The Value Of IVIM-DWI In The Differential Diagnosis And Treatment Response Prediction Of TACE Of Hepatocellular Carcinoma

Part Ⅰ The Value of IVIM-DWI in the diagnosis and differential diagnosis of hepatocellular carcinomaObjective: To investigate the value of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)in the diagnosis and differential diagnosis of hepatocellular carcinoma(HCC).Materials and Methods: A total of 81 patients with hepatic malignant tumors who were treated in our hospital were collected.There were 55 cases of HCC,10 cases of ICC and 16 cases of LM.All the patients underwent conventional MRI(plain scan),IVIM-DWI(b=0,20,40,80,100,200,400,800,100)and dynamic contrast enhanced MRI on a 3.0T MR before biopsy.Region of interest(ROIs)were placed in the largest solid area of lesions and normal liver tissues,respectively.The following quantitative indicators,including apparent diffusion coefficient(ADC),slow apparent diffusion coefficient(Dslow),fast apparent diffusion coefficient(Dfast)and fraction of fast apparent diffusion coefficient(f),were calculated using the Function-MADC software..All data were statistically analyzed.According to the receiver operating characteristic curve(ROC),the value of each parameter in the diagnosis and differential diagnosis of hepatocellular carcinoma were obtained.Results:(1)The values of ADC,Dslow,Dfast and f in HCC and normal liver tissues were not different significantly.(2)The values of ADC,Dslow as well as Dfast in HCC,intrahepatic cholangiocarcinoma(ICC)and liver metastasis(LM)tissues were different significantly,respectively.The valuesof ADC and Dslow in HCC and LM were lower than those in ICC tissues,but the values of ADC and Dslow in HCC and LM tissues were not different significantly.The Dfast values in HCC were higher than those in ICC and LM tissues,however,the values of Dfast in ICC and LM tissues were not different significantly.The values of f in HCC,ICC and LM tissues were not different significantly.(3)The areas under ROC(AUC)of ADC,Dslow,Dfast and f for the diagnosis of HCC were 0.773,0.801,0.777 and 0.799 respectively;the AUC of ADC,Dslow,Dfast for the differential diagnosis of HCC and ICC were 0.687,0.721 and 0.896 respectively;the AUC of the differential diagnosis of HCC and liver metastasis was 0.805.Conclusion: IVIM-DWI has a certain value in the diagnosis and differential diagnosis of hepatocellular carcinoma.Part Ⅱ IVIM-DWI for treatment response evaluation of transcatheter arterial chemoembolization in hepatocellular carcinomaObjective: To investigate the values of IVIM-DWI for treatment response evaluation of transcatheter arterial chemoembolization(TACE)in HCC.Materials and methods: IVIM-DWI was performed in 20 patients with HCC 1 to 3 days before and 30 to 40 days after TACE treatment.The IVIM-DWI parameters,including ADC,Dslow,Dfast and f,were calculated by using the Function-MADC software.Receiver-operating characteristic(ROC)curve was applied to analyze the evaluation value of IVIM-DWI for the treatment response evaluation of TACE of HCC.The t statistic was usedto analysis the difference of IVIM-DWI parameter values before and after TACE therapy.P<0.05 was considered statistically significant.Results: The values of ADC and Dslow in HCC tumors 30 to 40 days after TACE were significantly increased than those before TACE(p< 0.05),and the values of Dfast 30 to 40 days after TACE significantly decreased than those before TACE,but the values of f in tumors were not seen statistically difference(p> 0.05).The values of ADC,Dslow and Dfast were significantly different between effective group and invalid group before TACE treatment,but the f value was not.The AUC of ADC,Dslow and Dfast for the treatment response evaluation of TACE were 0.783,0.797 and 0.847 respectively.Conclusion: IVIM-DWI can be used to evaluate the therapeutic response of TACE therapy for HCC.