Intra-arterial therapies for liver cancer: assessing tumor response

Expert Rev Anticancer Ther. 2017 Feb;17(2):119-127. doi: 10.1080/14737140.2017.1273775. Epub 2016 Dec 27.


Intra-arterial therapies (IATs) play an integral role in the management of unresectable hepatocellular carcinoma and liver metastases. The ability to accurately assess tumor response to intra-arterial therapies is crucial for clinical management. Several one- and two-dimensional manual imaging-based response assessment techniques, based both on tumor size or enhancement, have shown to be highly subjective and merely surrogate for the actual tumor as a whole. Areas covered: Given the currently existing literature, we will discuss all available tumor assessment techniques and criteria for liver cancer with a strong emphasis on 3D quantitative imaging biomarkers of tumor response in this review. Expert commentary: The growing role of information technology in medicine has brought about the advent of software-assisted, segmentation-based assessment techniques that address the outstanding issues of a subjective reader and provide for more accurate assessment techniques for the locally treated lesions. Three-dimensional quantitative tumor assessment techniques are superior to one- and two-dimensional measurements. This allows for treatment alterations and more precise targeting, potentially resulting in improved patient outcome.

Keywords: 3D; ADC; RECIST; intraarterial therapy; liver cancer; qEASL; tumor response; tumor staging.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / metabolism
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / methods*
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Infusions, Intra-Arterial
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Treatment Outcome


  • Biomarkers, Tumor