Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe - University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Department of Diagnostic and Interventional Radiology, Kafrelsheikh University, Kafr Elsheikh, Egypt.
Eur Radiol. 2022 May;32(5):3288-3296. doi: 10.1007/s00330-021-08387-7. Epub 2021 Nov 19.
To determine the early treatment response after microwave ablation (MWA) of inoperable lung neoplasms using the apparent diffusion coefficient (ADC) value calculated 24 h after the ablation.
This retrospective study included 47 patients with 68 lung lesions, who underwent percutaneous MWA from January 2008 to December 2017. Evaluation of the lesions was done using MRI including DWI sequence with ADC value calculation pre-ablation and 24 h post-ablation. DWI-MR was performed with b values (50, 400, 800 mm/s). The post-ablation follow-up was performed using chest CT and/or MRI within 24 h following the procedure; after 3, 6, 9, and 12 months; and every 6 months onwards to determine the local tumor response. The post-ablation ADC value changes were compared to the end response of the lesions.
Forty-seven patients (mean age: 63.8 ± 14.2 years, 25 women) with 68 lesions having a mean tumor size of 1.5 ± 0.9 cm (range: 0.7-5 cm) were evaluated. Sixty-one lesions (89.7%) showed a complete treatment response, and the remaining 7 lesions (10.3%) showed a local progression (residual activity). There was a statistically significant difference regarding the ADC value measured 24 h after the ablation between the responding (1.7 ± 0.3 × 10 mm/s) and non-responding groups (1.4 ± 0.3 × 10 mm/s) with significantly higher values in the responding group (p = 0.001). A suggested ADC cut-off value of 1.42 could be used as a reference point for the post-ablation response prediction (sensitivity: 66.67%, specificity: 84.21%, PPV: 66.7%, and NPV: 84.2%). No significant difference was reported regarding the ADC value performed before the ablation as a factor for the prognosis of treatment response (p = 0.86).
ADC value assessment following ablation may allow the early prediction of treatment efficacy after MWA of inoperable lung neoplasms.
• ADC value calculated 24 h post-treatment may allow the early prediction of MWA efficacy as a treatment of pulmonary tumors and can be used in the early immediate post-ablation imaging follow-up. • The pre-treatment ADC value of lung neoplasms is not different between the responding and non-responding tumors.
使用消融后 24 小时计算的表观扩散系数（ADC）值来确定无法手术的肺部肿瘤行微波消融（MWA）后的早期治疗反应。
本回顾性研究纳入了 2008 年 1 月至 2017 年 12 月期间行经皮 MWA 的 47 例 68 个肺部病灶患者。在消融术前和术后 24 小时，使用包括 DWI 序列及 ADC 值计算的 MRI 对病灶进行评估。DWI-MR 采用 b 值（50、400、800mm/s）。消融术后 24 小时内，通过胸部 CT 和/或 MRI 进行即刻随访，术后 3、6、9 和 12 个月进行随访，之后每 6 个月随访一次，以确定局部肿瘤反应。将消融后 ADC 值的变化与病灶的最终反应进行比较。
47 例患者（平均年龄：63.8±14.2 岁，25 例女性）的 68 个病灶平均肿瘤大小为 1.5±0.9cm（范围：0.7-5cm）。61 个病灶（89.7%）表现出完全治疗反应，其余 7 个病灶（10.3%）表现出局部进展（残留活性）。消融后 24 小时 ADC 值在有反应组（1.7±0.3×10mm/s）和无反应组（1.4±0.3×10mm/s）之间存在统计学差异，有反应组的 ADC 值明显更高（p=0.001）。建议将 ADC 截断值为 1.42 作为消融后反应预测的参考点（灵敏度：66.67%，特异性：84.21%，PPV：66.7%，NPV：84.2%）。消融前 ADC 值作为治疗反应预后的因素，其差异无统计学意义（p=0.86）。
消融后 ADC 值评估可能有助于预测无法手术的肺部肿瘤行 MWA 后的早期治疗效果。
• 治疗后 24 小时计算的 ADC 值可早期预测 MWA 疗效，可作为肺部肿瘤的治疗方法，并可用于消融后早期即时影像学随访。• 肺部肿瘤的治疗前 ADC 值在有反应和无反应肿瘤之间没有差异。
