| Objective：1. To evaluate the effect of different ROI methods on ADC values and interobservervariability in patients with hepatocellular carcinoma (HCC) in the preoperative andpostoperative of transcatheter arterial chemoembolization (TACE).2. To investigate the postoprative assessment value of DWI for the patients withhepatocellular carcinoma treated by TACE.3. To explore the efficacy of3.0T MR dynamic enhancement scanning quantitativeanalysis in hepatocellular and monitor its response to TACE.Methods：1.36cases with advanced liver cancer confirmed by pathology were enrolled.Patients underwent MRI-DWI (b=0,1000, respectively) before TACE and one monthafter TACE, respectively. Three ROI protocals incluing whole-volume, single-slice andsmall solid samples were applied in this study. Then ADC values of tumors were measuredby two experienced radiologists. The mean ADC values and the differences between interobsrevers were ananlyzed by the intraclass correlation coefficient.2.32patients with advanced HCC confirmed by pathology undernwent DWI priorTACE and one month after TACE. The arterial lesions were evaluated one month afterTACE, and patients were divided into effective group and invalid group. The tumor size,ADC values of normal liver tissue and tumor, and differences between them weremeasured and the liver necrosis and tendency of ADC were observed, which was usefulfor the predication of residual tumor and recurrence, and provided the prognosis forpatients.3.24patients with liver cancer confirmed by puncture underwent3.0T MR imagingin one week before TACE, one month and three months after TACE, respectively. Thenthe longest diameter of tumor in axial planes was measured.And the parameters includingKtrans, Kepand vewere also measured in the preoperative and postoperative of TACE. Alldata were analyzed using one-way ANOVA, P<0.05for results had statisticalsignificance.Results：1. For three ROI methods, there was fair agreement between two radiologist (p>0.05,ICC=0.99). For the whole-volume, ICCs were0.91and0.79in the preoperative andpostoperative of TACE, respectively. For the single-slice, ICCs of the single-slice were0.77and0.63versus0.76and0.37for the small solid samples. After TACE, ADC valueswas the lowest for the small solid samples. And there was no significant differencebetween three methods. While SD values of whole-volume and single-slice were higherthan that of small solid samples.2. The tendency of ADC values were compared before and after TACE. ADC valuesincreased generally one month after TACE. In the preoperative, ADC value in invalidgroup was lower than that of effective group. In the postoperative, ADC value in effectivegroup was higher than that of invalid group. The tendency in invalid group was notsignificant, but obvious in effective group. After TACE, there was a positive correlationbetween ADC (%) and treatment effect, and there was a significant difference betweenthem. While the difference was not statistically significace between the tumor size and the tendency of ADC values in normal liver tissue.3. The patients were divided into effective group (N=18) and invalid group (N=6)based on RECIST as criterion. There was statistical significance between two groups inKtransanalysis. In the postoperative TACE of one month and after three months, KtransandKepwere no of significant difference compared with the preoperative examination betweeneffective and invalid group.Conclusion：1. The size and location of ROI had a considerable influence on the ADC values andinterobserver variability. Interobserver variability is more significant after TACE. ADCvalues obtained from the whole tumour volume was the most reproducible results.2. DWI as a noninvasive method can predict the effect after liver cancerchemotherapy embolism.3. When RECIST as criterion,3.0T DCE-MRI is feasible in evaluation of theefficacy after TACE. Furthermore, Ktransand Kepcan quantitatively evaluate the efficacy ofHCC after treatment. |
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