Progression evaluation value of ADCs of MR-DWI at different b values before transcatheter arterial chemoembolization in patients with hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Jing ¹ , ZHANG Quan ² , GU Peng ² ,  YUAN Fei ²

1. Department of Outpatient, Characteristic Medical Center of PAPF, Tianjin 300162, P. R. China;
2. Department of Medical Imaging, Characteristic Medical Center of PAPF, Tianjin 300162, P. R. China;

Corresponding author：

YUAN Fei, Email: doctoralisa@163.com

Keywords：

hepatocellular carcinoma; magnetic resonance imaging; transcatheter arterial chemoembolization; apparent diffusion coefficient

DOI：

10.7507/1007-9424.201912126

Video：

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Objective To compare the value of apparent diffusion coefficients (ADCs) of MR-DWI at different b values in evaluating the progression of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).Methods All of 168 patients with HCC who met the inclusion and exclusion criteria and received the TACE for the first time in the Characteristic Medical Center of PAPF were collected retrospectively, who were divided into a stable group and progressive group according to the results of MRI evaluation at the 6th month after the TACE treatment. The clinical and imaging data of the two groups were compared before the TACE treatment. The Cox proportional hazard regression model was used to analyze the risk factors for the disease progression after the TACE treatment. The receiver operating characteristic curve (ROC) was used to analyze the predicting of efficacy evaluation of TACE by the ADC values at different b values.Results Compared with the stable group, the proportions of hepatitis B cirrhosis history, portal vein tumor thrombus, and arteriovenous fistula were higher (P<0.05), and the BCLC stage and Child Pugh grade were worse (P<0.05), and the ADC values were higher (P<0.05) in the progressive group. The results of Cox analysis showed that the ADC values at b=600 and 800 s/mm² before the TACE, history of hepatitis B cirrhosis, portal vein tumor thrombus, arteriovenous fistula, advanced BCLC stage and Child-Pugh grade were the risk factors for the progression at the 6th month after the TACE treatment. When the b value was 800 s/mm², the ADC value had the highest efficacy in predicting the outcome of patients (area under ROC curve was 0.746), and the best diagnostic cut-off point was 1.20×10^–3 mm²/s, the sensitivity was 73.3% and the specificity was 71.8%.Conclusion ADC value of MR-DWI could predict progression after TACE in patients with HCC, and ADC value of 800 s/mm² has a better predictive value for them.

Citation： WANG Jing, ZHANG Quan, GU Peng, YUAN Fei. Progression evaluation value of ADCs of MR-DWI at different b values before transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(10): 1236-1240. doi: 10.7507/1007-9424.201912126 Copy

1.	中华人民共和国卫生和计划生育委员会医政医管局. 原发性肝癌诊疗规范(2017年版). 中华消化外科杂志, 2017, 16(7): 635-647.
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6.	王莉, 赵冬梅, 韩福刚. 磁共振成像评价肝癌TACE术后疗效的应用进展. 中国临床医学影像杂志, 2016, 27(2): 135-137.
7.	梁建业, 史长征, 罗良平. 表观扩散系数对淋巴瘤与良性病变的鉴别作用meta分析. 临床放射学杂志, 2017, 36(4): 461-466.
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12.	韩冰, 祁兴顺, 贾继东. 亚太肝细胞癌管理临床实践指南推荐意见(2017年更新版). 临床肝胆病杂志, 2017, 33(8): 1432-1434.
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15.	张扬, 王黎明, 吴凡, 等. 98例小肝癌患者的临床病理特征及预后分析. 中华肿瘤杂志, 2017, 39(5): 389-394.
16.	郭兵, 杨小李, 舒强, 等. 术前经导管动脉化疗栓塞治疗对BCLC 0-A期肝细胞肝癌患者预后的影响. 中国普外基础与临床杂志, 2019, 26(11): 1284-1288.
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21.	李臻, 张恒辉, 韩新巍, 等. 肝细胞癌TACE术后残留病灶的早期诊断现状与进展. 介入放射学杂志, 2015, 24(11): 1016-1020.
22.	Curvo-Semedo L, Lambregts DM, Maas M, <italic>et al</italic>. Diffusion-weighted MRI in rectal cancer: apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness. J Magn Reson Imaging, 2012, 35(6): 1365-1371.
23.	路欣, 徐凯, 李绍东, 等. 不同b值扩散加权MRI诊断肝脏局灶性病变的初步研究. 中国医学计算机成像杂志, 2013, 19(2): 148-151.
24.	Hao JG, Wang JP, Gu YL, <italic>et al</italic>. Importance of b value in diffusion weighted imaging for the diagnosis of pancreatic cancer. World J Gastroenterol, 2013, 19(39): 6651-6655.

