Pre-TACE kurtosis of ADCtotal derived from histogram analysis for diffusion-weighted imaging is the best independent predictor of prognosis in hepatocellular carcinoma
Pre-TACE kurtosis of ADCtotal derived from histogram analysis for diffusion-weighted imaging is the best independent predictor of prognosis in hepatocellular carcinoma
复制标题
DOI：
10.1007/s00330-018-5482-3
复制
发表时间：
2019-01-01
影响因子：
5.9
通讯作者：
Zeng, Meng-Su
中科院分区：
文献类型：
--
作者：
Wu, Li-Fang;Rao, Sheng-Xiang;Zeng, Meng-Su
目的确定基于直方图分析的 TACE 前 IVIM 成像预测不可切除的肝细胞癌 (HCC) 治疗预后的可行性。材料与方法 55 名患者在 TACE 前 1 周前瞻性接受 1.5T MRI。通过 mRECIST 评估，比较了有反应者和无反应者之间 IVIM 参数的直方图指标和 ADC 图。使用 Kaplan-Meier、对数秩检验和 Cox 比例风险回归模型将变量与进展时间 (TTP) 相关联。结果灌注分数 (PF) 的平均值 (p = 0.022)、中值 (p = 0.043) 和 25(th) 百分位数 (p < 0.001)、平均值 (p < 0.001)、中值 (p < 0.001)、25(th)百分位数 ADC((0,500)) 的 (p < 0.001) 和第 75(th) 百分位数 (p = 0.001)、ADC(总计) 的平均值 (p = 0.005)、中位数 (p = 0.008) 和 25(th) 百分位数 (p = 0.039) 较高，而 PF 的偏度和峰度 (p = 0.001， p = 0.005，分别），峰度 与无应答者相比，应答者的 ADC((0,500)) 和 ADC(总计)（分别为 p = 0.005、p = 0.001）较低。多变量分析表明，mRECIST 与 TTP 独立相关，ADC 峰度（总计）对疾病进展具有最佳预测性能。结论 TACE 前 ADC 峰度（总计）是 TTP 的最佳独立预测因子。要点 中心点 mRECIST 与 TTP 独立相关。中心点 ADC 峰度较低且均值较高往往有良好的反应。TACE 前中心点 ADC（总计）峰度是 TTP 的最佳独立预测因子。
PurposeTo determine the feasibility of pre-TACE IVIM imaging based on histogram analysis for predicting prognosis in the treatment of unresectable hepatocellular carcinoma (HCC).Materials and methodsFifty-five patients prospectively underwent 1.5T MRI 1 week before TACE. Histogram metrics for IVIM parameters and ADCs maps between responders and non-responders with mRECIST assessment were compared. Kaplan-Meier, log-rank tests and Cox proportional hazard regression model were used to correlate variables with time to progression (TTP).ResultsMean (p = 0.022), median (p = 0.043), and 25(th) percentile (p < 0.001) of perfusion fraction (PF), mean (p < 0.001), median (p < 0.001), 25(th) percentile (p < 0.001) and 75(th) percentile (p = 0.001) of ADC((0,500)), mean (p = 0.005), median (p = 0.008) and 25(th) percentile (p = 0.039) of ADC(total) were higher, while skewness and kurtosis of PF (p = 0.001, p = 0.005, respectively), kurtosis of ADC((0,500)) and ADC(total) (p = 0.005, p = 0.001, respectively) were lower in responders compared to non-responders. Multivariable analysis demonstrated that mRECIST was associated with TTP independently, and kurtosis of ADC(total) had the best predictive performance for disease progression.ConclusionPre-TACE kurtosis of ADC(total) is the best independent predictor for TTP.Key Points center dot mRECIST was associated with TTP independently.center dot Lower kurtosis and higher mean for ADCs tend to have good response.center dot Pre-TACE kurtosis of ADC(total)is the best independent predictor for TTP.