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Enhanced Treatment Assessment for Liver Cancer Using New Imaging Analysis Technique

By MedImaging International staff writers
Posted on 10 Jan 2016

Image: Liver images from before, and after treatment. The bottom-right image shows that less cancer is visible after treatment (Photo courtesy of RSNA).

A study presented at the annual Radiological Society of North America (RSNA 2015) meeting in Chicago USA has shown that a novel MRI analysis technique can significantly speed up the assessment of the effectiveness of liver cancer treatment compared to existing methods.

Hepatocellular Carcinoma (HCC) is the second most deadly cancer worldwide and treatment consists of an image-guided procedure called Transarterial Chemoembolization (TACE). During the procedure chemotherapeutic drugs are delivered to the tumor while at the same time the blood supply to the tumor is blocked. If a patient does not respond to TACE treatment the clinician needs treat them again, or change their therapy, as rapidly as possible. Infiltrative HCC is very difficult to treat after TACE with traditional methods because of the large number of lesions and their ill-defined borders.

The researchers used a new approach developed together with Philips Research North America (Cambridge, MA, USA), called the quantitative European Association for the Study of the Liver (qEASL) technique. The new 3D technology provides whole liver volumetric enhancement quantification on Magnetic Resonance Imaging (MRI) and enables a radiologist to segment and delineate an entire tumor in 15–20 seconds in a semi-automated process. The researchers assessed 68 liver cancer patients with infiltrative HCC, using the qEASL technique, before their first TACE procedure, and again one month after the procedure. The researchers measured treatment response, and predicted survival, and segmented the entire liver of the patients while identifying tumors. The researchers found that responders had an overall survival rate of around 21 months and a mean 57.8% decrease in enhancing volume. Non-responders had a survival rate of 6.8 months and a 19.1% increase enhancing volume on average.

According to the researchers, the qEASL approach can also be used with modalities such as cone-beam Computed Tomography (CT), Multidetector CT (MDCT), and Single-Photon Emission Computed Tomography (SPECT), and has also been validated for benign brain, and uterine lesions, and might also be applicable for systemic therapy.

Coauthor of the study, Julius Chapiro, MD, Yale University School of Medicine, said, "In clinical oncology, it is very challenging to assess tumor response to treatment. Up until now, we could measure the extent of tumor diameter or uptake with manual tools like the caliper on the screen, which are highly unreliable due to reader bias. The radiologist can segment the entire tumor with the assistance of the computer. It's a work-flow efficient, semi-automated process that takes 15 to 20 seconds to segment and allows you to delineate the tumor in 3D. The findings show that quantitative tumor enhancement is possible with 3-D qEASL and can predict survival after TACE for infiltrative and multifocal HCC. qEASL is not a diagnostic tool but rather a means of comparing differences before and after treatment to identify non-responders. The earlier the non-responders are identified and treated, the better their outcomes."

Related Links:
Philips Research North America

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67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294762156 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294762156 AND published='1' LIMIT 1

69 (35.04753112793): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (268.93615722656): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (221.96769714355): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (69.856643676758): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (23.841857910156): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (39.815902709961): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (27.179718017578): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.994415283203): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

105 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

106 (50.067901611328): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762156 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (48.160552978516): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762156 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

109 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

110 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294762156 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (412.94097900391): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294762156 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (523.09036254883): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (360.01205444336): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

115 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

116 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

117 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

118 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

119 (37.193298339844): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

120 (227.92816162109): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 17234.086990356): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

123 (45.7763671875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

124 (395.05958557129): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762156 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762156 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 458984.85183716): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (113.96408081055): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (385.99967956543): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (241.99485778809): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (71.048736572266): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (217.19932556152): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (462.05520629883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (398.15902709961): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (224.11346435547): SELECT name FROM jos_deeppockets WHERE id=215

136 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=215

137 (473.0224609375): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (506.87789916992): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (105.85784912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

140 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

141 (!!!!! 8041.1434173584): TRUNCATE TABLE jos_trademed_module

142 (97.990036010742): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762156 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (55.074691772461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294762156 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (869.9893951416): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

147 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

148 (!!!!! 1053.0948638916): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

150 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

151 (161.88621520996): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294762156 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294762156 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (480.89027404785): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (72.956085205078): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (35.04753112793): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

156 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294762156 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294762156 AND published='1' LIMIT 1

157 (126.12342834473): select jos_twitters.link from jos_twitters where cat=10

158 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

159 (27.894973754883): select jos_google_plus.link from jos_google_plus where cat=10

160 (26.941299438477): select jos_linkedin.link from jos_linkedin where cat=10

161 (329.01763916016): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1461.0290527344): insert into jos_banners_delta values (14615,'2025-05-01 16:49:48','18.224.212.19','view'),(14202,'2025-05-01 16:49:48','18.224.212.19','view'),(14203,'2025-05-01 16:49:48','18.224.212.19','view')

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