Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Magdeburg, Germany.
2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
Dig Dis. 2022;40(5):596-606. doi: 10.1159/000520716. Epub 2021 Nov 8.
The goal of this meta-analysis was to assess the apparent diffusion coefficient (ADC) as a pre- and posttreatment (ADC value changes [ΔADC]) predictive imaging biomarker of response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).
Scopus database, Embase database, and MEDLINE library were scanned for connections between pre- and posttreatment ADC values of HCC and response to TACE. Six studies qualified for inclusion. The following parameters were collected: authors, publication year, study design, number of patients, drugs for TACE, mean ADC value, standard deviation, measure method, b values, and Tesla strength. The Quality Assessment of Diagnostic Studies 2 instrument was employed to check the methodological quality of each study. The meta-analysis was performed by utilizing RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance were used to regard heterogeneity. The mean ADC values and 95% confidence intervals were computed.
Six studies (n = 271 patients with 293 HCC nodules) were included. The pretreatment mean ADC in the responder group was 1.20 × 10-3 mm2/s (0.98, 1.42) and 1.14 × 10-3 mm2/s (0.89, 1.39) in the nonresponder group. The analysis of post-TACE ΔADC revealed a threshold of ≥20% to identify treatment responders. No suitable pretreatment ADC threshold to predict therapy response or discriminate between responders and nonresponders before therapy could be discovered.
ΔADC can facilitate early objective response evaluation through post-therapeutic ADC alterations ≥20%. Pretreatment ADC cannot predict response to TACE.
本荟萃分析旨在评估表观扩散系数（ADC）作为经导管动脉化疗栓塞（TACE）治疗前后（ADC 值变化 [ΔADC]）预测肝细胞癌（HCC）患者反应的预测性成像生物标志物。
扫描 Scopus 数据库、Embase 数据库和 MEDLINE 库，以寻找 HCC 的 TACE 治疗前后 ADC 值与反应之间的联系。符合纳入标准的有 6 项研究。收集了以下参数：作者、出版年份、研究设计、患者人数、TACE 药物、平均 ADC 值、标准差、测量方法、b 值和特斯拉强度。采用诊断研究质量评估工具 2 评估每项研究的方法学质量。使用 RevMan 5.3 软件进行荟萃分析。采用 DerSimonian 和 Laird 随机效应模型，采用逆方差法来评估异质性。计算平均 ADC 值及其 95%置信区间。
纳入 6 项研究（n = 271 例 293 个 HCC 结节）。应答组的治疗前平均 ADC 值为 1.20×10-3mm2/s（0.98，1.42），无应答组为 1.14×10-3mm2/s（0.89，1.39）。TACE 后 ΔADC 分析显示，≥20%的阈值可用于识别治疗应答者。治疗前无法发现合适的 ADC 阈值来预测治疗反应或区分治疗应答者和无应答者。
通过治疗后 ADC 变化≥20%，ΔADC 可有助于早期客观反应评估。治疗前 ADC 不能预测 TACE 的反应。
