Wu Xiao-Ming, Wang Jun-Feng, Ji Jian-Song, Chen Ming-Gao, Song Jian-Gang
Department of Radiology, Jinhua People's Hospital, Jinhua.
Department of Radiology, Lishui Municipal Center Hospital, Lishui, People's Republic of China.
Onco Targets Ther. 2017 Mar 16;10:1637-1643. doi: 10.2147/OTT.S115568. eCollection 2017.
Although the efficacy of transcatheter arterial chemoembolization (TACE) has been recommended as first-line therapy for nonsurgical patients with hepatocellular carcinoma (HCC), it is difficult to accurately predict the efficacy of TACE. Therefore, this study evaluated the efficacy of TACE for HCC using magnetic resonance (MR) diffusion-weighted imaging (DWI). A total of 84 HCC patients who received initial TACE were selected and assigned to the stable group (n=39) and the progressive group (n=45). Before TACE treatment, a contrast-enhanced MR scan and DWI (=300, 600, and 800 s/mm) were performed on all patients. The modified response evaluation criteria in solid tumors were used for evaluation of tumor response. Receiver operating characteristic curve was employed to predict the value of apparent diffusion coefficient (ADC) for TACE efficacy. The ADC values of HCC patients in the progressive group were higher than those in the stable group at different -values (=300, 600, and 800 s/mm) before TACE treatment. The area under the curve of ADC values with -values of 300, 600, and 800 s/mm were 0.693, 0.724, and 0.746; the threshold values were 1.94×10 mm/s, 1.28×10 mm/s, and 1.20×10 mm/s; the sensitivity values were 55.6%, 77.8%, and 73.3%; and the specificity values were 82.1%, 61.5%, and 71.8%, respectively. Our findings indicate that the ADC values of MR-DWI may accurately predict the efficacy of TACE in the treatment of HCC patients.
尽管经动脉化疗栓塞术（TACE）的疗效已被推荐为非手术肝细胞癌（HCC）患者的一线治疗方法，但准确预测TACE的疗效仍很困难。因此，本研究使用磁共振（MR）扩散加权成像（DWI）评估了TACE治疗HCC的疗效。共选择了84例接受初次TACE治疗的HCC患者，并将其分为稳定组（n = 39）和进展组（n = 45）。在TACE治疗前，对所有患者进行了对比增强MR扫描和DWI（= 300、600和800 s/mm²）检查，并采用实体瘤改良反应评估标准评估肿瘤反应。采用受试者操作特征曲线预测表观扩散系数（ADC）对TACE疗效的预测价值。在TACE治疗前，进展组HCC患者在不同b值（= 300、600和800 s/mm²）下的ADC值高于稳定组。b值为300、600和800 s/mm²时ADC值的曲线下面积分别为0.693、0.724和0.746；阈值分别为1.94×10⁻³mm²/s、1.28×10⁻³mm²/s和1.20×10⁻³mm²/s；敏感度分别为55.6%、77.8%和73.3%；特异度分别为82.1%、61.5%和71.8%。我们的研究结果表明，MR-DWI的ADC值可准确预测TACE治疗HCC患者的疗效。
