Diffusion-weighted magnetic resonance imaging to predict response of hepatocellular carcinoma to chemoembolization.
Publication Type | Academic Article |
Authors | Chung J, Naik N, Lewandowski R, Deng J, Mulcahy M, Kulik L, Sato K, Ryu R, Salem R, Larson A, Omary R |
Journal | World J Gastroenterol |
Volume | 16 |
Issue | 25 |
Pagination | 3161-7 |
Date Published | 07/07/2010 |
ISSN | 2219-2840 |
Keywords | Carcinoma, Hepatocellular, Chemoembolization, Therapeutic, Diffusion Magnetic Resonance Imaging, Liver Neoplasms |
Abstract | AIM: To investigate whether intra-procedural diffusion-weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during transcatheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 +/- 11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Anatomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm(2)) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm(2)/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (alpha = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of +/-5%, +/-10%, and +/-15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 +/- 0.29 mm(2)/s vs 1.65 +/- 0.35 x 10(-3) mm(2)/s, P < 0.014). CONCLUSION: Intra-procedural ADC changes of > 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE. |
DOI | 10.3748/wjg.v16.i25.3161 |
PubMed ID | 20593501 |
PubMed Central ID | PMC2896753 |