Abdominal Radiology

, Volume 44, Issue 7, pp 2594–2601 | Cite as

Using principal component analysis for the prediction of tumor response to transarterial chemoembolization

  • Jessica P. MillerEmail author
  • Raja Ramaswamy
  • Olaguoke Akinwande
Interventional Radiology



To quantitate the tumor blush of hepatocellular carcinoma (HCC) at the time of transarterial chemoembolization (TACE) using principal component analysis (PCA), and to correlate the quantitated tumor blush to response to therapy.

Materials and methods

In this proof-of-concept study, 27 primary HCC tumors in 25 patients (18 men, 7 women; mean age 66 years ± 9) were analyzed. We conducted a retrospective analysis of TACE procedures that were performed during March through July of 2017. Digital subtraction angiography (DSA) was combined with PCA to condense spatial and temporal information into a single image. The tumor and liver contrast enhancements were calculated, and the ratio was used to determine the relative vascular enhancement of the tumor. Tumor response to therapy was determined at 1-month post procedure.


Using PCA-generated fluoroscopic imaging (PCA-FI), we quantitated the tumor blush and assigned a vascular enhancement value (VEV) to each tumor. Tumors that responded to treatment (N = 12) had statistically higher VEVs compared with the nonresponders (N = 15), with a mean value of 0.96 ± 0.455 vs. 0.57 ± 0.309, (p = 0.013).


We developed a method for quantitating tumor blush using routine angiographic images. The VEVs calculated using these images may allow for the prediction of tumor response to therapy. This pilot study suggests that there is a correlation between tumor blush intensity and tumor response.


Fluoroscopy Angiogram Quantitative Perfusion TACE Hepatocellular carcinoma 



Jessica Miller was supported by the NIH Medical Scientist Training Program (MSTP) Training Grant: T32 GM007200.


  1. 1.
    Mittal S, El-Serag HB (2013) Epidemiology of HCC: Consider the Population. J Clin Gastroenterol 47:S2–6CrossRefGoogle Scholar
  2. 2.
    Varela M, Real MI, Burrel M, et al. (2007) Chemoembolization of hepatocellular carcinoma with drug eluting beads: Efficacy and doxorubicin pharmacokinetics. J Hepatol 46(3):474–481CrossRefGoogle Scholar
  3. 3.
    Burrel M, Reig M, Forner A, et al. (2012) Survival of patients with hepatocellular carcinoma treated by transarterial chemoembolisation (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design. J Hepatol 56(6):1330–1335Google Scholar
  4. 4.
    Lammer J, Malagari K, Vogl T, et al. (2010) Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: Results of the PRECISION V study. Cardiovasc Intervent Radiol 33(1):41–52CrossRefGoogle Scholar
  5. 5.
    Park HJ, Kin JH, Choi SY, et al. (2017) Prediction of Therapeutic Response of Hepatocellular Carcinoma to Transcatheter Arterial Chemoembolization Based on Pretherapeutic Dynamic CT and Textural Findings. AJR Am J Roentgenol 209(4):W211–W220CrossRefGoogle Scholar
  6. 6.
    Yang L, Zhang XM, Zhou XP, et al. (2010) Correlation between tumor perfusion and lipiodol deposition in hepatocellular carcinoma after transarterial chemoembolization. J Vasc Interv Radiol 21(12):1841–1846CrossRefGoogle Scholar
  7. 7.
    Wold S, Esbensen K, Geladi P (1987) Principal component analysis. Chemom Intellig Lab Syst 2(1–3):37–52CrossRefGoogle Scholar
  8. 8.
    Hillman EM, Moore A (2007) All-optical anatomical co-registration for molecular imaging of small animals using dynamic contrast. Nat Photonics 1(9):526–530CrossRefGoogle Scholar
  9. 9.
    Hillman EM, Amoozegar CB, Wang T, et al. (2011) In vivo optical imaging and dynamic contrast methods for biomedical research. Philos Trans A Math Phys Eng Sci 369(1955):4620–4643CrossRefGoogle Scholar
  10. 10.
    Miller JP, Wang ST, Orukari I, et al. (2018) Perfusion-based fluorescence imaging method delineates diverse organs and identifies multifocal tumors using generic near-infrared molecular probes. J Biophotonics 11(4):e201700232CrossRefGoogle Scholar
  11. 11.
    Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30(1):52–60CrossRefGoogle Scholar
  12. 12.
    Wimmer T, Steiner J, Talakic E, et al. (2017) Computed Tomography Perfusion Following Transarterial Chemoembolization of Hepatocellular Carcinoma: A Feasibility Study in the Early Period. J Comput Assist Tomogr 41(5):708–712CrossRefGoogle Scholar
  13. 13.
    Tamandl D, Waneck F, Sieghart W, et al. (2017) Early response evaluation using CT-perfusion one day after transarterial chemoembolization for HCC predicts treatment response and long-term disease control. Eur J Radiol 90:73–80CrossRefGoogle Scholar
  14. 14.
    Yang K, Zhang XM, Yang L, et al. (2016) Advanced imaging techniques in the therapeutic response of transarterial chemoembolization for hepatocellular carcinoma. World J Gastroenterol 22(20):4835–4847CrossRefGoogle Scholar
  15. 15.
    Taouli B, Johnson RS, Hajdu CH, et al. (2013) Hepatocellular carcinoma: perfusion quantification with dynamic contrast-enhanced MRI. AJR Am J Roentgenol 201(4):795–800CrossRefGoogle Scholar
  16. 16.
    Wang J, Cheng JJ, Huang KY, et al. (2016) Quantitative assessment of angiographic perfusion reduction using color-coded digital subtraction angiography during transarterial chemoembolization. Abdom Radiol 41(3):545–552CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Washington University School of MedicineSt. LouisUSA
  2. 2.Department of Interventional RadiologyWashington University School of MedicineSt. LouisUSA

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