MDCT necrosis quantification in the assessment of hepatocellular carcinoma response to yttrium 90 radioembolization therapy: comparison of two-dimensional and volumetric techniques.


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Galizia, MS; Töre, HG; Chalian, H; McCarthy, R; Salem, R; Yaghmai, V

Published Date

  • January 2012

Published In

Volume / Issue

  • 19 / 1

Start / End Page

  • 48 - 54

PubMed ID

  • 22054801

Pubmed Central ID

  • 22054801

Electronic International Standard Serial Number (EISSN)

  • 1878-4046

Digital Object Identifier (DOI)

  • 10.1016/j.acra.2011.09.005


  • eng

Conference Location

  • United States