Predicting Treatment Response of Colorectal Cancer Liver Metastases to Conventional Lipiodol-Based Transarterial Chemoembolization Using Diffusion-Weighted MR Imaging: Value of Pretreatment Apparent Diffusion Coefficients (ADC) and ADC Changes Under Therapy
Predicting Treatment Response of Colorectal Cancer Liver Metastases to Conventional Lipiodol-Based Transarterial Chemoembolization Using Diffusion-Weighted MR Imaging: Value of Pretreatment Apparent Diffusion Coefficients (ADC) and ADC Changes Under Therapy
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DOI：
10.1007/s00270-017-1634-0
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发表时间：
2017-06-01
影响因子：
2.9
通讯作者：
Vogl, Thomas J.
中科院分区：
文献类型：
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作者：
Lahrsow, Maximilian;Albrecht, Moritz H.;Vogl, Thomas J.
应用磁共振弥散加权成像(DWI)获得的表观弥散系数(ADC)来预测不能切除的结直肠癌肝转移瘤(CRLM)治疗后1个月和3个月对重复cTACE的疗效。治疗间隔为4周。在治疗开始后1个月和3个月评估疗效。中轴直径缩小30%的转移灶被归类为有反应病变。在初次cTACE后一个月，有7个病变出现早期反应。有反应和无反应皮损的ADC值绝对值差异无统计学意义(p=0.94)。初次cTACE三个月后，17个转移灶有反应。治疗前有反应的ADC值(中位数1.08×10(-3)mm(2)/S)与无反应(中位数1.30×10(-3)mm(2)/S)比较，差异有统计学意义(P=0.021)。治疗前ADC对预测反应有较好的诊断价值(AUC0.7)。在3个月有反应的病变也显示在治疗前和初次cTACE后1个月的测量之间ADC值显著增加(p<；0.001)。应用ADC值增加12.17%，可以预测首次介入治疗后3个月的反应，其敏感性和特异性分别为77%和74%(AuC 0.817)。此外，在第三次cTACE后大小改变的百分比和ADC改变的百分比之间有很强且显著的相关性(r=0.651，p<；0.001)。在CRLM患者中，ADC值的测量是评估cTACE疗效的潜在生物标志物。
To use absolute pretreatment apparent diffusion coefficients (ADC) derived from diffusion-weighted MR imaging (DWI) to predict response to repetitive cTACE for unresectable liver metastases of colorectal carcinoma (CRLM) at 1 and 3 months after start of treatment.Fifty-five metastases in 34 patients were examined with DWI prior to treatment and 1 month after initial cTACE. Treatment was performed in 4-week intervals. Response was evaluated at 1 and 3 months after start of therapy. Metastases showing a decrease of ae30% in axial diameter were classified as responding lesions.One month after initial cTACE, seven lesions showed early response. There was no significant difference in absolute pretreatment ADC values between responding and non-responding lesions (p = 0.94). Three months after initial cTACE, 17 metastases showed response. There was a significant difference (p = 0.021) between absolute pretreatment ADC values of lesions showing response (median 1.08 x 10(-3) mm(2)/s) and no response (median 1.30 x 10(-3) mm(2)/s). Pretreatment ADC showed fair diagnostic value to predict response (AUC 0.7). Lesions showing response at 3 months also revealed a significant increase in ADC between measurements before treatment and at one month after initial cTACE (p < 0.001). Applying an increase in ADC of 12.17%, response at 3 months after initial cTACE could be predicted with a sensitivity and specificity of 77 and 74%, respectively (AUC 0.817). Furthermore, there was a strong and significant correlation (r = 0.651, p < 0.001) between percentage change in size after third cTACE and percentage change in ADC.In patients with CRLM, ADC measurements are potential biomarkers for assessing response to cTACE.