Histogram analysis of apparent diffusion coefficient predicts response to radiofrequency ablation in hepatocellular carcinoma

作     者：Xiaohong Ma Han Ouyang Shuang Wang Meng Wang Chunwu Zhou Xinming Zhao 

作者机构：Department of Diagnostic Radiology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences Peking Union Medical College Department of Epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences Peking Union Medical College 

出 版 物：《Chinese Journal of Cancer Research》 (中国癌症研究（英文版）)

年 卷 期：2019年第31卷第2期

页      面：366-374页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by CAMS Innovation Fund for Medical Sciences (CIFMS) (No. 2016-I2M-1-001) PUMC Youth Fund (No. 2017320010) Beijing Hope Run Fund of Cancer Foundation of China (No. LC2016B15) 

主　　题：Diffusion-weighted imaging apparent diffusion coefficient histogram analysis hepatocellular carcinoma radiofrequency ablation survival time 

摘      要：Objective: The aim of this study was to predict tumor progression in patients with hepatocellular carcinoma(HCC) treated with radiofrequency ablation(RFA) using histogram analysis of apparent diffusion coefficients(ADC).Methods: Breath-hold diffusion weighted imaging(DWI) was performed in 64 patients(33 progressive and 31 stable) with biopsy-proven HCC prior to RFA. All patients had pre-treatment magnetic resonance imaging(MRI)and follow-up computed tomography(CT) or MRI. The ADC values(ADC_(10), ADC_(30_, ADC_(median) and ADC_(max))were obtained from the histogram s 10 th, 30 th, 50 th and 100 th percentiles. The ratios of ADC_(10), ADC_(30_,ADCmedian and ADCmax to the mean non-lesion area-ADC(RADC_(10), RADC_(30_, RADC_(median), and RADC_(max)) were calculated. The two patient groups were compared. Key predictive factors for survival were determined using the univariate and multivariate analysis of the Cox model. The Kaplan-Meier survival analysis was performed, and pairs of survival curves based on the key factors were compared using the log-rank test.Results: The ADC_(30_, ADCmedian, ADCmax, RADC_(30_, RADC_(median), and RADC_(max) were significantly larger in the progressive group than in the stable group(P0.05). The median progression-free survival(PFS) was 22.9 months for all patients. The mean PFS for the stable and progressive groups were 47.7±1.3 and 9.8±1.3 months,respectively. Univariate analysis indicated that RADC_(10), RADC_(30_, and RADC_(median) were significantly correlated with the PFS [hazard ratio(HR)=31.02, 43.84, and 44.29, respectively, P0.05 for all]. Multivariate analysis showed that RADCmedian was the only independent predictor of tumor progression(P=0.04). And the cutoff value of RADC_(median) was 0.71.Conclusions: Pre-RFA ADC histogram analysis might serve as a useful biomarker for predicting tumor progression and survival in patients with HCC treated with RFA.