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Purpose <p>Transarterial radioembolization (TARE) is a well-established treatment for unresectable hepatocellular carcinoma (HCC), though its effects on non-tumorous tissue remain a concern. In particular, the prognostic relevance of splenic volume changes after TARE is not fully understood. This study aimed to assess imaging-derived markers—specifically splenic volume dynamics—as predictors of disease progression.</p> Methods <p>We retrospectively analyzed laboratory and imaging data from 73 patients with histologically or imaging-confirmed HCC who underwent TARE with Yttrium-90 (<sup>90</sup>Y) at our institution between January 2012 and September 2022. Inclusion criteria were age ≥ 18 years, availability of baseline and 3-month follow-up imaging, and complete clinical documentation. Patients undergoing liver resection, transplantation, or additional therapies during follow-up were excluded.</p> Results <p>A relative increase in splenic volume at 3 months was the only independent predictor of progression-free survival (PFS), yielding a ROC-AUC of 0.86 (95%-CI: 0.76–0.95). An increase of 18% or more most accurately identified patients with early disease progression (&lt; 12 months) with a sensitivity 0.74 and specificity 0.97, outperforming conventional clinical and laboratory parameters, including two-dimensional craniocaudal spleen measurements.</p> Conclusions <p>Automated splenic volumetry showed superior prognostic value over traditional markers in HCC patients treated with TARE. A post-treatment increase in spleen volume represents an additional, robust, and readily accessible imaging biomarker for early risk stratification and individualized treatment planning.</p>

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Fully automated spleen segmentation predicts progression-free survival in HCC patients following transarterial radioembolization

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月17日

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  • Lisa Steinhelfer,
  • Friederike Jungmann,
  • Lukas Endroes,
  • Manuel Nickel,
  • Noemi Schweizer,
  • Ursula Ehmer,
  • Bernhard Haller,
  • Robert Walter,
  • Christopher Spaeth,
  • Henrik Einwächter,
  • Jannis Bodden,
  • Karina Knorr,
  • Matthias Eiber,
  • Rickmer Braren

摘要

Purpose

Transarterial radioembolization (TARE) is a well-established treatment for unresectable hepatocellular carcinoma (HCC), though its effects on non-tumorous tissue remain a concern. In particular, the prognostic relevance of splenic volume changes after TARE is not fully understood. This study aimed to assess imaging-derived markers—specifically splenic volume dynamics—as predictors of disease progression.

Methods

We retrospectively analyzed laboratory and imaging data from 73 patients with histologically or imaging-confirmed HCC who underwent TARE with Yttrium-90 (90Y) at our institution between January 2012 and September 2022. Inclusion criteria were age ≥ 18 years, availability of baseline and 3-month follow-up imaging, and complete clinical documentation. Patients undergoing liver resection, transplantation, or additional therapies during follow-up were excluded.

Results

A relative increase in splenic volume at 3 months was the only independent predictor of progression-free survival (PFS), yielding a ROC-AUC of 0.86 (95%-CI: 0.76–0.95). An increase of 18% or more most accurately identified patients with early disease progression (< 12 months) with a sensitivity 0.74 and specificity 0.97, outperforming conventional clinical and laboratory parameters, including two-dimensional craniocaudal spleen measurements.

Conclusions

Automated splenic volumetry showed superior prognostic value over traditional markers in HCC patients treated with TARE. A post-treatment increase in spleen volume represents an additional, robust, and readily accessible imaging biomarker for early risk stratification and individualized treatment planning.