One‐month apparent diffusion coefficient correlates with response to radiofrequency ablation of hepatocellular carcinoma

Barat, Maxime; Fohlen, Audrey; Cassinotto, Christophe; Jannot, Anne‐Sophie; Dautry, Raphaël; Pelage, Jean-Pierre; Boudiaf, Mourad; Pocard, Marc; Eveno, Clarisse; Taouli, Bachir; Soyer, Philippe; Dohan, Anthony

doi:10.1002/jmri.25521

Cited by 18 publications

(12 citation statements)

References 40 publications

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“…15 Nevertheless, a quantitative approach has been studied to assess tumour response and several pre-clinical and clinical studies have shown that quantification of ADC could help estimate the degree of tumour necrosis in HCC treated with locoregional therapy, since necrotic tissue shows higher ADC values than viable tumours. 16,[80][81][82][83] It is important to note that these modifications can be observed early, within a week after treatment. 18,19 Researchers have also investigated the role of baseline pre-treatment ADC values in predicting future tumour response.…”

Section: Functional Imagingmentioning

confidence: 99%

Evaluation of liver tumour response by imaging

et al. 2020

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The goal of assessing tumour response on imaging is to identify patients who are likely to benefitor notfrom anticancer treatment, especially in relation to survival. The World Health Organization was the first to develop assessment criteria. This early score, which assessed tumour burden by standardising lesion size measurements, laid the groundwork for many of the criteria that followed. This was then improved by the Response Evaluation Criteria in Solid Tumours (RECIST) which was quickly adopted by the oncology community. At the same time, many interventional oncology treatments were developed to target specific features of liver tumours that result in significant changes in tumours but have little effect on tumour size. New criteria focusing on the viable part of tumours were therefore designed to provide more appropriate feedback to guide patient management. Targeted therapy has resulted in a breakthrough that challenges conventional response criteria due to the non-linear relationship between response and tumour size, requiring the development of methods that emphasize the appearance of tumours. More recently, research into functional and quantitative imaging has created new opportunities in liver imaging. These results have suggested that certain parameters could serve as early predictors of response or could predict later tumour response at baseline. These approaches have now been extended by machine learning and deep learning. This clinical review focuses on the progress made in the evaluation of liver tumours on imaging, discussing the rationale for this approach, addressing challenges and controversies in the field, and suggesting possible future developments.

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Section: Functional Imagingmentioning

confidence: 99%

Evaluation of liver tumour response by imaging

et al. 2020

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“…Nodular enhancing foci within the ablation zone are considered as a sign of local recurrence. Low ADC values at 1 mo (< 1.145 × 10 -3 mm 2 /s) after RFA have been shown to be associated with an early local recurrence of HCC[ 83 ].…”

Section: Clinical Applications In Livermentioning

confidence: 99%

Diffusion weighted magnetic resonance imaging of liver: Principles, clinical applications and recent updates

Shenoy-Bhangle

Baliyan

Kordbacheh

et al. 2017

WJH

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Diffusion-weighted imaging (DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors such as the ease of acquisition and ability to obtain functional information in the absence of intravenous contrast, especially in patients with abnormal renal function, have contributed to the growing interest in exploring clinical applications of DWI. In the liver, DWI demonstrates a gamut of clinical applications ranging from detecting focal liver lesions to monitoring response in patients undergoing serial follow-up after loco-regional and systemic therapies. DWI is also being applied in the evaluation of diffuse liver diseases such as non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis. In this review, we intend to review the basic principles, technique, current clinical applications and future trends of DW-MRI in the liver.

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“…DWI is an important MRI functional imaging tool with the unique ability to display microscopic functional information such as the tissue cell structure and cell membrane integrity, and its quantitative parameters can provide information on the status of a lesion after treatment [ 3 , 10 , 12 ]. In our study, ADC, eADC, and changes of ADC and eADC after MWA were important imaging parameters for predicting ER after MWA.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric liver MRI for predicting early recurrence of hepatocellular carcinoma after microwave ablation

Zhang

Liu

et al. 2022

Cancer Imaging

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Background High early recurrence (ER) of hepatocellular carcinoma (HCC) after microwave ablation (MWA) represents a sign of aggressive behavior and severely worsens prognosis. The aim of this study was to estimate the outcome of HCC following MWA and develop a response algorithmic strategy based on multiparametric MRI and clinical variables. Methods In this retrospective study, we reviewed the records of 339 patients (mean age, 62 ± 12 years; 106 men) treated with percutaneous MWA for HCC between January 2014 and December 2017 that were evaluated by multiparametric MRI. These patients were randomly split into a development and an internal validation group (3:1). Logistic regression analysis was used to screen imaging features. Multivariate Cox regression analysis was then performed to determine predictors of ER (within 2 years) of MWA. The response algorithmic strategy to predict ER was developed and validated using these data sets. ER rates were also evaluated by Kaplan–Meier analysis. Results Based on logistic regression analyses, we established an image response algorithm integrating ill-defined margins, lack of capsule enhancement, pre-ablative ADC, ΔADC, and EADC to calculate recurrence scores and define the risk of ER. In a multivariate Cox regression model, the independent risk factors of ER (p < 0.05) were minimal ablative margin (MAM) (HR 0.57; 95% CI 0.35 – 0.95; p < 0.001), the recurrence score (HR: 9.25; 95% CI 4.25 – 16.56; p = 0.021), and tumor size (HR 6.21; 95% CI 1.25 – 10.82; p = 0.014). Combining MAM and tumor size, the recurrence score calculated by the response algorithmic strategy provided predictive accuracy of 93.5%, with sensitivity of 92.3% and specificity of 83.1%. Kaplan–Meier estimates of the rates of ER in the low-risk and high-risk groups were 6.8% (95% CI 4.0 – 9.6) and 30.5% (95% CI 23.6 – 37.4), respectively. Conclusion A response algorithmic strategy based on multiparametric MRI and clinical variables was useful for predicting the ER of HCC after MWA.

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One‐month apparent diffusion coefficient correlates with response to radiofrequency ablation of hepatocellular carcinoma

Abstract: 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1648-1658.

Cited by 18 publications

References 40 publications

Evaluation of liver tumour response by imaging

Evaluation of liver tumour response by imaging

Diffusion weighted magnetic resonance imaging of liver: Principles, clinical applications and recent updates

Multiparametric liver MRI for predicting early recurrence of hepatocellular carcinoma after microwave ablation

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