Utility of diffusion weighted imaging with the quantitative apparent diffusion coefficient in diagnosing residual or recurrent hepatocellular carcinoma after transarterial chemoembolization: a meta-analysis

Liu, Zhao; Fan, Jin-Ming; He, Chen; Li, Zhi-Fan; Xu, Yan; Li, Zhao; Liu, Haifeng; Lei, Junqiang

doi:10.1186/s40644-019-0282-9

Cited by 12 publications

(9 citation statements)

References 35 publications

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“…In cases of conventional TACE with Lipiodol or after use of special hyperdense drug-eluting beads, blooming artifacts of MDCT might hamper the recognition of small viable tumor tissue in MDCT; in such cases, MRI offers a clear diagnostic advantage [ 222 ]. Additionally, diffusion-weighted imaging can improve the depiction of residual or recurrent HCCs after TACE, and the ADC value may serve as a quantitative biomarker for treatment response [ 223 ].…”

Section: Imaging Assessment Of Hcc Following Percutaneous Locoregiona...mentioning

confidence: 99%

Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade. Throughout the last few years, pathological, biological, genetic, and immune-chemical analyses have revealed several tumoral subtypes with diverse biological behavior, highlighting the need for the re-evaluation of established radiological methods. Considering these changes, novel methods that provide functional and quantitative parameters in addition to morphological information are increasingly incorporated into modern diagnostic protocols for HCC. In this way, differential diagnosis became even more challenging throughout the last few years. Use of liver specific contrast agents, as well as CT/MRI perfusion techniques, seem to not only allow earlier detection and more accurate characterization of HCC lesions, but also make it possible to predict response to treatment and survival. Nevertheless, several limitations and technical considerations still exist. This review will describe and discuss all these imaging modalities and their advances in the imaging of HCC lesions in cirrhotic and non-cirrhotic livers. Sensitivity and specificity rates, method limitations, and technical considerations will be discussed.

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Section: Imaging Assessment Of Hcc Following Percutaneous Locoregiona...mentioning

confidence: 99%

Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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“…Therefore, tumor treatment efficacy has been judged by whether sufficiently ablated margins are obtained compared to the preoperative images or whether a restricted diffusion area suggests recurrence or residual tumor on the DWIs. If there is some viable component after transarterial chemoembolization (TACE), the lesion shows restricted diffusion ( 23 ). However, the efficacy of diffusion-weighted imaging for the presence of recurrence after RFA has not been established ( 27 , 28 ).…”

Section: Discussionmentioning

confidence: 99%

“…The lesion showing intermediate hyperintensity on the T2-weighted image and restricted diffusion (hyperintensity on DWI and hypointensity on ADC map) was considered malignant ( 21 , 22 ). The post-therapeutic lesions that showed hyperintensity on the T2-weighted image, and iso- or hypointensity on the DWI, were considered to have no recurrence and in a good therapeutic course ( 23 ), and were eventually classified as a benign lesion. The decreasing signal intensity on the T2-weighted image due to SPIO accumulation was observed in well-differentiated HCC or focal nodular hyperplasia (FNH).…”

Section: Methodsmentioning

confidence: 99%

The feasibility of superparamagnetic iron oxide–enhanced magnetic resonance imaging for assessing liver lesions in patients with contraindications for iodine CT contrast media or gadolinium-based MR contrast media: a retrospective case-control study

