ArticleEuropean journal of nuclear medicine and molecular imaging2026
AI-based tumor and organ volumetry predicts early progression after Y-90 radioembolization in liver-dominant metastatic disease.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeIn patients with liver-dominant metastatic disease undergoing yttrium-90 (⁹⁰Y) transarterial radioembolization (TARE), response assessment remains challenging, particularly in multifocal disease where manual RECIST-based measurements may not adequately reflect overall hepatic tumor burden. In addition, the prognostic relevance of volumetric changes in tumor, liver, and spleen after TARE remains unclear. This retrospective study evaluated automated CT-based whole-liver tumor volumetry as a quantitative imaging biomarker for response assessment and progression risk stratification following TARE.
methodsWe retrospectively analyzed imaging and clinical data from 57 adults with liver-dominant metastatic disease (colorectal, neuroendocrine, uveal melanoma, and breast cancer) treated with yttrium-90 (⁹⁰Y) resin TARE between January 2012 and December 2022. Inclusion criteria were age ≥ 18 years, availability of baseline contrast-enhanced CT imaging, and clinical follow-up. Patients undergoing liver resection, transplantation, or additional locoregional therapies during follow-up were excluded.
resultsBaseline tumor volume was a strong independent predictor of progression-free survival (PFS), demonstrating excellent discriminatory performance (ROC-AUC 0.91; 95% CI 0.82-1.00). A threshold of 270 mL most accurately identified early progression (< 12 months), with a sensitivity of 0.84 and specificity of 0.92. In contrast, lesion count, embolization strategy, and maximum tumor diameter were not significantly associated with PFS.
conclusionsAutomated baseline tumor volumetry demonstrated promising prognostic performance compared with conventional clinical and procedural parameters in patients with liver-dominant metastases treated with ⁹⁰Y TARE. Automated quantification of intrahepatic tumor burden may serve as a useful and readily accessible imaging biomarker for early risk stratification, although external validation is required before clinical implementation.
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