The diffusion-weighted imaging perfusion fraction f is a potential marker of sorafenib treatment in advanced hepatocellular carcinoma: a pilot study.
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.
Lewin
Maïté
M
Departments of Radiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. maite.lewin@sat.aphp.fr
Fartoux
Laetitia
L
Vignaud
Alexandre
A
Arrivé
Lionel
L
Menu
Yves
Y
Rosmorduc
Olivier
O
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
D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib