Intra-arterial therapies for liver cancer: assessing tumor response

ABSTRACT

Introduction: Intra-arterial therapies (IATs) play an integral role in the management of unresectable hepatocellular carcinoma and liver metastases. The ability to accurately assess tumor response to intra-arterial therapies is crucial for clinical management. Several one- and two-dimensional manual imaging-based response assessment techniques, based both on tumor size or enhancement, have shown to be highly subjective and merely surrogate for the actual tumor as a whole.

Areas covered: Given the currently existing literature, we will discuss all available tumor assessment techniques and criteria for liver cancer with a strong emphasis on 3D quantitative imaging biomarkers of tumor response in this review.

Expert commentary: The growing role of information technology in medicine has brought about the advent of software-assisted, segmentation-based assessment techniques that address the outstanding issues of a subjective reader and provide for more accurate assessment techniques for the locally treated lesions. Three-dimensional quantitative tumor assessment techniques are superior to one- and two-dimensional measurements. This allows for treatment alterations and more precise targeting, potentially resulting in improved patient outcome.

KEYWORDS:

• 3D
• ADC
• intraarterial therapy
• liver cancer
• qEASL
• RECIST
• tumor response
• tumor staging

Declaration of interest

JF Geschwind has received grant support from Philips Healthcare, BTG, Guerbet, Boston Scientific, Threshold, and the National Institutes of Health. He has been a consultant to Philips Healthcare, BTG, Terumo, Guerbet, Bayer HealthCare, and Boston Scientific. J Chapiro has received grant support from the German-Israeli Foundation for Scientific Research and Development, the Rolf W. Günther Foundation for Radiological Sciences, Philips Healthcare, and Berlin Institute of Health.

J van Breugel received grant support from the Royal Netherlands Academy of Arts and Sciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.