title: Serial diffusion-weighted MRI in patients with hepatocellular carcinoma: Prediction and assessment of response to transarterial chemoembolization. Preliminary experience.
abstract: OBJECTIVE
  To assess the role of apparent diffusion coefficient (ADC) measured with diffusion-weighted imaging (DWI) in predicting and assessing response of hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE).
  
  
  METHODS
  Thirty-six patients with cirrhosis and untreated HCC who underwent TACE and MRI within 3 months before and after TACE were assessed. MRI included DWI and contrast-enhanced T1-weighted imaging. Two observers measured ADC of HCCs and liver parenchyma on pre- and post-TACE MRIs and measured degree of tumor necrosis on subtracted post-contrast images on post-TACE MRI. Pre-, post-TACE tumor ADC, and changes in tumor ADC (ΔADC) were compared between lesions stratified by degree of tumor necrosis (measured on post-TACE MRI).
  
  
  RESULTS
  Forty seven HCCs were evaluated (mean size 4.4cm, range 1.0-14.1cm). HCCs with poor and incomplete response to TACE (<50% necrosis on post-TACE MRI) had significantly lower pre-treatment ADC and lower post TACE ADC compared to HCCs with good/complete response (≥50% necrosis): ADC pre-TACE 1.35±0.42 vs. 1.64±0.39×10(-3)mm(2)/s (p=0.042); post-TACE ADC 1.34±0.36 vs. 1.92±0.47 (p=0.0008). There was no difference in ΔADC values.
  
  
  CONCLUSIONS
  This preliminary data suggests that pre-TACE tumor ADC can be used to predict HCC response to TACE.
authors.affiliation: New York University Langone Medical Center, Department of Radiology, 530 First Avenue, New York, NY 10016, USA. mannellilorenzo@yahoo.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Mannelli
authors.forename: Sooah
authors.initials: S
authors.lastname: Kim
authors.forename: Cristina H
authors.initials: CH
authors.lastname: Hajdu
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.forename: Bachir
authors.initials: B
authors.lastname: Taouli
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA