Role of magnetic resonance diffusion-weighted imaging in evaluating response after chemoembolization of hepatocellular carcinoma.
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.


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).


CONCLUSIONS
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.
Yuan
Zheng
Z
Department of Radiology, Affiliated Changzheng Hospital, The Second Military Medical University, 415 Feng Yang Road, Shanghai 200003, PR China. yuanzheng0404@163.com
Ye
Xiao-Dan
XD
Dong
Sheng
S
Xu
Li-Chao
LC
Xu
Xue-Yuan
XY
Liu
Shi-Yuan
SY
Xiao
Xiang-Sheng
XS
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome