Open AccessApparent Diffusion Coefficient Can Predict Therapy Response of Hepatocellular Carcinoma to Transcatheter Arterial Chemoembolization
Author(s) -
Ralph Drewes,
Constanze Heinze,
Maciej Pech,
Maciej Powerski,
Katja Woidacki,
Andreas Wienke,
Alexey Surov,
Jazan Omari
Publication year - 2021
Publication title -
digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.879
H-Index - 66
eISSN - 1421-9875
pISSN - 0257-2753
DOI - 10.1159/000520716
Subject(s) - medicine , hepatocellular carcinoma , effective diffusion coefficient , meta analysis , confidence interval , transcatheter arterial chemoembolization , diffusion mri , response evaluation criteria in solid tumors , radiology , nuclear medicine , oncology , magnetic resonance imaging , chemotherapy , progressive disease
Aim: The goal of this meta-analysis was to assess the apparent diffusion coefficient (ADC) as a pre- and posttreatment (ΔADC) predictive imaging biomarker of response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).Methods: SCOPUS database, EMBASE database and MEDLINE library were scanned for connections between pre- and posttreatment ADC values of HCC and response to TACE. Six studies qualified for inclusion. The following parameters were collected: authors, publication year, study design, number of patients, drugs for TACE, mean ADC value, standard deviation, measure method, b-values and Tesla-strength. The QUADAS-2 instrument was employed to check the methodological quality of each study. The meta-analysis was performed by utilizing RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance were used to regard heterogeneity. Mean ADC values and 95% confidence intervals were computed. Results: Six studies (n=271 patients with 293 HCC nodules) were included. The pretreatment mean ADC in the responder group was 1.20 x 10-3 mm2/s (0.98, 1.42) and 1.14 x 10-3 mm2/s (0.89, 1.39) in the non-responder group. The analysis of post TACE ADC value changes (ΔADC) revealed a threshold of ≥ 20% to identify treatment responders. No suitable pretreatment ADC threshold to predict therapy response or discriminate between responders and non-responders before therapy could be discovered. Conclusion: ΔADC can facilitate early objective response evaluation through post-therapeutic ADC alterations ≥ 20%. Pretreatment ADC cannot predict response to TACE.