1. 中华人民共和国卫生和计划生育委员会医政医管局. 原发性肝癌诊疗规范(2017年版). 中华消化外科杂志, 2017, 16(7): 635-647.
2. Li K, Wang HT, He YK, <italic>et al</italic>. New idea for treatment strategies for Barcelona Clinic Liver Cancer stages based on a network meta-analysis. Medicine (Baltimore), 2017, 96(20): e6950.
3. Peng Z, Wei M, Chen S, <italic>et al</italic>. Combined transcatheter arterial chemoembolization and radiofrequency ablation <italic>versus </italic>hepatectomy for recurrent hepatocellular carcinoma after initial surgery: a propensity score matching study. Eur Radiol, 2018, 28(8): 3522-3531.
4. 车斯尧, 何龙光, 陈钦寿, 等. 非手术治疗原发性肝癌的现状与进展. 中华肝胆外科杂志, 2016, 22(6): 428-432.
5. Furuta M, Moriguchi M, Okuda K, <italic>et al</italic>. Impact of insufficient response with an increase in tumor number in predicting transcatheter arterial chemoembolization refractoriness for hepatocellular carcinoma. Dig Dis, 2018, 36(5): 385-394.
6. 王莉, 赵冬梅, 韩福刚. 磁共振成像评价肝癌TACE术后疗效的应用进展. 中国临床医学影像杂志, 2016, 27(2): 135-137.
7. 梁建业, 史长征, 罗良平. 表观扩散系数对淋巴瘤与良性病变的鉴别作用meta分析. 临床放射学杂志, 2017, 36(4): 461-466.
8. 中国医师协会介入医师分会. 中国肝细胞癌经动脉化疗栓塞治疗(TACE)临床实践指南. 介入放射学杂志, 2018, 27(12): 1117-1126.
9. Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis, 2010, 30(1): 52-60.
10. 陈万青, 孙可欣, 郑荣寿, 等. 2014年中国分地区恶性肿瘤发病和死亡分析. 中国肿瘤, 2018, 27(1): 1-14.
11. 李静, 祁兴顺, 韩涛, 等. 《2016年美国肝病学会肝细胞癌治疗指南》摘译. 临床肝胆病杂志, 2017, 33(4): 621-622.
12. 韩冰, 祁兴顺, 贾继东. 亚太肝细胞癌管理临床实践指南推荐意见(2017年更新版). 临床肝胆病杂志, 2017, 33(8): 1432-1434.
13. Lv N, Kong Y, Mu L, <italic>et al</italic>. Effect of perioperative parecoxib sodium on postoperative pain control for transcatheter arterial chemoembolization for inoperable hepatocellular carcinoma: a prospective randomized trial. Eur Radiol, 2016, 26(10): 3492-3499.
14. 李飞龙, 杨品, 闫坤, 等. 肝癌TACE术后的影像学评价. 中国CT和MRI杂志, 2017, 15(4): 143-146.
15. 张扬, 王黎明, 吴凡, 等. 98例小肝癌患者的临床病理特征及预后分析. 中华肿瘤杂志, 2017, 39(5): 389-394.
16. 郭兵, 杨小李, 舒强, 等. 术前经导管动脉化疗栓塞治疗对BCLC 0-A期肝细胞肝癌患者预后的影响. 中国普外基础与临床杂志, 2019, 26(11): 1284-1288.
17. Dutta R, Mahato RI. Recent advances in hepatocellular carcinoma therapy. Pharmacol Ther, 2017, 173: 106-117.
18. Chockalingam A, Duran R, Sohn JH, <italic>et al</italic>. Radiologic-pathologic analysis of quantitative 3D tumour enhancement on contrast-enhanced MR imaging: a study of ROI placement. Eur Radiol, 2016, 26(1): 103-113.
19. Malyarenko DI, Newitt D, J Wilmes L, <italic>et al</italic>. Demonstration of nonlinearity bias in the measurement of the apparent diffusion coefficient in multicenter trials. Magn Reson Med, 2016, 75(3): 1312-1323.
20. Nasu K, Kuroki Y, Sekiguchi R, <italic>et al</italic>. Measurement of the apparent diffusion coefficient in the liver: is it a reliable index for hepatic disease diagnosis? Radiat Med, 2006, 24(6): 438-444.
21. 李臻, 张恒辉, 韩新巍, 等. 肝细胞癌TACE术后残留病灶的早期诊断现状与进展. 介入放射学杂志, 2015, 24(11): 1016-1020.
22. Curvo-Semedo L, Lambregts DM, Maas M, <italic>et al</italic>. Diffusion-weighted MRI in rectal cancer: apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness. J Magn Reson Imaging, 2012, 35(6): 1365-1371.
23. 路欣, 徐凯, 李绍东, 等. 不同b值扩散加权MRI诊断肝脏局灶性病变的初步研究. 中国医学计算机成像杂志, 2013, 19(2): 148-151.
24. Hao JG, Wang JP, Gu YL, <italic>et al</italic>. Importance of b value in diffusion weighted imaging for the diagnosis of pancreatic cancer. World J Gastroenterol, 2013, 19(39): 6651-6655.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Progression evaluation value of ADCs of MR-DWI at different b values before transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

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