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

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7.	梁建業, 史長征, 羅良平. 表觀擴散系數對淋巴瘤與良性病變的鑒別作用meta分析. 臨床放射學雜志, 2017, 36(4): 461-466.
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12.	韓冰, 祁興順, 賈繼東. 亞太肝細胞癌管理臨床實踐指南推薦意見(2017年更新版). 臨床肝膽病雜志, 2017, 33(8): 1432-1434.
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14.	李飛龍, 楊品, 閆坤, 等. 肝癌TACE術后的影像學評價. 中國CT和MRI雜志, 2017, 15(4): 143-146.
15.	張揚, 王黎明, 吳凡, 等. 98例小肝癌患者的臨床病理特征及預后分析. 中華腫瘤雜志, 2017, 39(5): 389-394.
16.	郭兵, 楊小李, 舒強, 等. 術前經導管動脈化療栓塞治療對BCLC 0-A期肝細胞肝癌患者預后的影響. 中國普外基礎與臨床雜志, 2019, 26(11): 1284-1288.
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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, 徐凱, 李紹東, 等. 不同b值擴散加權MRI診斷肝臟局灶性病變的初步研究. 中國醫學計算機成像雜志, 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. 中華人民共和國衛生和計劃生育委員會醫政醫管局. 原發性肝癌診療規范(2017年版). 中華消化外科雜志, 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. 車斯堯, 何龍光, 陳欽壽, 等. 非手術治療原發性肝癌的現狀與進展. 中華肝膽外科雜志, 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, 趙冬梅, 韓福剛. 磁共振成像評價肝癌TACE術后療效的應用進展. 中國臨床醫學影像雜志, 2016, 27(2): 135-137.
7. 梁建業, 史長征, 羅良平. 表觀擴散系數對淋巴瘤與良性病變的鑒別作用meta分析. 臨床放射學雜志, 2017, 36(4): 461-466.
8. 中國醫師協會介入醫師分會. 中國肝細胞癌經動脈化療栓塞治療(TACE)臨床實踐指南. 介入放射學雜志, 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. 陳萬青, 孫可欣, 鄭榮壽, 等. 2014年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2018, 27(1): 1-14.
11. 李靜, 祁興順, 韓濤, 等. 《2016年美國肝病學會肝細胞癌治療指南》摘譯. 臨床肝膽病雜志, 2017, 33(4): 621-622.
12. 韓冰, 祁興順, 賈繼東. 亞太肝細胞癌管理臨床實踐指南推薦意見(2017年更新版). 臨床肝膽病雜志, 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. 李飛龍, 楊品, 閆坤, 等. 肝癌TACE術后的影像學評價. 中國CT和MRI雜志, 2017, 15(4): 143-146.
15. 張揚, 王黎明, 吳凡, 等. 98例小肝癌患者的臨床病理特征及預后分析. 中華腫瘤雜志, 2017, 39(5): 389-394.
16. 郭兵, 楊小李, 舒強, 等. 術前經導管動脈化療栓塞治療對BCLC 0-A期肝細胞肝癌患者預后的影響. 中國普外基礎與臨床雜志, 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, 張恒輝, 韓新巍, 等. 肝細胞癌TACE術后殘留病灶的早期診斷現狀與進展. 介入放射學雜志, 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, 徐凱, 李紹東, 等. 不同b值擴散加權MRI診斷肝臟局灶性病變的初步研究. 中國醫學計算機成像雜志, 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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