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Diffusion-Weighted Magnetic Resonance Imaging in Hepatocellular Carcinoma as a Predictor of a Response to Cisplatin-Based Hepatic Arterial Infusion Chemotherapy
- Source :
- Frontiers in Oncology, Vol 10 (2020), Frontiers in Oncology
- Publication Year :
- 2020
- Publisher :
- Frontiers Media SA, 2020.
-
Abstract
- This study aimed to identify the utility of diffusion-weighted magnetic resonance (MR) imaging with an apparent diffusion coefficient (ADC) map as a predictor of the response of hepatocellular carcinoma (HCC) to cisplatin-based hepatic arterial infusion chemotherapy (HAIC). We retrospectively evaluated 113 consecutive patients with Barcelona Clinical Liver Cancer (BCLC) stage B or C HCC, who underwent gadoxetic acid-enhanced and diffusion-weighted MR imaging. The appropriate cutoff for the pretreatment tumor-to-liver ADC ratio was determined to be 0.741. Of the 113 patients, 50 (44%) presented with a pretreatment tumor-to-liver ADC ratio < 0.741 (low group). Evaluation of the treatment response after 2-3 cycles of HAIC in these 50 patients revealed that 21 patients (42%) experienced an objective response to HAIC. On the other hand, only 11 of the 63 patients (17%) with a pretreatment tumor-to-liver ADC ratio ≥ 0.741 (high group) showed an objective response. Thus, the objective response rate was significantly higher in the low group than in the high group (P = 0.006). Multivariate logistic regression analysis using parameters including perfusion alteration, percentage of non-enhancing portions, and pretreatment tumor-to-liver ADC ratio revealed that a pretreatment tumor-to-liver ADC ratio < 0.741 (odds ratio 3.217; P = 0.014) was the sole predictor of an objective response to HAIC. Overall survival rates were significantly higher in patients with objective responses to HAIC than in those without objective responses (P = 0.001 by log-rank test). In conclusion, patients with BCLC stage C or C HCC with a pretreatment tumor-to-liver ADC ratio < 0.741 showed a favorable intrahepatic response to cisplatin-based HAIC. Therefore, diffusion-weighted MR imaging can play a critical role as a predictor of response to cisplatin-based HAIC in unresectable HCC.
- Subjects :
- Cancer Research
medicine.medical_specialty
Urology
hepatic arterial infusion chemotherapy
lcsh:RC254-282
magnetic resonance
03 medical and health sciences
0302 clinical medicine
medicine
Effective diffusion coefficient
diffusion restriction
Stage (cooking)
Original Research
oncology_oncogenics
Cisplatin
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
hepatocellular carcinoma
Odds ratio
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
BCLC Stage
body regions
objective response
Oncology
030220 oncology & carcinogenesis
Hepatocellular carcinoma
030211 gastroenterology & hepatology
Liver cancer
business
medicine.drug
Subjects
Details
- ISSN :
- 2234943X
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Frontiers in Oncology
- Accession number :
- edsair.doi.dedup.....f8c6fb94e424387ca0ade630d7b8ef10