreatment tumor vascularity plays in determining outcomes after yttrium-90 radioembolization. A hypothesis was tested that radiographic vascularity of a tumor does not affect patient survival. Materials and Methods: In this two-institution retrospective study, 137 patients with metastatic liver disease underwent 90Y radioembolization. Primary sites were categorized as colon, neuroendocrine, and other. All patients underwent triphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging, as well as detailed hepatic angiography. Two board-certified interventional radiologists interpreted all images and evaluated them for the presence of enhancement. Median survival times, as well as 1- and 2-year survival rates, were compared between patients with hypervascular and hypovascular tumors on (i) cross-sectional imaging and (ii) angiography with use of the log-rank statistic (α = 0.05). Results: On angiography, 108 patients had hypervascular tumors and 29 had hypovascular tumors. Median survival times for the two subgroups were 300 days and 261 days, respectively (P = .95). On CT, 24 patients had hypervascular tumors and 113 had hypovascular tumors. Median survival times for these subgroups were 306 days and 284 days, respectively (P = .67). Eighty-four patients' tumors that were hypovascular on CT were hypervascular on angiography. There were no statistical differences in survival between patients with hypervascular and hypovascular tumors, regardless if vascularity was defined based on CT or angiography. Conclusions: Radiographic vascular appearance of liver tumors, regardless of imaging modality, does not affect survival after radioembolization. Therefore, hypovascular tumors should not be considered contraindicated for radioembolization.

Original languageEnglish (US)
Pages (from-to)1564-1569
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume20
Issue number12
DOIs
StatePublished - Dec 1 2009

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Yttrium
Neoplasm Metastasis
Survival
Liver
Neoplasms
Angiography
Tomography
Blood Vessels
Liver Diseases
Colon
Survival Rate
Retrospective Studies
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "The Role of Tumor Vascularity in Predicting Survival after Yttrium-90 Radioembolization for Liver Metastases",
abstract = "Purpose: It is unclear what role pretreatment tumor vascularity plays in determining outcomes after yttrium-90 radioembolization. A hypothesis was tested that radiographic vascularity of a tumor does not affect patient survival. Materials and Methods: In this two-institution retrospective study, 137 patients with metastatic liver disease underwent 90Y radioembolization. Primary sites were categorized as colon, neuroendocrine, and other. All patients underwent triphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging, as well as detailed hepatic angiography. Two board-certified interventional radiologists interpreted all images and evaluated them for the presence of enhancement. Median survival times, as well as 1- and 2-year survival rates, were compared between patients with hypervascular and hypovascular tumors on (i) cross-sectional imaging and (ii) angiography with use of the log-rank statistic (α = 0.05). Results: On angiography, 108 patients had hypervascular tumors and 29 had hypovascular tumors. Median survival times for the two subgroups were 300 days and 261 days, respectively (P = .95). On CT, 24 patients had hypervascular tumors and 113 had hypovascular tumors. Median survival times for these subgroups were 306 days and 284 days, respectively (P = .67). Eighty-four patients' tumors that were hypovascular on CT were hypervascular on angiography. There were no statistical differences in survival between patients with hypervascular and hypovascular tumors, regardless if vascularity was defined based on CT or angiography. Conclusions: Radiographic vascular appearance of liver tumors, regardless of imaging modality, does not affect survival after radioembolization. Therefore, hypovascular tumors should not be considered contraindicated for radioembolization.",
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The Role of Tumor Vascularity in Predicting Survival after Yttrium-90 Radioembolization for Liver Metastases. / Sato, Kent T; Omary, Reed A.; Takehana, Christopher; Ibrahim, Saad; Lewandowski, Robert J; Ryu, Robert K.; Salem, Riad.

In: Journal of Vascular and Interventional Radiology, Vol. 20, No. 12, 01.12.2009, p. 1564-1569.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Role of Tumor Vascularity in Predicting Survival after Yttrium-90 Radioembolization for Liver Metastases

AU - Sato, Kent T

AU - Omary, Reed A.

AU - Takehana, Christopher

AU - Ibrahim, Saad

AU - Lewandowski, Robert J

AU - Ryu, Robert K.

AU - Salem, Riad

PY - 2009/12/1

Y1 - 2009/12/1

N2 - Purpose: It is unclear what role pretreatment tumor vascularity plays in determining outcomes after yttrium-90 radioembolization. A hypothesis was tested that radiographic vascularity of a tumor does not affect patient survival. Materials and Methods: In this two-institution retrospective study, 137 patients with metastatic liver disease underwent 90Y radioembolization. Primary sites were categorized as colon, neuroendocrine, and other. All patients underwent triphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging, as well as detailed hepatic angiography. Two board-certified interventional radiologists interpreted all images and evaluated them for the presence of enhancement. Median survival times, as well as 1- and 2-year survival rates, were compared between patients with hypervascular and hypovascular tumors on (i) cross-sectional imaging and (ii) angiography with use of the log-rank statistic (α = 0.05). Results: On angiography, 108 patients had hypervascular tumors and 29 had hypovascular tumors. Median survival times for the two subgroups were 300 days and 261 days, respectively (P = .95). On CT, 24 patients had hypervascular tumors and 113 had hypovascular tumors. Median survival times for these subgroups were 306 days and 284 days, respectively (P = .67). Eighty-four patients' tumors that were hypovascular on CT were hypervascular on angiography. There were no statistical differences in survival between patients with hypervascular and hypovascular tumors, regardless if vascularity was defined based on CT or angiography. Conclusions: Radiographic vascular appearance of liver tumors, regardless of imaging modality, does not affect survival after radioembolization. Therefore, hypovascular tumors should not be considered contraindicated for radioembolization.

AB - Purpose: It is unclear what role pretreatment tumor vascularity plays in determining outcomes after yttrium-90 radioembolization. A hypothesis was tested that radiographic vascularity of a tumor does not affect patient survival. Materials and Methods: In this two-institution retrospective study, 137 patients with metastatic liver disease underwent 90Y radioembolization. Primary sites were categorized as colon, neuroendocrine, and other. All patients underwent triphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging, as well as detailed hepatic angiography. Two board-certified interventional radiologists interpreted all images and evaluated them for the presence of enhancement. Median survival times, as well as 1- and 2-year survival rates, were compared between patients with hypervascular and hypovascular tumors on (i) cross-sectional imaging and (ii) angiography with use of the log-rank statistic (α = 0.05). Results: On angiography, 108 patients had hypervascular tumors and 29 had hypovascular tumors. Median survival times for the two subgroups were 300 days and 261 days, respectively (P = .95). On CT, 24 patients had hypervascular tumors and 113 had hypovascular tumors. Median survival times for these subgroups were 306 days and 284 days, respectively (P = .67). Eighty-four patients' tumors that were hypovascular on CT were hypervascular on angiography. There were no statistical differences in survival between patients with hypervascular and hypovascular tumors, regardless if vascularity was defined based on CT or angiography. Conclusions: Radiographic vascular appearance of liver tumors, regardless of imaging modality, does not affect survival after radioembolization. Therefore, hypovascular tumors should not be considered contraindicated for radioembolization.

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