title: The diffusion-weighted imaging perfusion fraction f is a potential marker of sorafenib treatment in advanced hepatocellular carcinoma: a pilot study.
abstract: OBJECTIVE
  To determine the total Apparent Diffusion Coefficient (ADC), the pure Diffusion coefficient (D) and the perfusion fraction (f) in advanced hepatocellular carcinoma (HCC) under sorafenib treatment.
  
  
  METHODS
  Two target tumors were prospectively analyzed in 12 patients at baseline, 2-weeks and 2-months treatment using b values of 0, 200, 400, 800 s/mm. Repeatability error was estimated on a healthy volunteer.
  
  
  RESULTS
  Lesion sizes, ADC and D values did not significantly change during treatment (overall mean values, respectively, 47.8 ± 31.0 mm, 1.34 ± 0.14 × 10⁻³ mm² s and 1.18 ± 0.22 × 10⁻³ mm²/s). However, f values significantly increased in seven responder patients (+38.39% at 2-weeks, +50.94% at 2-months, P = 0.005) while they decreased in five non responder patients (-41.93% at 2-weeks, P = 0.006). Furthermore, f was inversely correlated with αFP levels (P = 0.032) and responder patients had a higher mean overall survival (OS) than non responder patients (12.29 ± 4.46 vs. 7.80 ± 4.9 months). The % variation of f relative to baseline at 2-months was correlated with OS (P = 0.038) and symptomatic time to progression (P = 0.022).
  
  
  CONCLUSIONS
  Contrary to ADC and D, the perfusion fraction f is a valuable marker of sorafenib treatment in advanced HCC.
authors.affiliation: Departments of Radiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. maite.lewin@sat.aphp.fr
authors.forename: Maïté
authors.initials: M
authors.lastname: Lewin
authors.forename: Laetitia
authors.initials: L
authors.lastname: Fartoux
authors.forename: Alexandre
authors.initials: A
authors.lastname: Vignaud
authors.forename: Lionel
authors.initials: L
authors.lastname: Arrivé
authors.forename: Yves
authors.initials: Y
authors.lastname: Menu
authors.forename: Olivier
authors.initials: O
authors.lastname: Rosmorduc
mesh_terms: D000368:Aged; D000465:Algorithms; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000188:drug therapy*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D010865:Pilot Projects; D011379:Prognosis; D011725:Pyridines / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib