title: Intravoxel incoherent motion MRI as a biomarker of sorafenib treatment for advanced hepatocellular carcinoma: a pilot study.
abstract: BACKGROUND
  To evaluate the association between the therapeutic outcomes of sorafenib for advanced hepatocellular carcinoma (HCC) and the parameters of intravoxel incoherent motion (IVIM).
  
  
  METHODS
  Nine patients were evaluated prospectively. All patients were Child-Pugh score A. The mean dimension of the lesion was 32 mm (range: 15-74 mm). MR images were obtained using a 1.5-Tesla superconductive MRI system. Diffusion-weighted imaging was performed under breath-holding using b-values of 0, 50, 100, 150, 200, 400, and 800 s/mm(2). The following IVIM parameters were calculated: apparent diffusion coefficient, true diffusion coefficient (DC), pseudo-diffusion coefficient, and perfusion fraction. MRI was performed before treatment and at 1, 2, and 4 weeks after beginning treatment. Tumor response at 4 weeks was assessed by CT or MRI using modified RECIST. IVIM parameters of the treatment responders and non-responders were compared.
  
  
  RESULTS
  The DC of responders at baseline was significantly higher than that of the non-responders. The sensitivity and specificity, when a DC of 0.8 (10(-3) mm(2)/s) or higher was considered to be a responder, were 100 % and 67 %, respectively. No significant differences were found in the other parameters between the responders and the non-responders. All IVIM parameters of the responders and non-responders did not change significantly after treatment.
  
  
  CONCLUSIONS
  The DC before treatment may be a useful parameter for predicting the therapeutic outcome of sorafenib for advanced HCC.
authors.affiliation: Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. rad_shirota@yahoo.co.jp.
authors.forename: Natsuhiko
authors.initials: N
authors.lastname: Shirota
authors.affiliation: Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. saito-k@tokyo-med.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Saito
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan. sugimoto@tokyo-med.ac.jp.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. takarayrc@yahoo.co.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takara
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan. moriyasu@tokyo-med.ac.jp.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
authors.affiliation: Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. ktokuue@tokyo-med.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Tokuuye
mesh_terms: D000368:Aged; D000465:Algorithms; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015415:Biomarkers; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D012074:Remission Induction; D012680:Sensitivity and Specificity; D000077157:Sorafenib; D016896:Treatment Outcome; D048490:raf Kinases / Q000037:antagonists & inhibitors
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D003287:Contrast Media; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D000077157:Sorafenib; D048490:raf Kinases
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