Predictive values of diffusion-weighted imaging and perfusion-weighted imaging in evaluating the efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma
Predictive values of diffusion-weighted imaging and perfusion-weighted imaging in evaluating the efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma
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DOI：
10.2147/ott.s112555
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发表时间：
2016-01-01
影响因子：
4
通讯作者：
Jin, Ping
中科院分区：
文献类型：
--
作者：
Lin, Min;Tian, Man-Man;Jin, Ping
本研究旨在探讨弥散加权成像（DWI）和灌注加权成像（PWI）对肝细胞癌（HCC）患者经导管动脉化疗栓塞术（TACE）疗效的预测价值。从2013年4月至2015年11月，共选择了118例接受TACE治疗的HCC患者。所有患者在TACE前后均行T1 WI/T2 WI、DWI和PWI检查。根据改良的实体瘤疗效评价标准1.1评价疗效。应用受试者工作特征曲线评价定量DWI和PWI参数对肝癌患者TACE疗效的诊断能力。在118例HCC患者中，完全缓解17例（14.4%），部分缓解50例（42.4%），疾病稳定28例（23.7%），疾病进展23例（19.5%）。有效组（完全缓解+部分缓解）67例，无效组（疾病稳定+疾病进展）51例。TACE前有效组与无效组的肿瘤最大直径（MTD）、表观扩散系数（ADC）、慢ADC（D-slow）、快ADC（D-fast）、最大水平血管传递常数（K-transs）、反流速率常数（K-ep）比较，差异均有统计学意义（均P < 0.05）。TACE后有效组MTD、Dfast、K-ep均低于无效组，ADC、D-slow均高于无效组（均P < 0.05）。肿瘤消退率与MTD、K-trans、K-ep和D-fast呈负相关，与ADC和D-slow呈正相关。受试者工作特征曲线分析表明，ADC、D-slow、D-fast、K-transs和K-ep的曲线下面积分别为0.869、0.833、0.812、0.802和0.809。总之，这些结果表明，定量DWI和PWI参数可能有助于评价TACE治疗HCC患者的疗效。
This study explored the predictive values of diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) in evaluating the efficacy of transcatheter arterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC). A total of 118 HCC patients treated with TACE were selected from April 2013 to November 2015. T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI), DWI, and PWI were performed on all patients before and after TACE. Efficacy was evaluated according to modified Response Evaluation Criteria in Solid Tumors 1.1. Receiver operating characteristic curve was used to evaluate the diagnostic power of quantitative DWI and PWI parameters in evaluating the efficacy of TACE for HCC patients. Among the 118 HCC patients, there were 17 cases (14.4%) with complete response, 50 cases (42.4%) with partial response, 28 cases (23.7%) with stable disease, and 23 cases (19.5%) with progressive disease. There were 67 patients in the effective group (complete response + partial response) and 51 patients in the ineffective group (stable disease + progressive disease). Before TACE, there were significant differences in maximum tumor diameter (MTD), apparent diffusion coefficient (ADC), slow ADC (D-slow), fast ADC (D-fast), transfer constant of vessel at the maximum level (K-trans), and rate constant of backflux (K-ep) between the effective and ineffective groups (all P < 0.05). After TACE, the effective group exhibited lower MTD, Dfast, and K-ep and higher ADC and D-slow than the ineffective group (all P < 0.05). Tumor regression rate negatively correlated with MTD, K-trans, K-ep, and D-fast but positively correlated with ADC and D-slow. Receiver operating characteristic curve analysis suggested that the area under the curve of ADC, D-slow, D-fast, K-trans, and K-ep were 0.869, 0.833, 0.812, 0.802, and 0.809, respectively. In conclusion, these results suggest that quantitative DWI and PWI parameters might be useful in evaluating the efficacy of TACE in the treatment of HCC patients.