Imaging Technology
Early evaluate the feasibility and reproducibility of sorafenib-targeted therapy for hepatocellular carcinoma by volume measurement approach
Yijie Fang, Jielin Pan, Huifang Lu, Yunping Jiang, Shaolin Li, Wenli Cai, Guobin Hong
Published 2019-02-10
Cite as Chin J Radiol, 2019, 53(2): 133-137. DOI: 10.3760/cma.j.issn.1005-1201.2019.02.010
Abstract
ObjectiveEarly evaluate the feasibility and reproducibility of sorafenib-targeted therapy for hepatocellular carcinoma by RECIST1.1, mRECIST and three-dimensional volume measurement.
MethodsSeventy patients with pathology or typical imaging findings confirmed as hepatocellular carcinoma along with the sorafenib-targeted treatment for more than 2 months between October 2004 to April 2017 in the Fifth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. Patients underwent chest, abdominal and pelvic CT scans and enhanced scans before and after 2 weeks of sorafenib treatment. Two physicians used RECIST 1.1, mRECIST, and volume measurement criteria to evaluate the efficacy of treatment. According to their averaged results, the patients were divided into two groups (control group and non-control group). Kaplan-Meier survival analysis was used to compare the prognostic values between different response evaluation criterias for early predicting the efficacy of sorafenib-targeted therapy in advanced hepatocellular carcinoma. Kappa test was used to assess the efficacy response consistency in intra-group and inter-group.
ResultsBased on mRECIST and RECIST 1.1 measurements, the control group included 34 cases, and the non-control group included 36 cases. Based on semi-automatic volume measurement, the control group included 38 cases, and the non-control group included 32 cases. Before the treatment with sorafenib, the RECIST 1.1 and mRECIST methods were used. There was a high degree of consistency between the two doctors (Kappa values were 0.79 and 0.71, respectively), and the semi-automatic volume measurement method was extremely consistent (Kappa value was 0.90); the consistency in intra-observer by three different methods was extremely high (Kappa values were 0.91, 0.85, 0.97, respectively). After the treatment with sorafenib, the consistency between the two radiologists using RECIST 1.1 measurement was high (Kappa value was 0.65), the consistency of mRECIST measurement was moderate (Kappa value was 0.52), and the consistency of tumor volume measurement was extremely high (Kappa The value was 0.83), the consistency in intra-observer using the above three methods was high or very high (Kappa values were 0.86, 0.74, 0.90, respectively). The RECIST 1.1 and mRECIST measurements were less sensitive in early evaluation of sorafenib-targeted treatment, and there was no significant difference between the control group and the non-control group (P=0.578 and 0.613) while the semi-automatic volumetric measurement was sensitive (P=0.004).
ConclusionSemi-automated three-dimensional volume measurement which has better intra-and inter-group consistency and reproducibility can reflect the efficacy of sorafenib-targeted therapy for hepatocellular carcinoma in early stage.
Key words:
Liver neoplasms; Tumor volume; Response evaluation criteria in solid tumors; Sorafenib
Contributor Information
Yijie Fang
Department of Radiology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
Jielin Pan
Department of Radiology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
Huifang Lu
Department of Radiology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
Yunping Jiang
Department of Radiology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
Shaolin Li
Department of Radiology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
Wenli Cai
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA
Guobin Hong
Department of Radiology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China