title: Early perfusion changes within 1 week of systemic treatment measured by dynamic contrast-enhanced MRI may predict survival in patients with advanced hepatocellular carcinoma.
abstract: OBJECTIVE
  To correlate early changes in the parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) within 1 week of systemic therapy with overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC).
  
  
  METHODS
  Eighty-nine patients with advanced HCC underwent DCE-MRI before and within 1 week following systemic therapy. The relative changes of six DCE-MRI parameters (Peak, Slope, AUC, Ktrans, Kep and Ve) of the tumours were correlated with OS using the Kaplan-Meier model and the double-sided log-rank test.
  
  
  RESULTS
  All patients died and the median survival was 174 days. Among the six DCE-MRI parameters, reductions in Peak, AUC, and Ktrans, were significantly correlated with one another. In addition, patients with a high Peak reduction following treatment had longer OS (P = 0.023) compared with those with a low Peak reduction. In multivariate analysis, a high Peak reduction was an independent favourable prognostic factor in all patients [hazard ratio (HR), 0.622; P = 0.038] after controlling for age, sex, treatment methods, tumour size and stage, and Eastern Cooperative Oncology Group performance status.
  
  
  CONCLUSIONS
  Early perfusion changes within 1 week following systemic therapy measured by DCE-MRI may aid in the prediction of the clinical outcome in patients with advanced HCC.
  
  
  CONCLUSIONS
  • DCE-MRI is helpful to evaluate perfusion changes of HCC after systemic treatment. • Early perfusion changes within 1 week after treatment may predict overall survival. • High Peak reduction was an independent favourable prognostic factor after systemic treatment.
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors.forename: Bang-Bin
authors.initials: BB
authors.lastname: Chen
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.|Department of Radiology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yu
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors.forename: Po-Chin
authors.initials: PC
authors.lastname: Liang
authors.affiliation: Department of Oncology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors.forename: Chiun
authors.initials: C
authors.lastname: Hsu
authors.affiliation: Department of Oncology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Hsu
authors.affiliation: Department of Oncology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors.forename: Ann-Lii
authors.initials: AL
authors.lastname: Cheng
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan. ttfshih@ntu.edu.tw.|Department of Medical Imaging, Taipei City Hospital, Taipei City, Taiwan. ttfshih@ntu.edu.tw.|Department of Medical Imaging, National Taiwan University Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan. ttfshih@ntu.edu.tw.
authors.forename: Tiffany Ting-Fang
authors.initials: TT
authors.lastname: Shih
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000453:epidemiology / Q000628:therapy; D003131:Combined Modality Therapy; D003287:Contrast Media / Q000494:pharmacology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008102:Liver Circulation / Q000502:physiology*; D008113:Liver Neoplasms / Q000098:blood supply* / Q000453:epidemiology / Q000628:therapy; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D015995:Prevalence; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Anti-angiogenic treatment; DCE-MRI; Hepatocellular carcinoma; Image biomarker; Quantitative perfusion MRI