Hassan Ahmed E, Mostafa Radwa E, Nada Ayman, Elazab Mohamed S, Awad Ahmed Sayed, Hamed Ikram M
Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Cairo, Egypt.
Department of Radiology, University of Missouri, USA.
Indian J Radiol Imaging. 2019 Apr-Jun;29(2):195-200. doi: 10.4103/ijri.IJRI_383_18.
To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of residual malignant tumor of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) with drug-eluting beads (DEBs).
Pre-contrast T1, T2, dynamic contrast-enhanced, and respiratory-triggered DW-MRI (b factor 0, 400, and 800 s/mm) were obtained in 60 patients with HCC who underwent tran-sarterial hepatic chemoembolization with DEBs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the DW imaging images. Apparent diffusion coefficients (ADCs) were calculated searching for the optimal cut-off value using the receiver operating characteristic (ROC) curve.
DW-MRI had a sensitivity of 77.1%, a specificity of 60.7%, a PPV of 71.05%, and a NPV of 68%. The difference between the malignant and benign groups' ADC variables was statistically significant ( < 0.003). The ROC curve showed that the area under the curve is C = 0.718 with SE = 0.069 and 95% confidence interval from 0.548 to 0.852.
In our study, we demonstrated that diffusion MRI has limited diagnostic value in the assessment of viable tumor tissue after TACE with DEBs in cases of HCC.
评估弥散加权磁共振成像（DW-MRI）在经动脉化疗栓塞术（TACE）联合药物洗脱微球（DEB）治疗后肝细胞癌（HCC）残留恶性肿瘤检测中的作用。
对60例行DEB经动脉肝化疗栓塞术的HCC患者进行对比前T1、T2、动态对比增强及呼吸触发DW-MRI（b值为0、400和800 s/mm²）检查。计算DW成像图像的灵敏度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。利用受试者工作特征（ROC）曲线计算表观扩散系数（ADC），寻找最佳截断值。
DW-MRI的灵敏度为77.1%，特异度为60.7%，PPV为71.05%，NPV为68%。恶性组与良性组的ADC变量差异具有统计学意义（P<0.003）。ROC曲线显示曲线下面积C = 0.718，标准误SE = 0.069，95%置信区间为0.548至0.852。
在我们的研究中，我们证明了弥散MRI在评估HCC患者DEB-TACE术后存活肿瘤组织方面的诊断价值有限。
