LABORATORY INVESTIGATION Quantitative and Volumetric European Association for the Study of the Liver and Response Evaluation Criteria in Solid Tumors Measurements: Feasibility of a Semiautomated Software Method to Assess Tumor Response after Transcatheter Arterial Chemoembolization MingDe Lin, PhD, Olivier Pellerin, MD, MSc, Nikhil Bhagat, MD, Pramod P. Rao, MD, Romaric Loffroy, MD, PhD, Roberto Ardon, PhD, Benoit Mory, PhD, Diane K. Reyes, BS, and Jean-Franc - ois Geschwind, MD ABSTRACT Purpose: To show that hepatic tumor volume and enhancement pattern measurements can be obtained in a time-efficient and reproducible manner on a voxel-by-voxel basis to provide a true three-dimensional (3D) volumetric assessment. Materials and Methods: Magnetic resonance (MR) imaging data obtained from 20 patients recruited for a single-institution prospective study were retrospectively evaluated. All patients had a diagnosis of hepatocellular carcinoma (HCC) and underwent drug-eluting beads (DEB) transcatheter arterial chemoembolization for the first time. All patients had undergone contrast-enhanced MR imaging before and after DEB transcatheter arterial chemoembolization; poor image quality excluded 3 patients, resulting in a final count of 17 patients. Volumetric RECIST (vRECIST) and quantitative EASL (qEASL) were measured, and segmentation and processing times were recorded. Results: There were 34 scans analyzed. The time for semiautomatic segmentation was 65 seconds  33 (range, 40–200 seconds). vRECIST and qEASL of each tumor were computed o 1 minute for each. Conclusions: Semiautomatic quantitative tumor enhancement (qEASL) and volume (vRECIST) assessment is feasible in a workflow-efficient time frame. Clinical correlation is necessary, but vRECIST and qEASL could become part of the assessment of intraarterial therapy for interventional radiologists. ABBREVIATIONS DEB = drug-eluting beads, EASL = European Association for the Study of the Liver, HCC = hepatocellular carcinoma, mRECIST = modified Response Evaluation Criteria in Solid Tumors, qEASL = quantitative EASL, RECIST = Response Evaluation Criteria in Solid Tumors, 3D = three-dimensional, vRECIST = volumetric RECIST From the Clinical Informatics, Interventional, and Translational Solutions (CIITS) (M.L.), Philips Research North America, Briarcliff Manor, New York; Russell H. Morgan Department of Radiology and Radiological Science (O.P., N.B., P.P.R., R.L., D.K.R., J.-F.G.), Division of Vascular and Interventional Radiology, Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287; and Medisys, Philips Research (R.A., B.M.), Suresnes, France. Received July 10, 2012; final revision received August 23, 2012; accepted August 27, 2012. Address correspondence to J.-F.G.; E-mail: jfg@jhmi.edu From the SIR 2012 Annual Meeting. M.L. is a Philips employee and has research funded in part by Philips and the NIH. O.P. and R.L. have research funded in part by the French Society of Radiology (FSR). N.B. has research funded in part by the NIH. R.A. and B.M. are Philips employees. J.-F.G. is a paid consultant for Biocompatibles, Bayer HealthCare, Guerbet, Nordion, Merit, Abbott, and Jennerex, and has research funded in part by the NIH. Neither of the other authors has identified a conflict of interest. This study was funded by NIH/NCI R01 CA160771, Philips Research North America, Briarcliff Manor, New York, and the French Society of Radiology (SFR). & SIR, 2012 J Vasc Interv Radiol 2012; 23:1629–1637 http://dx.doi.org/10.1016/j.jvir.2012.08.028