Baseline parameters of spectral CT could predict tumor response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients

Q3 Medicine Journal of Interventional Medicine Pub Date : 2025-12-01 DOI:10.1016/j.jimed.2023.12.005

Jian Lv , Ronghua Mu , Xiaoyan Qin , Wei Zheng , Peng Yang , Bingqin Huang , Xin Li , Fuzhen Liu , Xiqi Zhu

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Abstract

Objective

The present study aimed to assess the diagnostic efficacy of baseline spectral computed tomography (CT) parameters in predicting tumor response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).

Methods

Data were collected from 91 consecutive patients with HCC between June 2020 and July 2023. An independent samples t-test was performed to compare the demographic and spectral CT variables between the groups. Predictors were screened using binary logistic regression, and the diagnostic efficacy of the baseline parameters for predicting the response to TACE in patients with HCC was analyzed using receiver operating characteristic (ROC) curves.

Results

A total of 91 patients with HCC were included in the present study, categorized into response (n = 52; men, 48 (92.3 %); age, 58.72 ± 11.16 years) and non-response (n = 39; men, 36 (92.31 %); age, 59.50 ± 10.10 years) groups based on the evaluation criteria. There was a statistically significant difference in both iodine concentration (IC) and normalized IC (NIC) between the two groups (P < 0.05), and we found that the mean values of the three IC and NIC phases in the non-response group were significantly lower than those in the response group. The arterial, portal, and delayed phase ICs and NICs had significant positive effects on the response to TACE in patients with HCC (P < 0.05). Baseline spectral CT parameters, including IC and NIC, had satisfactory diagnostic efficacy for predicting tumor response to TACE (area under the curve [AUC] of baseline spectral parameters ranged from 0.698 to 0.879). The results of the DeLong test indicated no statistical differences between the AUC of all the parameters and models.

Conclusion

The present study found that the baseline spectral CT parameters could be surrogate imaging markers for predicting tumor response to TACE.

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光谱 CT 基线参数可预测肝细胞癌患者对经导管动脉化疗栓塞术的肿瘤反应

目的评价基线谱计算机断层扫描（CT）参数在预测肝细胞癌（HCC）患者对经导管动脉化疗栓塞（TACE）的肿瘤反应中的诊断效果。方法收集2020年6月至2023年7月连续91例HCC患者的数据。采用独立样本t检验比较两组间的人口学和光谱CT变量。使用二元logistic回归筛选预测因子，并使用受试者工作特征（ROC）曲线分析预测HCC患者TACE疗效的基线参数的诊断效果。结果本研究共纳入91例HCC患者，分为缓解组（n = 52），男性48例（92.3%）；年龄（58.72±11.16岁）和无反应(n = 39，男性36 (92.31%)；年龄（59.50±10.10岁）按评价标准分组。两组间碘浓度（IC）和归一化碘浓度（NIC）的差异均有统计学意义（P < 0.05），且我们发现无反应组的IC和NIC三个阶段的平均值均显著低于反应组。动脉、门静脉、延迟期ic和nic对HCC患者TACE疗效有显著的正向影响（P < 0.05）。基线光谱CT参数（包括IC和NIC）对预测肿瘤对TACE的反应具有满意的诊断效果（基线光谱参数曲线下面积[AUC]范围为0.698 ~ 0.879）。DeLong检验结果表明，各参数与模型的AUC均无统计学差异。结论CT基线谱参数可作为预测肿瘤TACE疗效的替代影像学指标。

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