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  • Title: Role of magnetic resonance diffusion-weighted imaging in evaluating response after chemoembolization of hepatocellular carcinoma.
    Author: Yuan Z, Ye XD, Dong S, Xu LC, Xu XY, Liu SY, Xiao XS.
    Journal: Eur J Radiol; 2010 Jul; 75(1):e9-14. PubMed ID: 19540083.
    Abstract:
    OBJECTIVE: To investigate the value of hepatocellular carcinoma pretreatment apparent diffusion coefficients (ADCs) and its ADCs changes after treatment in predicting and early monitoring the response after chemoembolization. MATERIALS AND METHODS: Twenty-five responding and nine nonresponding hepatocellular carcinoma lesions were prospectively evaluated with magnetic resonance diffusion-weighted imaging in 24 h before and in 48 h after chemoembolization. Quantitative ADC maps were calculated with images with b values of 0 and 500 s/mm(2). RESULTS: Nonresponding lesions had a significantly higher pretreatment mean ADC than did responding lesions (1.726+/-0.323 x 10(-3) mm(2)/s vs.1.294+/-0.18510(-3) mm(2)/s, P< or =0.001). The results of receiver operator characteristic (ROC) analysis for identification of nonresponding lesions showed that threshold ADC value of 1.618 x 10(-3) mm(2)/s had 96.0% sensitivity and 77.8% specificity. After transarterial chemoembolization, responding lesions had a significant increase in %ADC values than did nonresponding lesions (32.63% vs. 5.24%, P=0.025). The results of ROC analysis for identification of responding lesions showed that threshold %ADC value of 16.21% had 72% sensitivity and 100% specificity. No significant change was observed in normal liver parenchyma (P=0.862) and spleen (P=0.052). CONCLUSION: High pretreatment mean ADC value of hepatocellular carcinoma was predictive of poor response to chemoembolization. A significant increase in %ADC value was observed in lesions that responded to chemoembolization.
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