Role of dynamic contrast-enhanced and diffusion weighted MRI in evaluation of necrosis of hepatocellular carcinoma after chemoembolization

Osama, Reham M.; Abdelmaksoud, Ahmed Hosni; Tatawy, Sanaa A.M El; Nabeel, Mohammed; Metwally, Lamia I.A.

doi:10.1016/j.ejrnm.2013.09.012

Cited by 13 publications

(10 citation statements)

References 26 publications

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Section: Discussionsupporting

confidence: 93%

“…Our results are equivalent with those of Ebeed et al [5], Osama et al [14], and Goshima et al . [16] showing that DCE MRI is to be predominant to DWI in assessing post TACE treatment response and DWI is not continuously a solid indicator of HCC post treatment viability in comparison to DCE MRI [5,14,16]. As in our study, DCE MRI had a sensitivity of 100%, a specificity of 95.25%, a positive predictive value of 95%, a negative predictive value of 100%, and overall agreement of 97.5% while DWI statistics values are 52.63%, 90.48%, 83.33%, 67.86%, and 72.5% respectively.…”

Section: Discussionsupporting

confidence: 93%

“…Through our study, we had higher sensitivity for DCE MRI compared to other researches done by Ebeed et al [5], Osama et al [14], Yu et al [15], and Goshima et al [16]; this occurs because in all other researches, inappropriate breath holding led to motion artifacts with subsequent false-negative interpretation by the viewer; however, in our study, we had one case that was categorized as LR-TR non-evaluable and follow-up showed that it is viable; therefore, there are no definite falsenegative cases in our study [5,[14][15][16]. We also had one false-positive case due to misinterpretation of a perilesional arterioportal enhancement.…”

Section: Discussionmentioning

confidence: 44%

“…In the experiences of Ebeed et al [5] and Osama et al [14], liquefactive breaking down and intra-lesional necrosis are recognized to be the reason of hyper-intensity in DWI images of post therapeutic breaking down of viable lesions [5,14].…”

Section: Discussionmentioning

confidence: 99%

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Value of dynamic and DWI MRI in evaluation of HCC viability after TACE via LI-RADS v2018 diagnostic algorithm

Saleh

Bahig

Shebrya

et al. 2019

Egypt J Radiol Nucl Med

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Background: Detection of the value of DCE (dynamic contrast enhanced) MRI and DWI (diffusion-weighted imaging) in follow-up of treatment response for HCC (hepatocellular carcinoma) lesions post TACE (trans-arterial chemo-embolization) through LI-RADS v2018 algorithmic approach. Results: A prospective study was performed on 30 patients with 41 treated hepatic focal lesions. The patients underwent DCE MRI with DWI in less than 1-month duration following TACE procedure and were radiologically assessed to observe tumoral post treatment response; then, another follow-up after another 3 months later was done for non-viable, equivocal, and non-evaluable post treatment response categories. Statistical analysis showed that DCE MRI had 100% level of sensitivity, specificity of 95.24%, PPV of 95.00%, and NPV of 100% with an overall agreement of 97.50%. While on the other hand, statistics showed that DWI has 52.63% level of sensitivity, specificity of 90.48%, PPV of 83.33%, PPV of 67.86%, and NPV of 72.50%. The difference between non-viable and viable groups' ADC variables was found statistically significant at P value < 0.001, and best cut off value that augments sensitivity and specificity is 1.35. At this ADC value, sensitivity reaches 78.9% and specificity is 85.7%. Conclusions:Our study showed that DCE MRI has 100% level of sensitivity via application of LI-RADS v2018 diagnostic algorithmic approach while DWI alone has 52.63% level of sensitivity, yet it can enhance the diagnostic confidence of DCE MRI for post treatment response viability detection.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

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Value of dynamic and DWI MRI in evaluation of HCC viability after TACE via LI-RADS v2018 diagnostic algorithm

Saleh

Bahig

Shebrya

et al. 2019

Egypt J Radiol Nucl Med

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“…Our results differ from Osama et al ,[11] who observed higher sensitivity of DWI (100%) with a similar specificity of 65.5%. The best ADC cut-off value in this study was 1.26 × 10 −3 mm 2 /s.…”

