The role of functional MR imaging in the assessment of tumor response after chemoembolization in patients with hepatocellular carcinoma
The role of functional MR imaging in the assessment of tumor response after chemoembolization in patients with hepatocellular carcinoma
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DOI：
10.1097/01.rvi.0000200052.02183.92
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发表时间：
2006-03-01
影响因子：
2.9
通讯作者：
Geschwind, JFH
中科院分区：
文献类型：
--
作者：
Kamel, IR;Bluemke, DA;Geschwind, JFH
目的：使用扩散和动态对比剂增强磁共振 (MR) 成像评估肝细胞癌 (HCC) 经动脉化疗栓塞 (TACE) 后的治疗反应。 材料和方法：对 38 名 HCC 患者（33 名男性患者和 5 名女性患者）进行 TACE 前后的 MR 成像研究进行评估。在 1.5-T 装置上进行扩散和动态造影剂增强 MR 成像。成像方案包括动脉期和门静脉期的 T2 加权快速自旋回波、屏气扩散加权回波平面、屏气未增强和造影剂增强 T1 加权三维脂肪饱和度梯度回忆回波成像。治疗前后记录肿瘤大小、强化百分比和表观扩散系数（ADC）值。还进行了生存分析。结果：该研究包括 38 个病变，平均直径为 8.0 cm。治疗后肿瘤直径平均减少 8 毫米（t 检验；P = .0005），不符合实体瘤完全或部分缓解的疗效评估标准。动脉期 (30%) 和静脉期 (47%) 肿瘤增强的减少具有统计学意义（符号秩检验；分别为 P = .0003 和 P < 0.00005）。治疗后肿瘤 ADC 值从 0.0015 mm(2)/秒增加至 0.0018 mm(2)/秒（t 检验；P = .026），而肝脏、脾脏和肌肉的 ADC 值保持不变。患者中位生存期为 19 个月。结论：TACE 后，随着 ADC 值的增加，肿瘤尺寸减小并增强。在该队列中，TACE 后扩散和动态对比剂增强 MR 成像参数显着改变，这些可能是评估肿瘤反应的有用工具。
PURPOSE: To assess treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with use of diffusion and dynamic contrast medium-enhanced magnetic resonance (MR) imaging.MATERIALS AND METHODS: MR imaging studies before and after TACE in 38 patients with HCC (33 male patients and five female patients) were evaluated. Diffusion and dynamic contrast medium-enhanced MR imaging was performed on a 1.5-T unit. The imaging protocol included T2-weighted fast spin-echo, breath-hold diffusion-weighted echoplanar, and breath-hold unenhanced and contrast medium-enhanced T1-weighted three-dimensional fat-saturation gradient-recalled echo imaging in the arterial and portal venous phases. Tumor size, percent enhancement, and apparent diffusion coefficient (ADC) values were recorded before and after treatment. Survival analysis was also performed.RESULTS: The study included 38 lesions with a mean diameter of 8.0 cm. Mean reduction in tumor diameter was 8 mm after treatment (t test; P = .0005), which did not fulfill Response Evaluation Criteria in Solid Tumors for complete or partial response. Reduction in tumor enhancement in the arterial (30%) and venous (47%) phases was statistically significant (signed-rank test; P = .0003 and P < 0.00005, respectively). Tumor ADC value increased from 0.0015 mm(2)/sec to 0.0018 mm(2)/sec after treatment (t test; P = .026), whereas the ADC values for the liver, spleen, and muscle remained unchanged. Median patient survival was 19 months.CONCLUSIONS: After TACE, tumors demonstrated decreased size and enhancement with increases in ADC values. In this cohort, diffusion and dynamic contrast medium-enhanced MR imaging parameters were significantly altered after TACE, and these could be useful tools in the assessment of tumor response.