Department of Radiology, Kochi University, Nankoku-shi, Kochi 783-8505, Japan.
Oncol Rep. 2010 Sep;24(3):727-32. doi: 10.3892/or_00000914.
The decision to repeat transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is based on correct evaluation of response to therapy. The purpose of this study was to investigate whether apparent diffusion coefficient (ADC), a quantitative parameter of diffusion-weighted imaging (DWI), can predict early HCC recurrence after TACE. Results obtained using this method were compared with those using iodized-oil computed tomography (CT). DWI was performed on 25 patients with 36 HCCs before and 5-7 days after TACE to calculate the ADC of HCC. Patients were also evaluated with iodized-oil CT immediately after TACE. Contrast-enhanced CT was performed 3 months after TACE to confirm early relapse of HCC lesion. After TACE, the percent change in ADC (%ADC) from before to after therapy was significantly increased in non-relapsed lesions (85.2+/-12.4%) compared to relapsed lesions (8.0+/-56.7%, p=0.0004). However, no difference in area under the curve was seen for receiver operating characteristic analysis to predict early relapse after TACE between %ADC from DWI (95% confidence interval, 0.743-1.026) and iodized-oil CT (95% confidence interval, 0.703-1.016). ADC from DWI can evaluate the efficacy of TACE for HCC as effectively as iodized-oil CT, and may help in deciding whether to repeat TACE.
经导管动脉化疗栓塞（TACE）治疗肝细胞癌（HCC）后是否需要重复治疗取决于对治疗反应的正确评估。本研究旨在探讨扩散加权成像（DWI）的定量参数表观扩散系数（ADC）是否可以预测 TACE 后 HCC 的早期复发。该方法的结果与碘油 CT 的结果进行了比较。对 25 例 36 个 HCC 患者在 TACE 前和 TACE 后 5-7 天进行 DWI 以计算 HCC 的 ADC。患者还在 TACE 后立即接受碘油 CT 评估。在 TACE 后 3 个月进行增强 CT 以确认 HCC 病变的早期复发。TACE 后，与复发病变（8.0+/-56.7%，p=0.0004）相比，未复发病变的 ADC 从治疗前到治疗后的百分比变化（%ADC）（85.2+/-12.4%）明显增加。但是，在预测 TACE 后早期复发的受试者工作特征分析中，DWI 的%ADC（95%置信区间，0.743-1.026）和碘油 CT（95%置信区间，0.703-1.016）之间的曲线下面积没有差异。DWI 的 ADC 可以像碘油 CT 一样有效地评估 TACE 治疗 HCC 的疗效，并可能有助于决定是否重复 TACE。
