title: Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging for Prediction of Early Arterial Blood Flow Stasis in Radioembolization of Breast Cancer Liver Metastases.
abstract: OBJECTIVE
  To retrospectively evaluate predictive value of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for early arterial blood flow stasis during transarterial radioembolization (TARE) of liver dominant breast metastases (LdBM).
  
  
  METHODS
  Preinterventional 1.5T DWI (b0, b1, b2 = 0, 50, 800 s/mm(2)) data for 28 liver lobes of 18 female patients treated by resin-based radioembolization (10 bilobar and 8 unilobar treatments) were analyzed. Apparent diffusion coefficient (ADC) (0, 800) and an estimation of the true diffusion coefficient D' and of the perfusion fraction f' were calculated for the 2 largest metastases. Response rate at 3 months and survival were analyzed. Procedures without full dose application because of early stasis were assigned to group A (n = 15), and procedures with full dose application were assigned to group B (n = 13).
  
  
  RESULTS
  Metastases in group A showed significantly lower f' (0.035 ± 0.018 vs 0.076 ± 0.015, P < .0001) and a trend toward lower ADC(0, 800) with values given in 10(-6) mm(2)/s (1,066 ± 141 vs 1,189 ± 176, P = .051); no group difference was shown for D'. Groups were best discriminated by weighted mean f' values of the 2 largest metastases with accuracy of 100%. Mean tumor diameter before and after TARE was 51 mm ± 18 and 50 mm ± 24 in group A and 47 mm ± 27 and 48 mm ± 32 for group B. Imaging response did not differ between groups (P = .545). Overall survival did not differ significantly between group A (230 d) and B (155 d) (P = .124).
  
  
  CONCLUSIONS
  Perfusion-sensitive IVIM parameter f' may predict early blood flow stasis in patients undergoing TARE for LdBM. Determination of this parameter before intervention may increase awareness of the interventionalist and increase safety of microsphere administration.
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany. Electronic address: claus.christian.pieper@ukb.uni-bonn.de.
authors.forename: Claus Christian
authors.initials: CC
authors.lastname: Pieper
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Winfried Albert
authors.initials: WA
authors.lastname: Willinek
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Hojjat
authors.initials: H
authors.lastname: Ahmadzadehfar
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Guido Matthias
authors.initials: GM
authors.lastname: Kukuk
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Alois Martin
authors.initials: AM
authors.lastname: Sprinkart
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Block
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Hans Heinz
authors.initials: HH
authors.lastname: Schild
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Mürtz
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D016208:Databases, Factual; D038524:Diffusion Magnetic Resonance Imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes