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Radiologic–Pathologic Correlation of Hepatocellular Carcinoma Treated with Chemoembolization

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Abstract

To correlate posttreatment radiologic and pathologic findings in patients who underwent transarterial chemoembolization before transplantation or resection. Thirty-five patients with postchemoembolization follow-up imaging underwent liver transplantation/resection. Pre- and posttreatment contrast-enhanced magnetic resonance imaging were used to evaluate radiologic findings. Imaging characteristics using World Health Organization (WHO) and European Association for the Study of the Liver (EASL) criteria after treatment were evaluated. Treated lesions were examined by pathology (gold standard) for the assessment of necrosis. Radiologic findings on magnetic resonance imaging were correlated to pathologic findings to assess the predictability by imaging of actual necrosis. Kappa (κ) statistics were used to determine intermethod agreement between WHO and EASL criteria. Fourteen (40%) of 35 lesions had biopsy-proven hepatocellular carcinoma. Thirteen (37%) of 35 target lesions showed complete pathologic necrosis. Complete pathologic necrosis was seen in 35% of lesions with pretreatment size <3 cm. Complete pathologic necrosis was seen in 1 (100%) of 1, 6 (67%) of 9, 6 (33%) of 18, and 0 (0%) of 7 of the lesions that exhibited complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by WHO criteria, respectively. Complete pathologic necrosis was seen in 9 (82%) of 11, 4 (36%) of 11, 0 (0%) of 8, and 0 (0%) of 5 of the lesions that showed CR, PR, SD, or PD by EASL criteria, respectively. EASL CR and WHO response were shown to have ≥85% specificity for predicting complete pathologic necrosis. The κ coefficient for agreement between WHO and EASL was 0.29. EASL and WHO criteria had minimal intermethod agreement. EASL CR and WHO response were able to predict pathologic necrosis.

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Authors and Affiliations

  1. Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, 676 N St. Clair, Suite 800, Chicago, IL, 60611, USA

    Ahsun Riaz, Robert J. Lewandowski, Robert K. Ryu, Vanessa Gates, Frank H. Miller, Kent T. Sato, Reed A. Omary & Riad Salem

  2. Department of Medicine, Division of Hepatology, Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, 675 N St. Clair, Galter 15-250, Chicago, IL, USA

    Laura Kulik

  3. Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, 676 N St. Clair, Suite 850, Chicago, IL, USA

    Mary F. Mulcahy

  4. Department of Surgery, Division of Transplant Surgery, Northwestern Memorial Hospital, 675 N St. Clair, Galter 17-200, Chicago, IL, USA

    Talia Baker & Michael Abecassis

  5. Department of Pathology, Northwestern Memorial Hospital, 251 E. Huron Street, Feinberg 7-210, Chicago, IL, USA

    Ritu Nayar

  6. Department of Surgery, Division of Transplant Surgery, Northwestern Memorial Hospital, 676 N St. Clair, Suite 600, Chicago, IL, USA

    Ed Wang

  7. Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago, IL, USA

    Riad Salem

Authors
  1. Ahsun Riaz
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  2. Robert J. Lewandowski
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  3. Laura Kulik
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  4. Robert K. Ryu
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  5. Mary F. Mulcahy
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  6. Talia Baker
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  7. Vanessa Gates
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  8. Ritu Nayar
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  9. Ed Wang
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  10. Frank H. Miller
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  11. Kent T. Sato
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  12. Reed A. Omary
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  13. Michael Abecassis
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  14. Riad Salem
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Corresponding author

Correspondence to Riad Salem.

Additional information

Riad Salem and Reed Omary supported in part by NIH R01 CA126809.

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Riaz, A., Lewandowski, R.J., Kulik, L. et al. Radiologic–Pathologic Correlation of Hepatocellular Carcinoma Treated with Chemoembolization. Cardiovasc Intervent Radiol 33, 1143–1152 (2010). https://doi.org/10.1007/s00270-009-9766-5

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  • DOI: https://doi.org/10.1007/s00270-009-9766-5

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