Functional MR Imaging In Early Evaluation Of Therapeutic Effect Of Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization

Part I The Mean Apparent Diffusion Coeffecient Value and Exponential Apparent Diffusion Coefficient Value in the Early Evaluation of Therapeutic Effect of Transcatheter Arterial Chemoembolization for Hepatocellular CarcinomaObjective:To investigate the clinical value of mean apparent diffusion coeffecient (mADC) value, exponential apparent diffusion coefficient eADC) of magnetic resonance diffusion weighted imaging(DWI) in the early evaluation of therapeutic effect of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma(HCC).Materials and Methods:DWI were performed in a total of 28 patients with HCC underwent the single-shot spin-echo echo-planar imaging(SE-EPI) sequence(b=800s/mm2 and 0) at 1.5 T MRI before TACE and 3-10 days after TACE. The measurement of mADC value and eADC value and mADC colour maps and eADC maps were acquired from MRI machine software FuncTool 2.5.36a Version, statistically analysis using SPSS 14.0, least significant difference test (LSD test) was utilized. Patients were followed up to II-phase Operation. Comparison the DWI map to pathological findings including macroscopic observationResult:The mADC value of tumor was significantly higher after TACE[(1.47±0.22)×10-3mm2/s] than before TACE[(1.33±0.24)×10-3mm2/s] (P＜O.05). The eADC value of tumor was significantly lower after TACE[(2.40±0.54)X 10-1] than before TACE[(2.76±0.64)X 10-1] (P＜O.05). The mADC value of liver was insignificantly higher after TACE[(1.57±0.10)X 10-3mm2/s] than before TACE[(1.54±0.06)×10-3mm2/s] (P>0.05). The eADC value of liver was insignificantly lower after TACE[(2.10±0.29)X10-1] than before TACE[(2.16±0.29) X 10-1] (P>0.05). Furthermore, there were significantly differences between the mADC and eADC value of tumor and liver before TACE and after TACE, respectively(P＜O.05).Conclusion DWI is a very sensitive imaging technique that can be used to dynamically monitor HCC before and after TACE by measuring mADC and eADC.PartⅡMagnetic Resonance Spectroscopy in the Early Evaluation of Therapeutic Effect of Hepatocellular Carcinoma after Transcatheter Arterial ChemoembolizationObjective:Proton magnetic resonance spectroscopy (MRS) of the liver in vivo is in experimental phase. MRS observation on liver cancer after transcatheter arterial chemoembolization (TACE) has seldom been reported. This study was to investigate the value of in vivo MRS in the assessment of hepatocellular carcinoma(HCC) and monitor its early metabolic change after TACE.Methods:In this prospective study,28 consecutive patients with HCC pathologically-confirmed were recruited. The1H MRS of the hepatic lesion was performed with 1.5T whole body MR scanner at pre-TACE and 3-10 days after TACE. The main metabolites three items such as choline and lipid, the glucogen/glucose-to-lipid ratios, the glutamine/glutamate-to-lipid ratios before and after TACE therapy were measured. Statistical analysis was used with SPSS 14. Least significant difference test (LSD test) was utilized to compare meanings in those groups where the mean difference was significant statistically.Results:Choline-to-lipid ratios, glucogen/glucose-to-lipid ratios, glutamine/glutamate-to-lipid ratios were 0.21±0.08,0.11±0.05, and 0.28±0.10 before TACE, respectively, and were 0.10±0.08,0.07±0.07, 0.18±0.12 after TACE, respectively. There were significantly differences (P＜O.05).Conclusions:Using proton magnetic resonance spectroscopy can evaluate the early metabolic response of hepatocellular carcinoma to transcatheter arterial chemoembolization.P artⅢWhole Liver Magnetic Resonance Perfusion Imaging in Early Evaluation of Therapeutic Effect of Hepatocellular Carcinoma after Transcatheter Arterial ChemoembolizationOBJECTIVE:To investigate the value of MR perfusion imaging in early evaluating therapeutic effect of the transarterial chemoembolization treatment of hepatocellular carcinoma.Materials and Methods:28 consecutive patients with pathologically-confirmed HCC were recruited. Patients underwent MR perfusion imaging at pre-TACE and 3-10 days after TACE. The negative enhancement integral(NEI), the time to peak (TTP), the maximum slope of decrease(MSD), the signal enhance ratio(SER) were acquired from MRI machine software FuncTool 2.5.36a Version. Statistical analysis was used by SPSS 14. Least significant difference test (LSD test) was utilized,RESULTS:The time intensity curve of tumor was observed to descend rapidly to reach the peak and quikly go down before TACE, whereas it descended slowly to reach the peak and slowly went down after TACE. The values of TTP, and SER after TACE[(43.66±12.03)s,41.17±27.50, respectively]were significantly lower than before TACE [(51.24±10.28)s,60.58±36.33,respectively) (all P＜O.05). The value of NEI after TACE(149.6±80.11) was significantly higher than befor TACE(108.7±58.86) (P＜O.05). The value of MSD after TACE was lower than before TACE, but no statistical significance (P>0.05).Conclusion:PWI is a very sensitive imaging technique that can be used to dynamically monitor early changes of HCC before and after TACE.