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Evaluating local hepatocellular carcinoma recurrence post‐transcatheter arterial chemoembolization: Is diffusion‐weighted MRI reliable as an indicator?
Author(s) -
Goshima Satoshi,
Kanematsu Masayuki,
Kondo Hiroshi,
Yokoyama Ryujiro,
Tsuge Yusuke,
Shiratori Yoshimune,
Onozuka Minoru,
Moriyama Noriyuki
Publication year - 2008
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21316
Subject(s) - transcatheter arterial chemoembolization , hepatocellular carcinoma , medicine , radiology , diffusion mri , magnetic resonance imaging
Purpose To evaluate the detectability of local hepatocellular carcinoma (HCC) recurrence after transcatheter arterial chemoembolization (TACE) by diffusion‐weighted MR imaging in correlation with those of gadolinium‐enhanced MR imaging. Materials and Methods Respiratory‐triggered diffusion‐weighted MR images ( b factor, 500 s/mm 2 ; number of averaging, six were obtained in 25 patients with 39 HCCs. Two independent radiologists evaluated diffusion‐weighted MR images, gadolinium‐enhanced MR images after TACE, and assigned confidence levels for postoperative HCC recurrence. Apparent diffusion coefficients (ADCs) in HCCs were also measured. Sensitivities and specificities were compared using an extension of the McNemar test. Observer performance was also determined by ROC curve analysis. Results Local recurrences in 14 HCCs and complete tumor necrosis in 25 HCCs after TACE were determined. Sensitivity for the detection of local HCC recurrence was higher on gadolinium‐enhanced MR imaging (82%) than on diffusion‐weighted MR imaging (60.7%) for the two readers in combination and separately ( P < 0.05). Specificities were comparably high for both sequences. Az values were higher for gadolinium‐enhanced MR images (0.92) than for diffusion‐weighted MR images (0.74) for readers in combination and separately ( P < 0.05). Mean ADC values showed an increase after TACE ( P < 0.001). Conclusion Diffusion‐weighted MR imaging was not found to be a reliable predictor of local HCC recurrence after TACE as compared with gadolinium‐enhanced MR imaging. J. Magn. Reson. Imaging 2008;27:834–839. © 2008 Wiley‐Liss, Inc.