Department of Radiology, Changzheng Hospital, the Second Military Medical University, 415 Feng Yang Road, Shanghai 200003, PR China.
Eur J Radiol. 2012 Mar;81(3):472-7. doi: 10.1016/j.ejrad.2010.12.081. Epub 2011 Feb 5.
to evaluate the prognostic value of apparent diffusion coefficient (ADC) values from MR diffusion-weighted imaging of unresectable hepatocellular carcinoma after chemoembolization.
our study was proved by our institute and informed consent was obtained from all patients before commencement of the study. Twenty-three patients with unresectable hepatocellular carcinoma were scanned immediately before and after chemoembolization within 24h using conventional anatomical MR imaging and diffusion-weighted imaging, from which ADC values in the lesions were measured. The changes in ADC values after chemoembolization were calculated. The relationship between the lesion ADC and the survival time was analyzed by correlation analysis. The overall cumulative survival was analyzed by the Kaplan-Meier method, and survival curves were compared by the log-rank test.
the mean overall survival period was (25.0±8.7) months. The pre-chemoembolization lesion ADC value was (1.36±0.249)×10(-3) mm2/s; the change in ADC values post-chemoembolization was (0.377±0.332)×10(-3) mm2/s. There were significant linear regression relation between the survival time and pre-chemoembolization lesion ADC values (r=-0.698, P<0.001) or the changes in ADC value post-chemoembolization (r=0.702, P<0.001). And Log-rank test showed that pre-chemoembolization ADC values (χ2=7.339, P=0.007) or the changes in ADC value post-chemoembolization (χ2=9.820, P=0.002) significantly influenced the overall cumulative survival.
Pre-treatment ADC values as well as changes in ADC values after treatment may provide useful information for predicting survival for patients with unresectable hepatocellular carcinoma.
评估经导管肝动脉化疗栓塞术（TACE）前后不可切除肝癌的磁共振扩散加权成像表观扩散系数（ADC）值的预后价值。
本研究经本院伦理委员会批准，所有患者均在研究开始前签署知情同意书。23 例不可切除的肝癌患者在 TACE 治疗前和治疗后 24 小时内进行常规解剖磁共振成像和扩散加权成像扫描，测量病灶 ADC 值。计算 TACE 后 ADC 值的变化。通过相关性分析，分析病灶 ADC 值与生存时间的关系。采用 Kaplan-Meier 法分析总累积生存率，对数秩检验比较生存曲线。
患者的平均总生存时间为（25.0±8.7）个月。TACE 前病灶 ADC 值为（1.36±0.249）×10(-3)mm2/s；TACE 后 ADC 值变化为（0.377±0.332）×10(-3)mm2/s。生存时间与 TACE 前病灶 ADC 值（r=-0.698，P<0.001）或 TACE 后 ADC 值变化（r=0.702，P<0.001）呈显著线性回归关系。Log-rank 检验显示，TACE 前 ADC 值（χ2=7.339，P=0.007）或 TACE 后 ADC 值变化（χ2=9.820，P=0.002）对总累积生存率有显著影响。
治疗前 ADC 值及其治疗后 ADC 值的变化可为预测不可切除肝癌患者的生存提供有价值的信息。
