Table 2.
Pre- and dynamic postcontrast imaging appearance of HCC (GTV) successfully treated with SBRT, using explant or AFP response as reference standard
| Subject | Size (cm) | % Change | Arterial hyperenhancement | Wash-out | Pseudocapsule | Lipid | Moderate T2w hyperintensity | Impeded diffusion |
|---|---|---|---|---|---|---|---|---|
| 1 (reference standard: explant shows no viable HCC; baseline AFP 12; AFP before transplant 16); 19 mo from end of SBRT to transplant | ||||||||
| Pre-SBRT | 2.4 | ✔ | ✔ | ✔ | No | ✔ | No | |
| 3 mo | 2.1 | −13 | No | ✔ | ✔ | No | No | No |
| 6 mo | 1.9 | −21 | No | ✔ | No | No | No | No |
| 12 mo | 1.5 | −38 | No | ✔ | No | No | No | No |
| 2 (reference standard: explant shows no viable HCC; baseline AFP 6; AFP before transplant 20); 13 mo from end of SBRT to transplant | ||||||||
| Pre-SBRT | 1.7 | ✔ | ✔ | No | ✔ | No | No | |
| 3 mo | 0.9 | −47 | ✔ | No | No | No | No | No |
| 6 mo | 0.8 | −53 | ✔ | ✔ | No | No | No | No |
| 12 mo | 0.8 | −53 | ✔ | ✔ | No | No | No | No |
| 3 (reference standard: explant shows >90% necrosis of treated HCC; baseline AFP 5.5; AFP before transplant 4.5); 4 mo from end of SBRT to transplant | ||||||||
| Pre-SBRT | 2.0 | ✔ | ✔ | No | No | No | No | |
| 3 mo | 1.9 | −5 | No | No | No | No | No | No |
| 6 mo | - | - | - | - | - | - | - | |
| 12 mo | - | - | - | - | - | - | - | |
| 4 (reference standard: explant shows >90% necrosis of treated HCC; baseline AFP 3; AFP before transplant 3); 12 mo from end of SBRT to transplant | ||||||||
| Pre-SBRT | 4.6 | ✔ | ✔ | No | ✔ | ✔ | ||
| 3 mo | 3.5 | −24 | No | ✔ | No | No | No | No |
| 6 mo | 3.4 | −26 | No | ✔ | No | No | No | No |
| 12 mo | 3.2 | −30 | No | ✔ | No | No | No | No |
| 5 (reference standard: explant shows >90% necrosis of treated HCC; baseline AFP 2; AFP before transplant 2); 7 mo from end of SBRT to transplant | ||||||||
| Pre-SBRT | 1.5 | ✔ | ✔ | ✔ | No | No | No | |
| 3 mo | 1.0 | −33 | Nondiagnostic | ✔ | No | No | No | No |
| 6 mo | 0.9 | −40 | ✔ | ✔ | No | No | No | No |
| 12 mo | - | - | - | - | - | - | - | |
| 6 (reference standard: explant shows no viable HCC; baseline AFP 3; AFP before transplant 2); 3.5 mo from end of SBRT to transplant | ||||||||
| Pre-SBRT | 1.5 | ✔ | ✔ | ✔ | No | No | No | |
| 3 mo | 1.5 | 0 | No | ✔ | ✔ | No | No | No |
| 6 mo | - | - | - | - | - | - | - | |
| 12 mo | - | - | - | - | - | - | - | |
| 7 (reference standard: alfa-fetoprotein response from 25,284 to <2); time to undetectable AFP 9 mo | ||||||||
| Pre-SBRT | 6.4 | ✔ | ✔ | No | No | ✔ | - | |
| 3 mo | 3.4 | −47 | No | ✔ | No | No | ✔ | No |
| 6 mo | 2.9 | −55 | No | ✔ | No | No | No | No |
| 12 mo | 2.7 | −58 | No | ✔ | No | No | No | No |
| 8 (reference standard: alfa-fetoprotein response from 372 to <2); time to undetectable AFP 3 mo | ||||||||
| Pre-SBRT | 7.5 | ✔ | ✔ | ✔ | No | Yes | - | |
| 3 mo | 3.2 | −57 | No | ✔ | ✔ | No | No | No |
| 6 mo | 2.0 | −73 | No | ✔ | ✔ | No | No | No |
| 12 mo | - | - | - | - | - | - | - | |
| 9 (reference standard: alfa-fetoprotein response from 121 to 6); time to decreased AFP 3 mo | ||||||||
| Pre-SBRT | 9.7 | ✔ | ✔ | ✔ | No | ✔ | ✔ | |
| 3 mo | 6.4 | −34 | ✔ | ✔ | No | No | No | No |
| 6 mo | - | - | - | - | - | - | - | |
| 12 mo | - | - | - | - | - | - | - | |
| 10 (reference standard: alfa-fetoprotein response from 80 to 2); time to decreased AFP 6 mo | ||||||||
| Pre-SBRT | 3.3 | ✔ | ✔ | No | - | - | - | |
| 3 mo | - | - | - | - | - | - | - | |
| 6 mo | 2.3 | −30 | ✔ | ✔ | No | - | - | - |
| 12 mo | 1.6 | −52 | No | ✔ | No | - | - | - |
Abbreviations: AFP = alpha-fetoprotein; GTV = gross tumor volume; HCC = hepatocellular carcinoma; SBRT = stereotactic body radiation therapy.
AFP is expressed as ng/mL. Missing data are indicated with (−). “% Change” refers to the percentage change in size compared with the pre-SBRT index examination.