The diffusion-weighted imaging perfusion fraction f is a potential marker of sorafenib treatment in advanced hepatocellular carcinoma: a pilot study

Lewin, M.; Fartoux, Lætitia; Vignaud, Alexandre; Arrivé, Lionel; Menu, Y.; Rosmorduc, Olivier

doi:10.1007/s00330-010-1914-4

Cited by 125 publications

(143 citation statements)

References 33 publications

(48 reference statements)

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“…However, they reflect different aspects of perfusion: D* is related to the length and velocity of the capillary network, whereas f reflects the fraction of the microcirculation that accounts for all diffusion in voxels. Unsurprisingly, several studies have observed similar mismatches for D* and f (29,(31)(32)(33), even in dynamic contrast enhancement research (34), which is another type of perfusion-related hemodynamic model. One convincing explanation for this contradiction is that f is dependent on echo time (TE): the longer the TE, the larger the f value.…”

Section: Discussionmentioning

confidence: 89%

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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A mong primary malignant hepatic tumors, hepatocellular carcinoma (HCC) is the most common disease and is highly associated with chronic hepatitis B and cirrhosis. Focal nodular hyperplasia (FNH) is the second most common benign focal liver lesion (1), and although it displays gentle biological behavior generally, it can cause abdominal pain or right upper quadrant discomfort occasionally. In terms of the extent of vascular supply during contrast enhancement, HCC and FNH both show a hyperarterialization pattern. HCC is characterized by rapid washout in portal and delayed phase compared with adjacent liver tissue, while FNH displays isointensity or mild hyperintensity in the venous phase because of its slower washout. Liver-specific contrast agents, such as gadoxetic acid, can provide unique information to diagnose these conditions more precisely; however, such agents increase the cost and time-consumption of diagnosis. Occasionally, HCC and FNH show confounding or atypical appearances on imaging, especially for high-or middle-grade differentiated HCC, leading to confusion, misdiagnosis ( Fig. 1), and even unnecessary interventions. Since the treatment of these two lesions is completely different, avoiding unnecessary invasive treatment or tests, such as biopsy, surgery, or interventional therapy, is vital for the prognosis and quality of life of the patient. Therefore, it is crucial to diagnose these conditions noninvasively and accurately before surgery.Diffusion-weighted imaging (DWI) is a functional technology to detect diffusion of water molecules and permits to capture more detailed disease information. For lesion detection, the signal intensity on diffusion-weighted image depends on several factors, particularly cell density. A B D O M I N A L I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to explore whether intravoxel incoherent motion (IVIM)-related parameters of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) demonstrate differences that could be used to differentiate and improve diagnostic efficiency. METHODSA total of 27 patients, including 22 with HCC and 5 with FNH, underwent liver 3.0 T magnetic resonance imaging for routine sequences. They were concurrently examined by IVIM diffusion-weighted imaging (DWI) scanning with 11 different b values (0-800 s/mm 2 ). IVIM-derived parameters, such as pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f ), and apparent diffusion coefficient (ADC total ), were quantified automatically by post-processing software and compared between HCC and FNH groups. A receiver operating characteristic (ROC) curve was then created to predict their diagnostic value. RESULTS

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Section: Discussionmentioning

confidence: 89%

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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“…For example, the perfusion parameter can be used as a biomarker for predicting the responsiveness of some types of tumors to chemotherapy. 11,12 Therefore, estimating these 2 distinctive phenomena in tumor tissues may be helpful in the preoperative characterization of tumors. A simplified IVIM MR imaging technique based on the IVIM model was used to assess the PP and D of hepatocellular carcinomas.…”

Section: Resultsmentioning

confidence: 99%

“…A simplified IVIM MR imaging technique based on the IVIM model was used to assess the PP and D of hepatocellular carcinomas. 12 In that study, the PP was determined with 4 b-values (0, 200, 400, and 800 s/mm 2 ), a technique that is easy to apply and fast compared with the IVIM imaging by using multiple b-values (eg, 0, 10, 20, 30, 50, 80, 100, 200, 400, and 800 s/mm 2 ).…”

Section: Resultsmentioning

confidence: 99%

Head and Neck Tumors: Assessment of Perfusion-Related Parameters and Diffusion Coefficients Based on the Intravoxel Incoherent Motion Model

Sumi

Nakamura

2012

AJNR Am J Neuroradiol

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“…Nevertheless, literature data are controversial. Lewin et al [107] reported a significant f (perfusion fraction) increase in responders at 2 wk and at 2 mo of sorafenib therapy, whereas a decrease was noted in non-responders at the same time intervals. Vouche et al [108] reported that ADC values did not change 1 and 3 mo after 90 Y TARE or 90 Y TARE plus sorafenib treatments.…”

Section: Primary Liver Tumorsmentioning

confidence: 98%

“…Sunitinib seems to induce K trans and Kep decrease and ADC increase [113,114] ; these modifications can be assessed even at a very early stage (after 2 wk of treatment). Lewin et al [107] 12 IVIM f increase HCC sorafenib Vouche et al [108] 15 DWI ADC increase HCC 90 Y TARE ± sorafenib…”

Section: Primary Liver Tumorsmentioning

confidence: 99%

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Robertis¹,

Martini²,

Demozzi³

et al. 2015

WJG

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Diffusion-weighted imaging (DWI), dynamic contrastenhanced magnetic resonance imaging (DCE-MRI) and perfusion computed tomography (CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT examinations. Nevertheless, the term "functional imaging" is commonly used to describe molecular imaging techniques, as positron emission tomography (PET) CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive "one-step" morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging, therefore these techniques could be used also for posttreatment assessment, even at an early stage. or altered cellular membranes will present diffusion restriction, which is depicted as signal hyperintensity areas on high b-value DW images and hypointensity on the apparent diffusion coefficient (ADC) maps; ADC measurement can also quantify water molecules' diffusion. As dedifferentiation or therapies may induce microscopic changes in neoplastic tissues that could modify water molecules' diffusion, DWI can distinguish between different degrees of malignancy and can be also proposed for post-treatment monitoring. Moreover, DWI can be performed in a single session with DCE-MRI, thus providing a comprehensive "one-step" morphological and functional evaluation of hepatobilio-pancreatic tumors.Perfusion imaging techniques evaluate changes in signal intensity (DCE-MRI) or density (pCT) after contrast medium injection, being therefore able to assess microvascularization through the evaluation of the dynamics of contrast medium distribution from vessels to the neoplastic tissue. Perfusion parameters are therefore theoretically good candidates for the evaluation of microscopic vascular differences between lesions with different pathological grade and for the assessment of treatment response, especially after chemoembolization or during treatments with antiangiogenic drugs.This editorial analyzes up-to-date literature data regarding the application of functional imaging techniques, apart from molecular imaging, to hepatic and pancreatic tumors, with particular emphasis on correlations to pathological features, prognostic stratification and therapeutic response assessment. FUNCTIONAL IMAGING TECHNIQUES: TECHNICAL BASESIn 1965 Stejskal and Tanne...

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The diffusion-weighted imaging perfusion fraction f is a potential marker of sorafenib treatment in advanced hepatocellular carcinoma: a pilot study

Abstract: Contrary to ADC and D, the perfusion fraction f is a valuable marker of sorafenib treatment in advanced HCC.

Cited by 125 publications

References 33 publications

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Head and Neck Tumors: Assessment of Perfusion-Related Parameters and Diffusion Coefficients Based on the Intravoxel Incoherent Motion Model

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

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