Using intravoxel incoherent motion (IVIM) MR imaging to predict lipiodol uptake in patients with hepatocellular carcinoma following transcatheter arterial chemoembolization: a preliminary result.
OBJECTIVE
To assess the usefulness of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) for predicting lipiodol uptake in patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).


METHODS
The institutional review board approved this study. 44 HCC patients underwent IVIM-DWI and Gd-EOB-DTPA-enhanced MRI prior to TACE. Using post-TACE CT as a reference standard, each HCC was classified into either lipiodol good uptake (LGU) or poor uptake (LPU) group. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion coefficient (D*), and perfusion fraction (f) in HCC were calculated. Arterial enhancement ratio (AER) and IVIM parameters were compared between those two groups using the Mann-Whitney U test.


RESULTS
Of the 51 HCCs, 37 (72.5%) were LGU group and 14 (27.5%) were LPU group. AER of HCC was significantly higher in LGU than LPU (0.99±0.54 and 0.67±0.45; P=.034). ADC, D, and f values were not significantly different (P=.073, .059, and .196, respectively) between these two groups. D* was significantly elevated in LGU than LPU (48.10±15.33 and 26.75±9.55; P=.001).


CONCLUSIONS
Both AER derived from contrast enhanced MRI and D* values derived from IVIM-DWI for HCC were significantly higher in LGU than in LPU. These parameters would be helpful for predicting the lipiodol uptake.
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Yang Shin
YS
Park
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. Electronic address: chlee86@korea.ac.kr.
Chang Hee
CH
Lee
Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Ji Hoon
JH
Kim
Siemens Healthcare, Seoul, Korea.
In Seong
IS
Kim
Siemens Healthcare, Oncology Application Development, Erlangen, Germany.
Berthold
B
Kiefer
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Tae Seok
TS
Seo
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Kyeong Ah
KA
Kim
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Cheol Min
CM
Park
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004998:Ethiodized Oil / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008113:Liver Neoplasms / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D004998:Ethiodized Oil; D004317:Doxorubicin; D019786:Gadolinium DTPA
DWI; Hepatocellular carcinoma; IVIM; Liver; MRI; TACE