Significance of Apparent Diffusion Coefficient for Pretreatment Prediction of Short-Term Treatment Effect of TACE for Hepatocellular Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGWei-wei ,  SONGBin , HUANGZi-xing , YUANFang , LIZheng-yan

Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding?author：

SONGBin, Email: cjr.songbin@vip.163.com

Keywords：

Hepatocellular carcinoma; Apparent diffusion coefficient; Transcatheter arterial chemoembolization

DOI：

10.7507/1007-9424.20150295

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the significance of apparent diffusion coefficient (ADC value) for pretrea-tment prediction of short-term treatment effect in patients with hepatocellular carcinoma (HCC) who underwent transca-theter arterial chemoembolization (TACE). Methods A total of twelve HCC patients with twenty-three HCC lesions who underwent TACE in our hospital from May. 2014 to May. 2015 were enrolled prospectively, to explore the difference between pre-and post-TACE in diameter of tumor, ADC value of HCC lesions, ADC value of liver parenchyma, and analyze the predictive significance of ADC value of HCC lesions for TACE in treatment of HCC. Results There were no statistical difference between pre-and post-TACE in diameter of HCC lesions and ADC value of liver parenchyma (P=0.635, P=0.473), but the ADC value of HCC lesions was higher after TACE than pre-TACE (P=0.003). After TACE, the area of necrosis in HCC lesions was≥50% in 17 lesions (73.9%, good effect group), and <50% in 6 lesions (26.1%, poor effect group). Compared with poor effect group, ADC values of HCC lesions in good effect group were both higher before and after TACE (P<0.050). Area under ROC curve (AUC value) of ADC value in HCC lesions before TACE for predicting the effect of TACE was 0.690 (95% CI:0.510-0.879), with the sensitivity and specificity of 82.3% (95% CI:65.5%-93.2%) and 53.8% (95% CI:25.1%-80.8%) respectively, and the demarcation point for good effect and poor effect was 1.24×10³ mm²/s. Conclusion This preliminary study demonstrates that the ADC value of HCC lesions before TACE may be a useful indicator to predict early response of TACE in treatment of HCC.

Citation： ZHANGWei-wei, SONGBin, HUANGZi-xing, YUANFang, LIZheng-yan. Significance of Apparent Diffusion Coefficient for Pretreatment Prediction of Short-Term Treatment Effect of TACE for Hepatocellular Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1133-1136. doi: 10.7507/1007-9424.20150295 Copy

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25.	陳炳, 趙振華, 楊建峰, 等. 肝細胞癌磁共振擴散加權成像與腫瘤細胞密度及微血管密度的相關性研究. 腫瘤學雜志, 2015, 21(5):440-442.

