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.
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.