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Abstract #0421

Complete Perilesional Ring on MRI as the indicator of pathological complete response after transarterial therapy for hepatocellular carcinoma

Meihan Duan1, Qiuxia Yang1, Rong Zhang1, Yunfei Yuan2, Jialu Zhang3, and Chuanmiao Xie1
1Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China, 2Hepatology, Sun Yat-sen University Cancer Center, Guangzhou, China, 3MR Research, GE Healthcare, Beijing, China

Synopsis

Keywords: Liver, Treatment Response, pathological complete response, transarterial therapy, mRECIST

Motivation: Identifying pathological complete response (pCR) nodules in hepatocellular carcinoma (HCC) after transarterial therapy is crucial to avoid unnecessary hepatectomy and retain liver function.

Goal(s): To improve the performance in pCR diagnosis beyond current mRECIST method, which has limited precision.

Approach: This study integrated complete perilesional ring features (complete hyper- and hypo-rings) on MR with mRECIST to stratify nodules into hyper-ring, hypo-ring, and no-ring categories.

Results: The ring classification refined pCR prediction, increasing the precision from 75.0% to 85.4% for hyper-ring nodules, while obtaining a lower pCR probability of 56.1% for the no-ring group, allowing more personalized treatment strategies.

Impact: The ring classification provides a more specific pCR probability on the basis of mRECIST, guiding 46.1% nodules with 85.4% pCR possibility to Watch & Wait strategy, and 27.4% nodules with 56.1% pCR possibility to comprehensive treatment by liver surgeon.

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