{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:22:52Z","timestamp":1787026972857,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020412","name":"Humanitas Research Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020412","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nucl. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction and aim<\/jats:title>\n                    <jats:p>Diagnosis of hepatocellular carcinoma (HCC) often occurs when the disease is unresectable and therapeutic options are limited. The extent of disease and liver function according to Child-Pugh (C-P) classification are the main prognostic factors guiding clinicians in the management of HCC. The integration of albumin-bilirubin (ALBI) grade is emerging to assess liver function on account of its objectivity and reproducibility. Our aim was to investigate the value of the ALBI grade in predicting the outcome in patients treated with transarterial radioembolization (TARE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively enrolled patients with advanced and unresectable HCC treated with TARE in our institution. All patients underwent a preliminary dosimetric study before Yttrium-90 resin microsphere TARE. Barcelona Clinic Liver Cancer (BCLC), C-P, and ALBI scores were established at the time of TARE. Overall survival (OS), progression-free survival (PFS), and survival after TARE were assessed with the Kaplan-Meier method. Survival analyses were stratified according to ALBI grade, C-P, and BCLC classification. Univariate and multivariate Cox proportional regression models determined the association between prognostic factors and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 72 patients were included in the study, showing an OS of 51 months. The ALBI grade identified groups of patients with different prognoses both in the whole cohort and within the C-P classes, especially between ALBI 1 and ALBI 2. This result is confirmed also within BCLC classes. In treatment na\u00efve patients, the ALBI grade was not able to predict outcomes, whereas the presence and degree of portal vein thrombosis (PVT) significantly affected prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ALBI grade provided a more accurate prognostic stratification than the C-P classification in patients with intermediate and advanced HCC treated with TARE. However, the outcome of HCC is affected not only by liver function but also by disease-related characteristics, such as disease burden and degree of PVT. Including the ALBI grade in clinical guidelines may improve the management of patients affected by HCC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnume.2022.934446","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T11:19:39Z","timestamp":1658488779000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["ALBI grade for outcome prediction in patients affected by hepatocellular carcinoma treated with transarterial radioembolization"],"prefix":"10.3389","volume":"2","author":[{"given":"Fabrizia","family":"Gelardi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Rodari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Pini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Zanca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Artesani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Tosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Chiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Sollini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"B1","unstructured":""},{"key":"B2","doi-asserted-by":"publisher","first-page":"68131","DOI":"10.18632\/oncotarget.19245","article-title":"Age-specific sex difference in the incidence of hepatocellular carcinoma in the United States","volume":"8","author":"Liu","year":"2017","journal-title":"Oncotarget."},{"key":"B3","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1053\/j.gastro.2018.08.065","article-title":"Epidemiology and management of hepatocellular carcinoma","volume":"156","author":"Kulik","year":"2019","journal-title":"Gastroenterology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"256","DOI":"10.4254\/wjh.v4.i9.256","article-title":"Natural history of untreatable hepatocellular carcinoma: A retrospective cohort study","volume":"4","author":"Cabibbo","year":"2012","journal-title":"World J Hepatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.jhep.2018.03.019","article-title":"EASL clinical practice guidelines: management of hepatocellular carcinoma","volume":"69","author":"Galle","year":"2018","journal-title":"J Hepatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1055\/s-2007-1007122","article-title":"Prognosis of hepatocellular carcinoma: the BCLC staging classification","volume":"19","author":"Llovet","year":"1999","journal-title":"Semin Liver Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1002\/hep.21980","article-title":"Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis","volume":"47","author":"Carr","year":"2008","journal-title":"Hepatology."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1767","DOI":"10.1002\/hep.27222","article-title":"Epidemiology of hepatocellular carcinoma in the United States: Where are we? Where do we go?","volume":"60","author":"El-Serag","year":"2014","journal-title":"Hepatology."},{"key":"B9","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1200\/JCO.2014.59.0521","article-title":"Addressing the interplay of liver disease and hepatocellular carcinoma on patient survival: The ALBI scoring model","volume":"33","author":"Knox","year":"2015","journal-title":"J Clin Oncol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1002\/bjs.1800600817","article-title":"Transection of the oesophagus for bleeding oesophageal varices","volume":"60","author":"Pugh","year":"1973","journal-title":"Br J Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"100347","DOI":"10.1016\/j.jhepr.2021.100347","article-title":"ALBI grade: evidence for an improved model for liver functional estimation in patients with hepatocellular carcinoma","volume":"3","author":"Demirtas","year":"2021","journal-title":"JHEP Rep."