title: Utility of diffusion-weighted imaging to assess hepatocellular carcinoma viability following transarterial chemoembolization.
abstract: The purpose of the present study was to evaluate whether diffusion-weighted imaging (DWI) can be used to assess hepatocellular carcinoma (HCC) viability following transarterial chemoembolization (TACE). A total of 41 consecutive patients were treated according to chemoembolization protocols. The follow-up was performed between six and eight weeks post-chemoembolization by multidetector computed tomography [or enhanced magnetic resonance imaging (MRI)] and DW-MRI on the same day. The presence of any residual tumor and the extent of tumor necrosis were evaluated according to the European Association for the Study of the Liver. The apparent diffusion coefficient (ADC) values of the entire area of the treated mass and the vital and necrotic tumor tissues were recorded. Correlation coefficients were also calculated to compare the percentage of necrosis with ADC values. The mean ADC values of the necrotic and vital tumor tissues were 2.22±0.31×10-3mm2/sec and 1.42±0.25×10-3mm2/sec, respectively (Mann-Whitney U test, P<0.001). The results from the receiver operating characteristic analysis showed that the threshold ADC value was 1.84×10-3mm2/sec with 92.3% sensitivity and 100% specificity for identifying the necrotic tumor tissues. A significant linear regression correlation was identified between the ADC value of the entire area of the treated mass and the extent of tumor necrosis (r=0.58; P<0.001). In conclusion, DWI can be used to assess HCC viability following TACE.
authors.affiliation: Department of Radiology, Shanghai People's Liberation Army No. 85 Hospital, Shanghai 200052, P.R. China ; Department of Radiology, Fudan University, Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Yuan
authors.affiliation: Department of Radiology, Fudan University, Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Li
authors.affiliation: Department of Radiology, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, P.R. China.
authors.forename: Xiao-Dan
authors.initials: XD
authors.lastname: Ye
authors.affiliation: Department of Radiology, Fudan University, Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors.forename: Wei-Jun
authors.initials: WJ
authors.lastname: Peng
authors.affiliation: Department of Radiology, Changzheng Hospital, The Second Military Medical University, Shanghai 200003, P.R. China.
authors.forename: Xiang-Sheng
authors.initials: XS
authors.lastname: Xiao
keywords: chemoembolization; diffusion-weighted imaging; hepatocellular carcinoma; magnetic resonance imaging