Diagnostic accuracy of intermediate b-value diffusion-weighted imaging for detection of residual hepatocellular carcinoma following transarterial chemoembolization with drug-eluting beads

Ahmed E Hassan; Radwa E Mostafa; Ayman Nada; Mohamed S Elazab; Ahmed Sayed Awad; Ikram M Hamed

doi:10.4103/ijri.IJRI_383_18

Indian Journal of Radiology and Imaging, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(02): 195-200
DOI: 10.4103/ijri.IJRI_383_18

Hepatobiliary and Pancreatic Imaging

Diagnostic accuracy of intermediate b-value diffusion-weighted imaging for detection of residual hepatocellular carcinoma following transarterial chemoembolization with drug-eluting beads

Authors

Ahmed E Hassan

Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Cairo, Egypt
Radwa E Mostafa

Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Cairo, Egypt
Ayman Nada

Department of Radiology, University of Missouri, USA
Mohamed S Elazab

Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Cairo, Egypt
Ahmed Sayed Awad

Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
Ikram M Hamed

Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Cairo, Egypt

Verantwortlicher Herausgeber dieser Rubrik:

Abstract

Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of residual malignant tumor of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) with drug-eluting beads (DEBs). Subjects and Methods: Pre-contrast T1, T2, dynamic contrast–enhanced, and respiratory-triggered DW-MRI (b factor 0, 400, and 800 s/mm²) were obtained in 60 patients with HCC who underwent tran-sarterial hepatic chemoembolization with DEBs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the DW imaging images. Apparent diffusion coefficients (ADCs) were calculated searching for the optimal cut-off value using the receiver operating characteristic (ROC) curve. Results: DW-MRI had a sensitivity of 77.1%, a specificity of 60.7%, a PPV of 71.05%, and a NPV of 68%. The difference between the malignant and benign groups’ ADC variables was statistically significant (P < 0.003). The ROC curve showed that the area under the curve is C = 0.718 with SE = 0.069 and 95% confidence interval from 0.548 to 0.852. Conclusion: In our study, we demonstrated that diffusion MRI has limited diagnostic value in the assessment of viable tumor tissue after TACE with DEBs in cases of HCC.

Keywords

Drug-eluting beads - diffusion-weighted magnetic resonance imaging - hepatocellular carcinoma-transcatheter arterial - chemoembolization; hepatic; malignant

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Referenzen

References
1 Lee S, Park KA, Choi SY. MRI findings and prediction of time to progression of patients with hepatocellular carcinoma treated with drug-eluting bead transcatheter arterial chemoembolization. J Korean Med Sci 2015; 30: 965-73
2 Corona-Villalobos CP, Halappa VG, Geschwind JF, Bonekamp S, Reyes D, Cosgrove D. et al. Volumetric assessment of tumor response using functional MR imaging in patients with hepatocellular carcinoma treated with a combination of doxorubicin-eluting beads and sorafenib. Eur Radiol 2015; 25: 380-90
3 Özkavukcu E, Haliloǧlu N, Erden A. Post-treatment MRI findings of hepatocellular carcinoma. Diagn Interv Radiol 2009; 15: 111-20
4 Kamel IR, Morgan HR. MRI appearance of treated liver lesions. Proc Intl Soc Mag Reson Med 2011; 19
5 Kele PG, van der Jagt EJ. Diffusion weighted imaging in the liver. World J Gastroenterol 2010; 16: 1567-76
6 Kamel IR, Bluemke DA, Eng J, Liapi E, Messersmith W, Reyes DK. et al. The role of functional MR imaging in the assessment of tumor response after chemoembolization in patients with hepatocellular carcinoma. J Vasc Interv Radiol 2006; 17: 505-12
7 Yuan Z, Ye XD, Dong S, Xu LC, Xu XY, Liu SY. et al. Role of magnetic resonance diffusion-weighted imaging in evaluating response after chemoembolization of hepatocellular carcinoma. Eur J Radiol 2010; 75: 9-14
8 Kamel IR, Bluemke DA, Ramsey D, Abusedera M, Torbenson M, Eng J. et al. Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR 2003; 181: 708-10
9 Kartalis N, Lindholm TL, Aspelin P, Permert J, Albiin N. Diffusion-weighted magnetic resonance imaging of pancreas tumours. Eur Radiol 2009; 19: 1981-90
10 Mohamed IY, Medhat MR, Mohamed HF. Role of diffusion-weighted magnetic resonance imaging in the evaluation of hepatocellular carcinoma response to transcatheter arterial chemoembolization using drug eluting beads; correlation with dynamic MRI. Egypt J Radiol Nucl Med 2017; 48: 817-24
11 Osama RM, Abdelmaksoud AH, El Tatawy SA, Nabeel MM, Metwally LI. Role of dynamic contrast-enhanced and diffusion weighted MRI in evaluation of necrosis of hepatocellular carcinoma after chemoembolization. Egypt J Radiol Nucl Med 2013; 44: 737-46
12 Goshima S, Kanematsu M, Kondo H, Yokoyama R, Tsuge Y, Shiratori Y. et al. Evaluating local hepatocellular carcinoma recurrence post-transcatheter arterial chemoembolization: Is diffusion-weighted MRI reliable as an indicator?. J Magn Reson Imaging 2008; 27: 834-9
13 Ludwig JM, Juan C, Kokabi N, Xing M, Kim HS. The role of diffusion-weighted imaging (DWI) in locoregional therapy outcome prediction and response assessment for hepatocellular carcinoma (HCC): The new era of functional imaging biomarkers. Diagnostics (Basel) 2015; 5: 546-63
14 Yu JS, Kim JH, Chung JJ, Kim KW. Added value of diffusion-weighted imaging in the MRI assessment of perilesional tumor recurrence after chemoembolization of hepatocellular carcinomas. J Magn Reson Imaging 2009; 30: 153-60