Role of the apparent diffusion coefficient of MRI in evaluating therapeutic efficacy after transcatheter arterial chemoembolization in hepatic cancer patients

杨　欢; 袁　正; 李文涛

doi:10.3969/j.issn.1007-3969.2016.03.009

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Role of the apparent diffusion coefficient of MRI in evaluating therapeutic efficacy after transcatheter arterial chemoembolization in hepatic cancer patients

更新时间：2025-12-31

- Role of the apparent diffusion coefficient of MRI in evaluating therapeutic efficacy after transcatheter arterial chemoembolization in hepatic cancer patients
- China Oncology Vol. 26, Issue 3, Pages: 257-262(2016)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院介入科，复旦大学上海医学院肿瘤学系,上海,200032
  2. 中国人民解放军第85 医院影像科,上海,200052
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2016.03.009
  CLC：
- Published Online：13 June 2016，
  
  Published：13 June 2016
- 稿件说明：
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杨　欢,袁　正,李文涛,等. 磁共振表观弥散系数对肝癌TACE疗效的预测价值[J]. 中国癌症杂志, 2016, 26(3): 257-262.

杨　欢, 袁　正, 李文涛. Role of the apparent diffusion coefficient of MRI in evaluating therapeutic efficacy after transcatheter arterial chemoembolization in hepatic cancer patients[J]. China Oncology, 2016, 26(3): 257-262.
杨　欢,袁　正,李文涛,等. 磁共振表观弥散系数对肝癌TACE疗效的预测价值[J]. 中国癌症杂志, 2016, 26(3): 257-262. DOI： 10.3969/j.issn.1007-3969.2016.03.009.

杨　欢, 袁　正, 李文涛. Role of the apparent diffusion coefficient of MRI in evaluating therapeutic efficacy after transcatheter arterial chemoembolization in hepatic cancer patients[J]. China Oncology, 2016, 26(3): 257-262. DOI： 10.3969/j.issn.1007-3969.2016.03.009.

摘要

背景与目的：肝癌患者经导管动脉化疗栓塞(transcatheter arterial chemoembolization，TACE)后早期疗效评价仍是临床难点。该研究旨在探讨表观弥散系数(apparent diffusion coefficient，ADC)对肝癌患者TACE术后疾病早期进展的预测效能。方法：本研究经伦理委员会批准，所有患者均被充分告知。共入组23例肝癌患者(男性14例，女性9例，年龄21~85岁，平均年龄53.3岁)，所有患者术前及术后1个月分别行MRI检查和弥散加权成像(diffusion-weighted imaging，DWI)检察(b=50、500、1 000 mm

/s)。术后3个月行MRI增强扫描检查，根据RECIST 1.1标准，把患者分为进展组和非进展组。采用配对t检验比较进展组、非进展组术前及术后1个月ADC值变化。采用非配对t检验比较进展组与非进展组之间的相关ADC参数。在23例肝癌患者中，采用受试者操作特征曲线(receiver operating characteristic curve，ROC)，确定一个鉴别进展和非进展的ADC变化率(ADC%)阈值。结果：14例肝癌患者出现进展，9例肝癌患者未进展。未进展组术后1个月肿瘤ADC值明显升高，与术前肿瘤ADC值之间差异有统计学意义(P=0.01)。进展组术前、术后1个月肿瘤ADC无明显变化(P=0.221)。进展组与非进展组术前肿瘤ADC、ADC%之间差异均无统计学意义(P0.05)。肝癌患者中，未进展组肿瘤ADC%显著高于进展组(P=0.029)，用ROC分析ADC%区分进展组与非进展组的能力，以-6.455%为阈值(95%CI：0.643~1.000)，曲线下面积为0.867，此时敏感度为100%，特异度为66.7%。结论：术后1个月肿瘤ADC值仅在未进展组明显增高。对于肝癌患者，ADC%能够有效预测患者经TACE治疗后是否早期发生疾病进展。

Abstract

Background and purpose: Early evaluating the therapeutic efficacy of transcatheter arterial chemoembolization (TACE) in patients with hepatic cancer is still a difficult clinical problem. The purpose of this study was to evaluate the ability of the apparent diffusion coefficient (ADC) to help predict early dis

ease progression after TACE. Methods: Institutional review board approval was obtained

and all patients signed informed consent. Magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) (b=50

500

1 000 mm

/s) were performed before and 1 month after initiating TACE for 23 patients with hepatic cancer (14 were male

9 were female; mean age: 53.3 years; range: 21-85 years). Contrast-enhanced MRI was performed 3 months after initiating TACE. Patients were classified as either progressing or non-progressing according to RECIST 1.1. The preoperative ADC values of tumor and the ADC values of tumor 1 month after TACE were analyzed by paired t-test in both progressing and non-progressing group. Unpaired t-test was used to compare ADC parameters between progressing and non-progressing group. In all the 23 hepatic cancer patients

receiver operating characteristic (ROC) curve analysis was performed to determine a threshold ADC ratio (ADC%) to differentiate progressing from non-progressing patients. Results: Thirteen progressing and 9 non-progressing patients were evaluated. Increase in ADCs of tumor was observed in non-progressing patients at 1 month after TACE compared with preoperative ADCs. There was a significant difference between the 2 groups (P=0.01). In progressing group

preoperative ADCs of tumor were similar to those at 1 month after TACE (P=0.221). There was no significant difference in preoperative ADCs of tumor and ADC% between the progressing and non-progressing groups. In patients with hepatic cancer

1 month ADC ratio in non-progressing patients were significantly higher than those of progressing patients (P=0.029). Using ROC to evaluate the ability of ADC% could predict early disease progression after TACE. Using -6.455% as the threshold

the area under the ROC curve was 0.867 (95%CI: 0.643-1.000). The sensitivity was 100%

and the specificity was 66.7%. Conclusion: One month after TACE

the increases in ADCs of tumor were observed only in the non-progressing group; and the ADC r

atio seems to be a promising tool for helping predict the early disease progression after TACE in patients with hepatic cancer.

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Related Institution

Department of Medical Oncology, The First Hospital of China Medical University

Department of Liver Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University

Department oncology, The Third People’s Hospital of Yibin

Department of Gastric Surgery, Division 1, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University

Department of Gastrointestinal Surgery, Zhongshan Hospital, Fudan University

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