1. ?Bruix J, Sala M, Llovet JM. Chemoembolization for hepatocellular carcinoma. Gastroenterology, 2004, 127(5 Suppl 1):S179-S188.
2. Kamel IR, Bluemke DA, Eng J, et al. The role of functional MR ima-ging in the assessment of tumor response after chemoembolization in patients with hepatocellular carcinoma. J Vasc Interv Radiol, 2006, 17(3):505-512.
3. Kamel IR, Bluemke DA, Ramsey D, et al. Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol, 2003, 181(3):708-710.
4. Kamel IR, Reyes DK, Liapi E, et al. Functional MR imaging assess-ment of tumor response after ⁹⁰Y microsphere treatment in patients with unresectable hepatocellular carcinoma. J Vasc Interv Radiol, 2007, 18(1 Pt 1):49-56.
5. Chen CY, Li CW, Kuo YT, et al. Early response of hepatocellular carcinoma to transcatheter arterial chemoembolization:choline levels and MR diffusion constants-initial experience. Radiology, 2006, 239(2):448-456.
6. Deng J, Miller FH, Rhee TK, et al. Diffusion-weighted MR imaging for determination of hepatocellular carcinoma response to yttrium-90 radioembolization. J Vasc Interv Radiol, 2006, 17(7):1195-1200.
7. Mannelli L, Kim S, Hajdu CH, et al. Assessment of tumor necrosis of hepatocellular carcinoma after chemoembolization:diffusion-weighted and contrast-enhanced MRI with histopathologic correla-tion of the explanted liver. AJR Am J Roentgenol, 2009, 193(4):1044-1052.
8. 中華人民共和國衛生部. 原發性肝癌診療規范(2011年版). 臨床肝膽病雜志, 2011, 27(11):1141-1159.
9. Mannelli L, Kim S, Hajdu CH, et al. Serial diffusion-weighted MRI in patients with hepatocellular carcinoma:prediction and assessment of response to transarterial chemoembolization. Preliminary experience. Eur J Radiol, 2013, 82(4):577-582.
10. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med, 2008, 359(4):378-390.
11. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evalua-tion criteria in solid tumours:revised RECIST guideline (version 1.1). Eur J Cancer, 2009, 45(2):228-247.
12. Kamel IR, Liapi E, Reyes DK, et al. Unresectable hepatocellular carcinoma:serial early vascular and cellular changes after transar-terial chemoembolization as detected with MR imaging. Radiology, 2009, 250(2):466-473.
13. Kim H, Morgan DE, Buchsbaum DJ, et al. Early therapy evaluation of combined anti-death receptor 5 antibody and gemcitabine in orthotopic pancreatic tumor xenografts by diffusion-weighted magnetic resonance imaging. Cancer Res, 2008, 68(20):8369-8376.
14. Kim H, Morgan DE, Zeng H, et al. Breast tumor xenografts:diffusion-weighted MR imaging to assess early therapy with novel apoptosis-inducing anti-DR5 antibody. Radiology, 2008, 248(3):844-851.
15. Dong S, Ye XD, Yuan Z, et al. Relationship of apparent diffusion coefficient to survival for patients with unresectable primary hepato-cellular carcinoma after chemoembolization. Eur J Radiol, 2012, 81 (3):472-477.
16. Yuan Z, Ye XD, Dong S, et al. Role of magnetic resonance diffusion-weighted imaging in evaluating response after chemoembolization of hepatocellular carcinoma. Eur J Radiol, 2010, 75(1):e9-e14.
17. 金征宇, 薛華丹. 全身彌散加權成像腫瘤學臨床應用圖譜. 北京:科學出版社, 2009:2-3.
18. Hamstra DA, Lee KC, Tychewicz JM, et al. The use of 19F spectros-copy and diffusion-weighted MRI to evaluate differences in gene-dependent enzyme prodrug therapies. Mol Ther, 2004, 10(5):916-928.
19. Koh DM, Scurr E, Collins D, et al. Predicting response of colorectal hepatic metastasis:value of pretreatment apparent diffusion coeffi-cients. AJR Am J Roentgenol, 2007, 188(4):1001-1008.
20. Cui Y, Zhang XP, Sun YS, et al. Apparent diffusion coefficient:potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases. Radiology, 2008, 248(3):894-900.
21. Kono K, Inoue Y, Nakayama K, et al. The role of diffusion-weighted imaging in patients with brain tumors. AJNR Am J Neuroradiol, 2001, 22(6):1081-1088.
22. Guo AC, Cummings TJ, Dash RC, et al. Lymphomas and high-grade astrocytomas:comparison of water diffusibility and histologic characteristics. Radiology, 2002, 224(1):177-183.
23. Ellingson BM, Malkin MG, Rand SD, et al. Validation of functional diffusion maps (fDMs) as a biomarker for human glioma cellularity. J Magn Reson Imaging, 2010, 31(3):538-548.
24. 莫蕾, 江新青, 陳阿梅, 等. DWI對宮頸癌的診斷及與腫瘤細胞密度相關性的初步研究. 中國CT和MRI雜志, 2011, 9(3):49-52.
25. 陳炳, 趙振華, 楊建峰, 等. 肝細胞癌磁共振擴散加權成像與腫瘤細胞密度及微血管密度的相關性研究. 腫瘤學雜志, 2015, 21(5):440-442.

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Significance of Apparent Diffusion Coefficient for Pretreatment Prediction of Short-Term Treatment Effect of TACE for Hepatocellular Carcinoma

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