Comparison of RECIST, mRECIST, and Choi Criteria for Early Response Evaluation of Hepatocellular Carcinoma After Transarterial Chemoembolization Using Drug-Eluting Beads

Abstract

Objective To determine appropriate imaging criteria for early response evaluation in patients with hepatocellular carcinoma treated with transarterial chemoembolization (TACE) using drug-eluting beads. Methods Seventy-six patients who underwent TACE with drug-eluting beads as a first-line treatment were included. Responses at 1 month after treatment were evaluated by comparing contrast-enhanced computed tomography or magnetic resonance imaging performed before TACE. Evaluations were performed according to Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST (mRECIST), and Choi criteria. Correlation with progression-free survival (PFS) was compared using the Kaplan-Meier method and log-rank test. Results Modified RECIST yielded a significant difference in PFS across the different response categories (P < 0.01); the Choi criteria exhibited a satisfactory difference in PFS, although the number of nonresponder patients was small (n = 5 [8.6%]). Conclusion Application of mRECIST criteria at the 1-month follow-up computed tomography may be a reliable early predictor of outcome response in patients with hepatocellular carcinoma treated with TACE using drug-eluting beads.