title: Diffusion and perfusion MRI prediction of progression-free survival in patients with hepatocellular carcinoma treated with concurrent chemoradiotherapy.
abstract: OBJECTIVE
  To assess whether MR perfusion and diffusion parameters taken before concurrent chemoradiotherapy (CCRT) are useful imaging biomarkers for predicting progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Twenty patients with locally advanced HCC who had no treatment before CCRT underwent dynamic contrast-enhanced (DCE) and diffusion-weighted MRI. Mean values of the volume transfer constant (K(trans) ), reflex constant (Kep ), extravascular extracellular volume fraction (Ve ) and the apparent diffusion coefficient (ADC) were estimated on a region of interest. The best cutoff value for each factor was assessed to differentiate between patients who had PFS shorter or longer than the median PFS. Patients were dichotomized in terms of the cutoff value. The survival outcome of the two groups and the predictive ability of each factor on PFS were evaluated.
  
  
  RESULTS
  Median time to PFS was 179 days. The best cutoff values for ADC, K(trans) , Kep , and Ve was 1.008 × 10(-3) mm(2) s(-1) , 0.108 min(-1) , 0.570 min(-1) , and 0.298%. Patients with higher ADC had significantly longer PFS than those with lower ADC(P < 0.0001).
  
  
  CONCLUSIONS
  The ADC of HCC acquired before CCRT correlated with PFS and was valuable in the prediction of the clinical outcome of HCC treated with CCRT.
authors.affiliation: Department of Radiology, St. Vincent's Hospital, The Catholic University of Korea, Gyeonggi-do, South Korea.
authors.forename: Kyung Ah
authors.initials: KA
authors.lastname: Kim
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Ji
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Ki Whang
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: DCE MRI; apparent diffusion coefficient; concurrent chemoradiotherapy; diffusion-weighted image; hepatocellular carcinoma