MDCT necrosis quantification in the assessment of hepatocellular carcinoma response to yttrium 90 radioembolization therapy: comparison of two-dimensional and volumetric techniques.
RATIONALE AND OBJECTIVES: The purpose of this study is to evaluate the reproducibility and agreement of tumor necrosis quantification performed by two-dimensional and volumetric methods in a cohort of patients with hepatocellular carcinoma (HCC) treated with yttrium-90 ((90)Y) radioembolization. MATERIALS AND METHODS: Twenty-nine consecutive patients (21 men, 8 women; mean age 66.6 years; age range, 44-90 years) with HCC treated with (90)Y radioembolization that underwent liver multidetector computed tomography (MDCT) were included. Two independent radiologists evaluated the necrosis proportion of the lesions with two-dimensional (2D) measurements according to the European Association for the Study of the Liver guidelines, and with a volumetric method using a voxel-by-voxel analysis. Interobserver reproducibility for each method was assessed by using within-subject coefficients of variation (WSCV), intraclass correlation coefficients (ICC), and Lin's concordance correlation coefficients (LCC). Agreement between both methods was assessed by using the Bland-Altman plot and the paired t-test. RESULTS: The volumetric method was more reproducible (WSCV = 27.8%; ICC = 0.914; LCC = 0.909) than the 2D (WSCV = 43.8%; ICC = 0.723; LCC = 0.841). There was a significant difference in the mean calculated necrosis proportions based on 2D and volumetric methods (P = .0129). CONCLUSION: Voxel-by-voxel quantification of HCC necrosis is a more reproducible method than 2D analysis.
Galizia, MS; Töre, HG; Chalian, H; McCarthy, R; Salem, R; Yaghmai, V
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