Abstract:
Objectives The therapeutic effect of transcatheter arterial chemoembolization (TACE) in massive hepatocellular carcinoma (HCC) using apparent diffusion coefficient (ADC) value measurements combined with gadolinium-enhanced magnetic resonance imaging (MRI) was evaluated.
Methods Routine, diffusion-weighted (b = 500, 0 s/mm2), and dynamic contrast-enhanced MRI were performed before and 4 wk to 6 wk after TACE in 32 patients with massive HCC. The ADC values in the whole tumor were measured and compared preand post-treatment The ADC values in the enhanced and unenhanced tumor portions were also measured after treatment. The obtained values as well as the ADC values before treatment in the enhanced and unenhanced portions were also compared.
Results The tumor ADC values significantly increased from (1.23 ± 0.19) × 10-3 mm2/s before TACE to (1.39± 0.18) x 103 mm2/s after TACE (P= 0.016). The ADC values in the unenhanced tumor portion (1.80 ±0.32) × 10-3 mm2/s were significantly greater than those in enhanced portion (1.15 ± 0.30) × 10-3 mm2/s after TACE (P < 0.001). The ADC values in the enhanced tumor portion were significantly lower than those before TACE (P= 0.048). The ADC values in the unenhanced tumor portion were significantly higher than those before TACE (P < 0.001).
Conclusion The ADC value may be beneficial in assessing tumor viability. Measuring the ADC value of the enhanced and unenhanced portions of a tumor may be more accurate in evaluating the therapeutic response of massive HCC to TACE.