OBJECTIVETo evaluate the value of MR diffusion-weighted imaging (DWI) histogram analysis for predicting tumor progression in patients with hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA).

METHODSIn a retrospective study, both 35 stable patients and 38 progressive patients with biopsy-proven HCC underwent breath-hold DWI before RFA treatment. The pre-treatment apparent diffusion coefficient (ADC) values were averaged from the lowest to 10th, 30th, 50th, and 100th percentile using DWI histogram analysis software respectively, and were called ADC10, ADC30, ADC50 and ADC100. The ratios of ADC10, ADC30, ADC50 and ADC100 to mean ADC of non-lesional area were calculated, called RADC10, RADC30, RADC50 and RADC100, respectively.

RESULTSBefore RFA treatment, the ADC30, ADC50, ADC100, RADC30, RADC50 and RADC100 values of the tumors in the progression group were significantly higher than those of the stable group (P < 0.05 for all), respectively. The progression-free survival (PFS) of all patients was (16.0 ± 10.6) months. Univariate Cox regression analysis indicated that RADC10, RADC30, RADC50 values of the tumor were significantly associated with PFS (P < 0.05 for both). In multivariate analysis, only the RADC50 value of tumor was a significant predictor for tumor progression (P < 0.05). When the cut-off value of RADC50 (0.72) was used, the PFS of below the cut-off value group [(30.2 ± 3.0) months] was significantly higher than that of those above the cut-off value group [(20.0 ± 3.1) months] (P = 0.01).

CONCLUSIONSPre-RFA DWI histogram analysis may serve as a biomarker for predicting tumor progression in patients with HCC treated with RFA.

Aged ; Biopsy ; Carcinoma, Hepatocellular ; surgery ; Catheter Ablation ; methods ; Diffusion Magnetic Resonance Imaging ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo investigate the value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoebolization (TACE).

METHODSConsecutive 32 HCC patients with previous TACE treatment were included in this study. For the follow-up, arterial phase (AP) and venous phase (VP) dual-phase CT scans were performed with a single-source dual-energy CT scanner (Discovery CT 750HD, GE Healthcare). Iodine concentrations were derived from iodine-based material-decomposition images in the liver parenchyma, tumors and coagulation necrosis (CN) areas. The iodine concentration difference (ICD) between the arterial-phase (AP) and venal-phase (VP) were quantitatively evaluated in different tissues.The lesion-to-normal parenchyma iodine concentration ratio (LNR) was calculated. ROC analysis was performed for the qualitative evaluation, and the area under ROC (Az) was calculated to represent the diagnostic ability of ICD and LNR.

RESULTSIn all the 32 HCC patients, the region of interesting (ROI) for iodine concentrations included liver parenchyma (n=42), tumors (n=28) and coagulation necrosis (n=24). During the AP the iodine concentration of CNs (median value 0.088 µg/mm(3)) appeared significantly higher than that of the tumors (0.064 µg/mm(3), P=0.022) and liver parenchyma (0.048 µg/mm(3), P=0.005). But it showed no significant difference between liver parenchyma and tumors (P=0.454). During the VP the iodine concentration in hepatic parenchyma (median value 0.181 µg/mm(3)) was significantly higher than that in CNs (0.140 µg/mm(3), P=0.042). There was no significant difference between liver parenchyma and tumors, CNs and tumors (both P>0.05). The median value of ICD in CNs was 0.006 µg/mm(3), significantly lower than that of the HCC (0.201 µg/mm(3), P<0.001) and hepatic parenchyma (0.117 µg/mm(3), P<0.001). The ICDs in tumors and hepatic parenchyma showed no significant difference (P=0.829). During the AP, the LNR had no significant difference between CNs and tumors (a median value 1.805 vs. 1.310, P=0.389), and during the VP, the difference was also non-significant (the median value 0.647 vs. 0.713, P=0.660). The mean Az value of ICDs for evaluation of surviving tumor tissues was 0.804, whiles LNR measured a disappointing result in both AV images and VP images.

CONCLUSIONQuantitative iodine-based material decomposition images with gemstone spectral CT imaging can improve the diagnostic efficacy of CT imaging for HCC patients after TACE treatment.

Arteries ; Carcinoma, Hepatocellular ; diagnostic imaging ; therapy ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Iodides ; Iodine ; Liver Neoplasms ; diagnostic imaging ; therapy ; ROC Curve ; Tomography, X-Ray Computed