Computed tomographic perfusion imaging for the prediction of response and survival to transarterial chemoembolization of hepatocellular carcinoma

Purpose: The purpose of this retrospective cohort study was to evaluate the clinical value of computed tomographic perfusion imaging (CTPI) parameters in predicting the response to treatment and overall survival in patients with hepatocellular carcinoma (HCC) treated with drug-eluting beads transarterial chemoembolization (DEBTACE). Methods: Between December 2010 and January 2013 eighteen patients (17 men, 1 woman;mean age 69 5.8 years) with intermediate stage HCC underwent CTPI of the liver prior to treatment with DEBTACE. Treatment response was evaluated on follow-up imaging according to modified Response Evaluation Criteriain Solid Tumors. Pre-treatment CTPI parameters were compared between responders (complete response) and nonresponders (partial response) with a Student t-test. We compared survival times with Kaplan-Meier method. Results: CTPI parameters of responders and nonresponders did not show statistical significant difference. The mean survival time was 25.4 ± 3.2 months (95 % CI: 18.7-32.1). Survival was statistically significantly longer in patients with BF lower than 50.44 ml/100ml/min ( p = 0.033), BV lower than 13.32 ml/100ml ( p = 0.028) and TTP higher than 19.035 s ( p = 0.015). Conclusions: CTPI enables prediction of survival in patients with intermediate stage HCC, treated with DEBTACE based on the pre-treatment values of BF, BV and TTP perfusion parameters. CT perfusion imaging can’t be used to predict treatment response to DEBTACE.