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Evaluation of efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma using magnetic resonance diffusion-weighted imaging

Authors Wu X, Wang J, Ji J, Chen M, Song J

Received 22 June 2016

Accepted for publication 23 November 2016

Published 16 March 2017 Volume 2017:10 Pages 1637—1643

DOI https://doi.org/10.2147/OTT.S115568

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Geoffrey Pietersz

Xiao-Ming Wu,1 Jun-Feng Wang,1 Jian-Song Ji,2 Ming-Gao Chen,1 Jian-Gang Song1

1Department of Radiology, Jinhua People’s Hospital, Jinhua, 2Department of Radiology, Lishui Municipal Center Hospital, Lishui, People’s Republic of China


Abstract: Although the efficacy of transcatheter arterial chemoembolization (TACE) has been recommended as first-line therapy for nonsurgical patients with hepatocellular carcinoma (HCC), it is difficult to accurately predict the efficacy of TACE. Therefore, this study evaluated the efficacy of TACE for HCC using magnetic resonance (MR) diffusion-weighted imaging (DWI). A total of 84 HCC patients who received initial TACE were selected and assigned to the stable group (n=39) and the progressive group (n=45). Before TACE treatment, a contrast-enhanced MR scan and DWI (b=300, 600, and 800 s/mm2) were performed on all patients. The modified response evaluation criteria in solid tumors were used for evaluation of tumor response. Receiver operating characteristic curve was employed to predict the value of apparent diffusion coefficient (ADC) for TACE efficacy. The ADC values of HCC patients in the progressive group were higher than those in the stable group at different b-values (b=300, 600, and 800 s/mm2) before TACE treatment. The area under the curve of ADC values with b-values of 300, 600, and 800 s/mm2 were 0.693, 0.724, and 0.746; the threshold values were 1.94×10-3 mm2/s, 1.28×10-3 mm2/s, and 1.20×10-3 mm2/s; the sensitivity values were 55.6%, 77.8%, and 73.3%; and the specificity values were 82.1%, 61.5%, and 71.8%, respectively. Our findings indicate that the ADC values of MR-DWI may accurately predict the efficacy of TACE in the treatment of HCC patients.

Keywords: magnetic resonance imaging, diffusion-weighted imaging, hepatocellular carcinoma, transcatheter arterial chemoembolization, apparent diffusion coefficient

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