Kurata¹,

Saito²,

Shirota³

et al. 2022

Quant Imaging Med Surg

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Background: The detection and characterization of liver lesions are problematic in patients with bronchial asthma, renal dysfunction, or a history of allergy to gadolinium-based magnetic resonance contrast media or iodine-computed tomography contrast media because these contrast media cannot be used. Hence, the information on the lesion vascularity cannot be obtained. Therefore, this retrospective case-control study evaluated the feasibility of superparamagnetic iron oxide (SPIO) in patients with one or more of these contraindications who underwent SPIO-enhanced magnetic resonance imaging for the assessment of liver lesions.Methods: Twenty-six patients with a total of 48 lesions were analyzed. SPIO was used in the case of all patients because each patient had at least one reason not to use iodine contrast or gadolinium-based contrast media. Additionally, all patients were subjected to the perfusion study. A total volume of 1.3 mL of SPIO was injected via the cubital vein at a rate of 3 mL per second, followed by 40 mL saline at the same speed. The scanning of the perfusion study was started 4 s after the beginning of superparamagnetic iron oxide injection and scanning took 50 s. Two radiologists independently evaluated whether the lesion was malignant or benign. Receiver operating characteristic analysis (ROC) was performed to determine the additional benefit of the perfusion study.Results: There were no adverse effects associated with SPIO. The area under the curve (AUC) value without perfusion study for observers 1 and 2 were 0.473 (P=0.794, 95% CI: 0.275-0.672) and 0.602 (P=0.305, 95% CI: 0.407-0.798), respectively, whereas the Az values with perfusion study for observers 1 and 2 were 0.782 (P=0.011, 95% CI: 0.565-0.998) and 0.784 (P=0.004, 95% CI: 0.591-0.977), respectively.Az value became significantly better when the perfusion study has added (P=0.001 and 0.012 by observers 1 and 2).Conclusions: SPIO can be used safely in patients with bronchial asthma, renal dysfunction, or a history of contrast media allergy. Furthermore, the diagnostic accuracy of SPIO was acceptable.

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“…To our knowledge, this is the first systematic review aiming at summarizing the role of non-Gaussian diffusion MRI models in HCC. To date, systematic studies were performed on conventional diffusion metrics for HCC detection and prognosis [15,90,91]. Surov et al performed a meta-analysis to assess the role of DWI in prediction of tumor grading and MVI in HCC, also including D in the investigated metrics [15].…”

Section: Discussionmentioning

confidence: 99%

The Role of Non-Gaussian Models of Diffusion Weighted MRI in Hepatocellular Carcinoma: A Systematic Review

Tramontano

Cavaliere

Salvatore

et al. 2021

JCM

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The importance of Diffusion Weighted Imaging (DWI) in hepatocellular carcinoma (HCC) has been widely handled in the literature. Due to the mono-exponential model limitations, several studies recently investigated the role of non-Gaussian DWI models in HCC. However, their results are variable and inconsistent. Therefore, the aim of this systematic review is to summarize current knowledge on non-Gaussian DWI techniques in HCC. A systematic search of the literature, including PubMed, Google Scholar, MEDLINE, and ScienceDirect databases, was performed to identify original articles since 2010 that evaluated the role of non-Gaussian DWI models for HCC diagnosis, grading, response to treatment, and prognosis. Studies were grouped and summarized according to the non-Gaussian DWI models investigated. We focused on the most used non-Gaussian DWI models (Intravoxel Incoherent Motion (IVIM), Diffusion Kurtosis Imaging (DKI), and Stretched Exponential—SE). The quality of included studies was evaluated by using QUADAS-2 and QUIPS tools. Forty-three articles were included, with IVIM and DKI being the most investigated models. Although the role of non-Gaussian DWI models in clinical settings has not fully been established, our findings showed that their parameters may potentially play a role in HCC. Further studies are required to identify a standardized DWI acquisition protocol for HCC diagnosis, grading, response to treatment, and prognosis.

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Utility of diffusion weighted imaging with the quantitative apparent diffusion coefficient in diagnosing residual or recurrent hepatocellular carcinoma after transarterial chemoembolization: a meta-analysis

Cited by 12 publications

References 35 publications

Current Imaging Diagnosis of Hepatocellular Carcinoma

Current Imaging Diagnosis of Hepatocellular Carcinoma

The feasibility of superparamagnetic iron oxide–enhanced magnetic resonance imaging for assessing liver lesions in patients with contraindications for iodine CT contrast media or gadolinium-based MR contrast media: a retrospective case-control study

The Role of Non-Gaussian Models of Diffusion Weighted MRI in Hepatocellular Carcinoma: A Systematic Review

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