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Predictive values of diffusion-weighted imaging and perfusion-weighted imaging in evaluating the efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma

Authors Lin M, Tian MM, Zhang WP, Xu L, Jin P

Received 11 May 2016

Accepted for publication 3 September 2016

Published 14 November 2016 Volume 2016:9 Pages 7029—7037

DOI https://doi.org/10.2147/OTT.S112555

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Samir Farghaly


Min Lin,1 Man-Man Tian,1 Wei-Ping Zhang,2 Li Xu,1 Ping Jin1

1Department of Radiology, 2Department of Oncology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China

Abstract: This study explored the predictive values of diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) in evaluating the efficacy of transcatheter arterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC). A total of 118 HCC patients treated with TACE were selected from April 2013 to November 2015. T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI), DWI, and PWI were performed on all patients before and after TACE. Efficacy was evaluated according to modified Response Evaluation Criteria in Solid Tumors 1.1. Receiver operating characteristic curve was used to evaluate the diagnostic power of quantitative DWI and PWI parameters in evaluating the efficacy of TACE for HCC patients. Among the 118 HCC patients, there were 17 cases (14.4%) with complete response, 50 cases (42.4%) with partial response, 28 cases (23.7%) with stable disease, and 23 cases (19.5%) with progressive disease. There were 67 patients in the effective group (complete response + partial response) and 51 patients in the ineffective group (stable disease + progressive disease). Before TACE, there were significant differences in maximum tumor diameter (MTD), apparent diffusion coefficient (ADC), slow ADC (Dslow), fast ADC (Dfast), transfer constant of vessel at the maximum level (Ktrans), and rate constant of backflux (Kep) between the effective and ineffective groups (all P<0.05). After TACE, the effective group exhibited lower MTD, Dfast, and Kep and higher ADC and Dslow than the ineffective group (all P<0.05). Tumor regression rate negatively correlated with MTD, Ktrans, Kep, and Dfast but positively correlated with ADC and Dslow. Receiver operating characteristic curve analysis suggested that the area under the curve of ADC, Dslow, Dfast, Ktrans, and Kep were 0.869, 0.833, 0.812, 0.802, and 0.809, respectively. In conclusion, these results suggest that quantitative DWI and PWI parameters might be useful in evaluating the efficacy of TACE in the treatment of HCC patients.

Keywords: hepatocellular carcinoma, transcatheter arterial chemoembolization, diffusion-weighted imaging, perfusion-weighted imaging, efficacy

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