TY - JOUR
T1 - Analysis of Tumor Burden as a Biomarker for Patient Survival with Neuroendocrine Tumor Liver Metastases Undergoing Intra-Arterial Therapies
T2 - A Single-Center Retrospective Analysis
AU - Miszczuk, Milena
AU - Chapiro, Julius
AU - Do Minh, Duc
AU - van Breugel, Johanna Maria Mijntje
AU - Smolka, Susanne
AU - Rexha, Irvin
AU - Tegel, Bruno
AU - Lin, Ming De
AU - Savic, Lynn Jeanette
AU - Hong, Kelvin
AU - Georgiades, Christos
AU - Nezami, Nariman
N1 - Publisher Copyright:
© 2022, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
PY - 2022/10
Y1 - 2022/10
N2 - Purpose: To assess the value of quantitative analysis of tumor burden on baseline MRI for prediction of survival in patients with neuroendocrine tumor liver metastases (NELM) undergoing intra-arterial therapies. Materials and Methods: This retrospective single-center analysis included 122 patients with NELM who received conventional (n = 74) or drug-eluting beads, (n = 20) chemoembolization and radioembolization (n = 28) from 2000 to 2014. Overall tumor diameter (1D) and area (2D) of up to 3 largest liver lesions were measured on baseline arterially contrast enhanced MR images. Three-dimensional quantitative analysis was performed using the qEASL tool (IntelliSpace Portal Version 8, Philips) to calculate enhancing tumor burden (the ratio between enhancing tumor volume and total liver volume). Based on Q-statistics, patients were stratified into low tumor burden (TB) or high TB. Results: The survival curves were significantly separated between low TB and high TB groups for 1D (p < 0.001), 2D (p < 0.001) and enhancing TB (p = 0.008) measurements, with, respectively, 2.7, 2.6 and 2.2 times longer median overall survival (MOS) in the low TB group (p < 0.001, p < 0.001 and p = 0.008). Multivariate analysis showed that 1D, 2D, and enhancing TB were independent prognostic factors for MOS, with respective hazard ratios of 0.4 (95%CI: 0.2–0.6, p < 0.001), 0.4 (95%CI: 0.3–0.7, p < 0.001) and 0.5 (95%CI: 0.3–0.8, p = 0.003). Conclusion: The overall tumor diameter, overall tumor area, and enhancing tumor burden are strong prognostic factors of overall survival in patients with neuroendocrine tumor liver metastases undergoing intra-arterial therapies.
AB - Purpose: To assess the value of quantitative analysis of tumor burden on baseline MRI for prediction of survival in patients with neuroendocrine tumor liver metastases (NELM) undergoing intra-arterial therapies. Materials and Methods: This retrospective single-center analysis included 122 patients with NELM who received conventional (n = 74) or drug-eluting beads, (n = 20) chemoembolization and radioembolization (n = 28) from 2000 to 2014. Overall tumor diameter (1D) and area (2D) of up to 3 largest liver lesions were measured on baseline arterially contrast enhanced MR images. Three-dimensional quantitative analysis was performed using the qEASL tool (IntelliSpace Portal Version 8, Philips) to calculate enhancing tumor burden (the ratio between enhancing tumor volume and total liver volume). Based on Q-statistics, patients were stratified into low tumor burden (TB) or high TB. Results: The survival curves were significantly separated between low TB and high TB groups for 1D (p < 0.001), 2D (p < 0.001) and enhancing TB (p = 0.008) measurements, with, respectively, 2.7, 2.6 and 2.2 times longer median overall survival (MOS) in the low TB group (p < 0.001, p < 0.001 and p = 0.008). Multivariate analysis showed that 1D, 2D, and enhancing TB were independent prognostic factors for MOS, with respective hazard ratios of 0.4 (95%CI: 0.2–0.6, p < 0.001), 0.4 (95%CI: 0.3–0.7, p < 0.001) and 0.5 (95%CI: 0.3–0.8, p = 0.003). Conclusion: The overall tumor diameter, overall tumor area, and enhancing tumor burden are strong prognostic factors of overall survival in patients with neuroendocrine tumor liver metastases undergoing intra-arterial therapies.
KW - 3D
KW - Intra-arterial therapy
KW - Neuroendocrine tumors
KW - Survival
KW - Tumor burden
KW - Volumetric assessment
KW - qEASL
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U2 - 10.1007/s00270-022-03209-9
DO - 10.1007/s00270-022-03209-9
M3 - Article
C2 - 35941241
AN - SCOPUS:85135749206
SN - 0174-1551
VL - 45
SP - 1494
EP - 1502
JO - Cardiovascular and interventional radiology
JF - Cardiovascular and interventional radiology
IS - 10
ER -