Diffusion-weighted imaging of hepatocellular carcinoma before and after transarterial chemoembolization: role in survival prediction and response evaluation

• DOI: 10.1007/s00261-019-02030-2
• Publication Date: 2019-05-08T18:25:06Z
• Authors: Tim A. Labeur; Jurgen H. Runge; Elisabeth G. Klom...; Heinz-Josef Klümpen; R. Bart Takkenberg; Otto M. van Delden
• Keywords: Male; Carcinoma, Hepatocellular; Liver Neoplasms; Middle Aged; Survival Analysis; 03 medical and health sciences; Diffusion Magnetic Resonance Imaging; 0302 clinical medicine; Image Interpretation, Computer-Assisted; Humans; Female; Chemoembolization, Therapeutic; Aged; Retrospective Studies

Survival outcomes of patients with hepatocellular carcinoma (HCC) treated transarterial chemoembolization (TACE) are heterogeneous. Measuring the apparent diffusion coefficient (ADC) using diffusion-weighted imaging (DWI) may improve overall survival prediction.To assess value measuring ADC before and after TACE in predicting survival.A retrospective analysis was performed HCC at a tertiary referral center between 2008 2017. The values changes (ΔADC) lesions (≥ 1 cm) liver parenchyma were assessed by DWI ≤ 3 months first TACE. Pre- post-TACE compared tumor response according to mRECIST correlated (OS) univariable multivariable Cox-regression analysis.A total 89 included, mostly Child-Pugh A (85%) BCLC stage B (53%) median OS 21.7 (95% CI 17.6-25.9). Tumor increased from 1081 mm2/s (IQR 964-1225) 1328 1197-1560) (p < 0.001). Responders showed higher ΔADC than non-responders (26 vs. 14%, p = 0.048). Pre-TACE not significantly associated both analysis, whereas remained an independent predictor OS.mRECIST confirmed as prognostic factor OS, but pre- or measurements not. Response increase non-response.