Diffusion and perfusion MRI prediction of progression‐free survival in patients with hepatocellular carcinoma treated with concurrent chemoradiotherapy

Kim, Kyung-Ah; Park, Mi‐Suk; Ji, Hyun; Park, Jun Yong; Han, Kwang Hyub; Kim, Do Young; Kim, Ki Whang

doi:10.1002/jmri.24161

Cited by 20 publications

(17 citation statements)

References 36 publications

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“…K trans refers to the velocity of intravascular contrast agent transferring to the extracellular matrix, which is a reflection of tumor blood flow, vascular surface area, vascular permeability, concentration and flow of contrast agent, and extracellular volume. K ep means the velocity of the contrast agent flowing back from the extracellular matrix to the blood vessel, which plays a crucial role in the efflux rate of the contrast agent in the extracellular matrix back to the blood vessel 19. According to the research of Jarnagin et al,20 after patients with HCC were treated with TACE, both K trans and K ep decreased, indicating that MRI quantitative parameters could predict treatment outcome.…”

Section: Discussionmentioning

confidence: 99%

Predictive values of diffusion-weighted imaging and perfusion-weighted imaging in evaluating the efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma

Lin¹,

Tian²,

Zhang

et al. 2016

OTT

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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 (Dslow), fast ADC (Dfast), transfer constant of vessel at the maximum level (Ktrans), and rate constant of backflux (Kep) between the effective and ineffective groups (all P<0.05). After TACE, the effective group exhibited lower MTD, Dfast, and Kep and higher ADC and Dslow than the ineffective group (all P<0.05). Tumor regression rate negatively correlated with MTD, Ktrans, Kep, and Dfast but positively correlated with ADC and Dslow. Receiver operating characteristic curve analysis suggested that the area under the curve of ADC, Dslow, Dfast, Ktrans, and Kep 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.

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Section: Discussionmentioning

confidence: 99%

Predictive values of diffusion-weighted imaging and perfusion-weighted imaging in evaluating the efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma

Lin¹,

Tian²,

Zhang

et al. 2016

OTT

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“…Even with these successes, several limitations of DCE-MRI have been identified (45,51,52) emphasizing the need for its systematic evaluation in assessing treatment response and predicting clinical outcomes. Accuracy and precision of the estimated quantitative parameters can be affected by the estimation of the arterial input function, spatial and temporal resolutions, pharmacokinetic models, and curve fitting strategies.…”

Section: Quantitative Mri Techniques Currently Available For Clinimentioning

confidence: 99%

MR Imaging Biomarkers in Oncology Clinical Trials

Abramson

Arlinghaus

Dula

et al. 2016

Magnetic Resonance Imaging Clinics of North America

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Quantitative magnetic resonance imaging (MRI) techniques have the ability to quantitatively report various pathophysiological processes associated with cancer. These measures have been shown to provide complementary information to that typically obtained from standard morphologically based criteria (e.g., size) and, furthermore, have been shown to outperform sized based measures in certain applications. In this review, we discuss eight areas of quantitative MRI that are either currently employed in clinical trials, or are emerging as promising techniques for both diagnosing cancer as well as assessing—or even predicting—the response of cancer to various therapies. The currently employed methods include the response evaluation criteria in solid tumors (RECIST), dynamic susceptibility MRI (DSC-MRI), dynamic contrast enhanced MRI (DCE-MRI), and diffusion weighted imaging (DWI). The emerging techniques covered are chemical exchange saturation transfer MRI (CEST-MRI), elastography, hyperpolarized MRI, and multi-parameter MRI. After a brief introduction to each technique, we present a small number of illustrative applications before noting the existing limitations of each method and what must be done to move each to more routine clinical application.

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“…Quantitative assessment of this heterogeneity in HCC physiology by noninvasive imaging has been proposed (31, 32), but presents a major challenge in clinical routine, due to motion artifacts and insufficient spatial resolution in abdominal imaging. Several studies are now beginning to address this issue with documented intra-and intersubject variability in several biomarkers, including FDG uptake, as well as DWI-and DCE-MRI parameters (33,34). The DEN model, therefore, may present a valuable tool, representing the complexity of the human disease, enabling the validation of imaging markers that identify subtypes and their testing in future co-clinical trials.…”

Section: Tumor Heterogeneitymentioning

confidence: 99%

Model Matters: Differences in Orthotopic Rat Hepatocellular Carcinoma Physiology Determine Therapy Response to Sorafenib

Groß¹,

Steiger²,

Sayyed³

et al. 2015

Clinical Cancer Research

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Purpose: Preclinical model systems should faithfully reflect the complexity of the human pathology. In hepatocellular carcinoma (HCC), the tumor vasculature is of particular interest in diagnosis and therapy. By comparing two commonly applied preclinical model systems, diethylnitrosamine induced (DEN) and orthotopically implanted (McA) rat HCC, we aimed to measure tumor biology noninvasively and identify differences between the models.Experimental Design: DEN and McA tumor development was monitored by MRI and PET. A slice-based correlation of imaging and histopathology was performed. Array CGH analyses were applied to determine genetic heterogeneity. Therapy response to sorafenib was tested in DEN and McA tumors.Results: Histologically and biochemically confirmed liver damage resulted in increased 18 F-fluorodeoxyglucose (FDG) PET uptake and perfusion in DEN animals only. DEN tumors exhibited G1-3 grading compared with uniform G3 grading of McA tumors. Array comparative genomic hybridization revealed a highly variable chromosomal aberration pattern in DEN tumors. Heterogeneity of DEN tumors was reflected in more variable imaging parameter values. DEN tumors exhibited lower mean growth rates and FDG uptake and higher diffusion and perfusion values compared with McA tumors. To test the significance of these differences, the multikinase inhibitor sorafenib was administered, resulting in reduced volume growth kinetics and perfusion in the DEN group only.Conclusions: This work depicts the feasibility and importance of in depth preclinical tumor model characterization and suggests the DEN model as a promising model system of multifocal nodular HCC in future therapy studies.

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Diffusion and perfusion MRI prediction of progression‐free survival in patients with hepatocellular carcinoma treated with concurrent chemoradiotherapy

Abstract: The ADC of HCC acquired before CCRT correlated with PFS and was valuable in the prediction of the clinical outcome of HCC treated with CCRT.

Cited by 20 publications

References 36 publications

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

MR Imaging Biomarkers in Oncology Clinical Trials

Model Matters: Differences in Orthotopic Rat Hepatocellular Carcinoma Physiology Determine Therapy Response to Sorafenib

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