Section: Discussioncontrasting

confidence: 99%

Diagnostic accuracy of intermediate b-value diffusion-weighted imaging for detection of residual hepatocellular carcinoma following transarterial chemoembolization with drug-eluting beads

Hassan

Mostafa

Nada

et al. 2019

Indian Journal of Radiology and Imaging

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Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of residual malignant tumor of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) with drug-eluting beads (DEBs). Subjects and Methods: Pre-contrast T1, T2, dynamic contrast–enhanced, and respiratory-triggered DW-MRI (b factor 0, 400, and 800 s/mm 2 ) were obtained in 60 patients with HCC who underwent tran-sarterial hepatic chemoembolization with DEBs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the DW imaging images. Apparent diffusion coefficients (ADCs) were calculated searching for the optimal cut-off value using the receiver operating characteristic (ROC) curve. Results: DW-MRI had a sensitivity of 77.1%, a specificity of 60.7%, a PPV of 71.05%, and a NPV of 68%. The difference between the malignant and benign groups’ ADC variables was statistically significant ( P < 0.003). The ROC curve showed that the area under the curve is C = 0.718 with SE = 0.069 and 95% confidence interval from 0.548 to 0.852. Conclusion: In our study, we demonstrated that diffusion MRI has limited diagnostic value in the assessment of viable tumor tissue after TACE with DEBs in cases of HCC.

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Diagnostic Efficacy of Contrast‐Enhanced MRI in Detecting Residual or Recurrent Hepatocellular Carcinoma After Transarterial Chemoembolization: A Systematic Review and Meta‐analysis

Liu

Liqiu

et al. 2019

Magnetic Resonance Imaging

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Background The diagnostic efficacy of contrast‐enhanced magnetic resonance imaging (CEMRI) in diagnosing residual or recurrent hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) is currently not completely clear. Purpose To investigate the diagnostic efficacy of CEMRI in detecting residual or recurrent HCCs after TACE by meta‐analysis. Study Type Systematic review and meta‐analysis. Population A systematic literature search was performed in PubMed, Embase, Web of Science, Ovid, and the Cochrane Library database up to June 2019 to find original studies on diagnosing patients suspected of residual or recurrent HCCs after TACE with CEMRI. Thirteen studies comprising 721 nodules were finally included. Field Strength/Sequence 1.5T or 3.0T, CEMRI. Assessment Quality assessment of the included studies was performed by applying the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool. Statistical Tests Sensitivity and specificity were pooled with a bivariate random‐effects model. Heterogeneity was assessed by the chi‐square test. The potential sources of heterogeneity were explored by subgroup and publication bias analyses. Results The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic (ROC) curve (AUC) of CEMRI in diagnosing residual or recurrent HCCs after TACE were 91% (95% confidence interval [CI]: 87%–96%), 93% (95% CI: 85%–97%), 12.22 (95% CI: 5.62–26.57), 0.09 (95% CI: 0.05–0.18), 126.99 (95% CI: 34.76–436.99) and 0.97 (95% CI: 0.95–0.98), respectively. Subgroup analysis revealed that CEMRI performed significantly better in prospective studies than in retrospective studies: 0.99 (95% CI: 0.96–1.00) vs. 0.95 (95% CI: 0.92–0.96) with P < 0.05. Data Conclusion Our meta‐analysis suggested that CEMRI had high diagnostic efficacy in detecting residual or recurrent HCCs after TACE and may serve as an alternative method for further evaluation after TACE. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;52:1019–1028.

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Role of dynamic contrast-enhanced and diffusion weighted MRI in evaluation of necrosis of hepatocellular carcinoma after chemoembolization

Cited by 13 publications

References 26 publications

Value of dynamic and DWI MRI in evaluation of HCC viability after TACE via LI-RADS v2018 diagnostic algorithm

Value of dynamic and DWI MRI in evaluation of HCC viability after TACE via LI-RADS v2018 diagnostic algorithm

Diagnostic accuracy of intermediate b-value diffusion-weighted imaging for detection of residual hepatocellular carcinoma following transarterial chemoembolization with drug-eluting beads

Diagnostic Efficacy of Contrast‐Enhanced MRI in Detecting Residual or Recurrent Hepatocellular Carcinoma After Transarterial Chemoembolization: A Systematic Review and Meta‐analysis

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