Response Evaluation of Malignant Liver Lesions after TACE/SIRT: Comparison of Manual and Semi-Automatic Measurement of Different Response Criteria in Multislice CT

Abstract

Purpose To compare measurement precision and interobserver variability in the evaluation of hepatocellular carcinoma (HCC) and liver metastases in MSCT before and after transarterial local ablative therapies. Materials and Methods Retrospective study of 72 patients with malignant liver lesions (42 metastases; 30 HCCs) before and after therapy (43 SIRT procedures; 29 TACE procedures). Established (LAD; SAD; WHO) and vitality-based parameters (mRECIST; mLAD; mSAD; EASL) were assessed manually and semi-automatically by two readers. The relative interobserver difference (RID) and intraclass correlation coefficient (ICC) were calculated. Results The median RID for vitality-based parameters was lower from semi-automatic than from manual measurement of mLAD(manual 12.5%; semi-automatic 3.4%), mSAD(manual 12.7%; semi-automatic 5.7%) and EASL (manual 10.4%; semi-automatic 1.8%). The difference in established parameters was not statistically noticeable (p>0.05). The ICCs of LAD(manual 0.984; semi-automatic 0.982), SAD(manual 0.975; semi-automatic 0.958) and WHO (manual 0.984; semi-automatic 0.978) are high, both in manual and semi-automatic measurements. The ICCs of manual measurements of mLAD(0.897), mSAD(0.844) and EASL (0.875) are lower. This decrease cannot be found in semi-automatic measurements of mLAD(0.997), mSAD(0.992) and EASL (0.998). Conclusion Vitality-based tumor measurements of HCC and metastases after transarterial local therapies should be performed semi-automatically due to greater measurement precision, thus increasing the reproducibility and in turn the reliability of therapeutic decisions. Key points Liver lesion measurements according to EASL and mRECIST are more precise when performed semi-automatically. The higher reproducibility may facilitate a more reliable classification of therapy response. Measurements according to RECIST and WHO offer equivalent precision semi-automatically and manually. Citation Format Höink AJ, Schülke C, Koch R etal. Response Evaluation of Malignant Liver Lesions After TACE/SIRT: Comparison of Manual and Semi-Automatic Measurement of Different Response Criteria in Multislice CT. Fortschr Röntgenstr 2017; 189: 1067-1075