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1111\/jgh.13250","article-title":"Usefulness of albumin\u2013bilirubin grade for evaluation of prognosis of 2584 Japanese patients with hepatocellular carcinoma","volume":"31","author":"Hiraoka","year":"2016","journal-title":"J Gastroenterol Hepatol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1111\/jgh.13291","article-title":"Integration of albumin\u2013bilirubin (ALBI) score into Barcelona Clinic Liver Cancer (BCLC) system for hepatocellular carcinoma","volume":"31","author":"Chan","year":"2016","journal-title":"J Gastroenterol Hepatol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1200\/JCO.2014.57.9151","article-title":"Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach - The albi grade","volume":"33","author":"Johnson","year":"2015","journal-title":"J Clin Oncol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1007\/BF01084369","article-title":"Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours","volume":"23","author":"Ho","year":"1996","journal-title":"Eur J Nucl Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12957-015-0493-x","article-title":"Surgical treatment for hepatocellular carcinoma with portal vein tumor thrombus: A novel classification","volume":"13","author":"Xu","year":"2015","journal-title":"World J Surg Oncol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"385","DOI":"10.3390\/cancers14020385","article-title":"Transarterial radioembolization for unresectable hepatocellular carcinoma: real-life efficacy and safety analysis of Korean patients","volume":"14","author":"Yim","year":"2022","journal-title":"Cancers."},{"key":"B18","doi-asserted-by":"publisher","first-page":"879","DOI":"10.3390\/cancers11060879","article-title":"Prognostic role of albumin, bilirubin, and ALBI scores: analysis of 1000 patients with hepatocellular carcinoma undergoing radioembolization","volume":"11","author":"Antkowiak","year":"2019","journal-title":"Cancers."},{"key":"B19","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1080\/17474124.2020.1748010","article-title":"ALBI versus child-pugh in predicting outcome of patients with HCC: a systematic review","volume":"14","author":"Peng","year":"2020","journal-title":"Expert Rev Gastroenterol Hepatol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1159\/000480256","article-title":"Hepatic function during repeated TACE procedures and prognosis after introducing sorafenib in patients with unresectable hepatocellular carcinoma: multicenter analysis","volume":"35","author":"Hiraoka","year":"2017","journal-title":"Dig Dis."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.1111\/liv.14194","article-title":"A new ALBI-based model to predict survival after transarterial chemoembolization for BCLC stage B hepatocellular carcinoma","volume":"39","author":"Lee","year":"2019","journal-title":"Liver Int."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1007\/s10637-015-0292-9","article-title":"Liver function assessment according to the Albumin-Bilirubin (ALBI) grade in sorafenib-treated patients with advanced hepatocellular carcinoma","volume":"33","author":"Ogasawara","year":"2015","journal-title":"Invest New Drugs."},{"key":"B23","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1038\/bjc.2016.33","article-title":"Long-term impact of liver function on curative therapy for hepatocellular carcinoma: application of the ALBI grade","volume":"114","author":"Toyoda","year":"2016","journal-title":"Br J Cancer"},{"key":"B24","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1002\/bjs.10095","article-title":"Albumin\u2013bilirubin versus Child\u2013Pugh score as a predictor of outcome after liver resection for hepatocellular carcinoma","volume":"103","author":"Wang","year":"2016","journal-title":"Br J Surg."},{"key":"B25","doi-asserted-by":"publisher","first-page":"3794","DOI":"10.3390\/cancers13153794","article-title":"Albi score is a strong predictor of toxicity following sirt for hepatocellular carcinoma","volume":"13","author":"Lescure","year":"2021","journal-title":"Cancers"},{"key":"B26","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1097\/COC.0000000000000384","article-title":"Assessment of the albumin-bilirubin (ALBI) grade as a prognostic indicator for hepatocellular carcinoma patients treated with radioembolization","volume":"41","author":"Gui","year":"2018","journal-title":"Am J Clin Oncol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"840","DOI":"10.21037\/jgo.2018.05.14","article-title":"Using the Albumin-Bilirubin (ALBI) grade as a prognostic marker for radioembolization of hepatocellular carcinoma","volume":"9","author":"Mohammadi","year":"2018","journal-title":"J Gastrointest Oncol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.jvir.2016.03.005","article-title":"Independent analysis of albumin-bilirubin grade in a 765-patient cohort treated with transarterial locoregional therapy for hepatocellular carcinoma","volume":"27","author":"Hickey","year":"2016","journal-title":"J Vasc Intervent Radiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"4315","DOI":"10.2217\/fon-2019-0658","article-title":"Tumor burden and liver function in HCC patient selection for selective internal radiation therapy: SARAH post-hoc study","volume":"16","author":"Palmer","year":"2019","journal-title":"Future Oncol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"158","DOI":"10.4081\/oncol.2020.515","article-title":"Selecting the first line treatment in non-metastatic hepatocellular carcinoma - comparing clinical practice guidelines","volume":"14","author":"Jogi","year":"2020","journal-title":"Oncol Rev."},{"key":"B31","doi-asserted-by":"publisher","first-page":"3290","DOI":"10.1007\/s10620-007-9808-2","article-title":"Hepatocellular carcinoma with portal vein tumor thrombosis: Clinical characteristics, prognosis, and patient survival analysis","volume":"52","author":"Takizawa","year":"2007","journal-title":"Dig Dis Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1016\/j.jhep.2017.12.026","article-title":"Development of a prognostic score to predict response to Yttrium-90 radioembolization for hepatocellular carcinoma with portal vein invasion","volume":"68","author":"Spreafico","year":"2018","journal-title":"J Hepatol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"4360","DOI":"10.3748\/wjg.v25.i31.4360","article-title":"Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: beyond the known frontiers","volume":"25","author":"Cerrito","year":"2019","journal-title":"World J Gastroenterol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s00270-020-02642-y","article-title":"Clinical application of trans-arterial radioembolization in hepatic malignancies in Europe: first results from the prospective multicentre observational Study CIRSE Registry for SIR-Spheres Therapy (CIRT)","volume":"44","author":"Helmberger","year":"2021","journal-title":"Cardiovasc Intervent Radiol."}],"container-title":["Frontiers in Nuclear Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnume.2022.934446\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T11:19:42Z","timestamp":1658488782000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnume.2022.934446\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,22]]},"references-count":34,"alternative-id":["10.3389\/fnume.2022.934446"],"URL":"https:\/\/doi.org\/10.3389\/fnume.2022.934446","relation":{},"ISSN":["2673-8880"],"issn-type":[{"value":"2673-8880","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,22]]},"article-number":"934446"}}