Prognostic Significance of Apparent Diffusion Coefficient in Hepatocellular Carcinoma Patients treated with Stereotactic Ablative Radiotherapy

Lo, Cheng‐Hsiang; Huang, Wen‐Yen; Hsiang, Chih-Weim; Lee, Meei-Shyuan; Lin, Chun–Shu; Yang, Juxiang; Hsu, Hsian-He; Chang, Wei‐Chou

doi:10.1038/s41598-019-50503-7

Cited by 16 publications

(13 citation statements)

References 32 publications

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“…Unlike the immediate post-treatment decreased-or non-enhancement following RFA and TACE, persistent arterial phase hyperenhancement for at least 12 months is common post SBRT and does not necessarily indicate viable neoplasm [25]. In addition to the mRECIST criteria, the AFP level as well as the apparent diffusion coefficient calculated from MRI sequences could improve the assessment of SBRT response and help to determine the LT candidates [26,27].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome and pathologic correlation of stereotactic body radiation therapy as a bridge to transplantation for advanced hepatocellular carcinoma: a case series

et al. 2021

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Background Stereotactic body radiotherapy (SBRT) is an emerging modality for hepatocellular carcinoma (HCC). However, there is scant information about its safety and effectiveness in the neoadjuvant setting prior to liver transplantation (LT). We present the clinical outcome and pathologic assessment of SBRT followed by LT for patients with advanced HCC. Methods This retrospective study included HCC patients treated with neoadjuvant SBRT prior to LT between 2009 and 2018. Radiographic response and adverse effects, including radiation-induced liver disease (RILD), were evaluated. Pathologic response was assessed by the percentage of tumor necrosis relative to the total tumor volume. Overall survival (OS) and recurrence-free survival (RFS) were calculated using the Kaplan–Meier method. Results Fourteen patients underwent SBRT for a total of 25 HCC lesions, followed by LT. The median tumor size was 4.45 cm in diameter, and the median prescribed dose was 45 Gy in 5 fractions. SBRT provided significant AFP reduction, 100% infield control, and a 62.5% response rate. The maximum detected toxicity included grade 3 thrombocytopenia and two grade 3–4 hyperbilirubinemia. One patient developed non-classic RILD. Patients were bridged to LT with a median time of 8.4 months after SBRT, and 23.1% of them achieved a complete pathologic response. The median OS and RFS were 37.8 and 18.3 months from the time of LT, respectively. Conclusions SBRT provides favorable tumor control and acceptable adverse effects for patients awaiting LT. Further prospective studies to test SBRT as a bridging therapy for LT are feasible.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome and pathologic correlation of stereotactic body radiation therapy as a bridge to transplantation for advanced hepatocellular carcinoma: a case series

et al. 2021

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“…Previous literature has reported that a lower post-RT ADC indicates favorable outcomes in patients with glioma, 29,42 whereas an increased post-RT ADC is a favorable prognostic factor in patients with hepatocellular carcinoma. 43 This study suggests that HP 13 C MRI could provide information that is potentially unavailable from conventional 1 H multiparametric MRI.…”

Section: Discussionmentioning

confidence: 81%

Simultaneous Metabolic and Perfusion Imaging Using Hyperpolarized 13C MRI Can Evaluate Early and Dose-Dependent Response to Radiation Therapy in a Prostate Cancer Mouse Model

Qin

Zhang

Bok

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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Hyperpolarized 13 C magnetic resonance imaging detected early and dosedependent radiation therapy response in a transgenic prostate cancer mouse model as early as 1 day after therapy. This novel molecular Purpose: To investigate use of a novel imaging approach, hyperpolarized (HP) 13 C magnetic resonance imaging (MRI) for simultaneous metabolism and perfusion assessment, to evaluate early and dose-dependent response to radiation therapy (RT) in a prostate cancer mouse model. Methods and Materials: Transgenic Adenocarcinoma of Mouse Prostate (TRAMP) mice (n Z 18) underwent single-fraction RT (4-14 Gy steep dose across the tumor) and were imaged serially at pre-RT baseline and 1, 4, and 7 days after RT using HP 13 C MRI with combined [1-13 C]pyruvate (metabolic active agent) and [ 13 C]urea (perfusion agent), coupled with conventional multiparametric 1 H MRI including

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“…This also agreed with Lo et al, who found that an ADC change of ≥25% within 6 months poststereotactic ablative radiotherapy (SABR) was an independent predictor of sustained HCC tumor control. The ADC values pre-and post-SABR were 1.43 ±0.28 x 10 -3 mm 2 /s and 1.72±0.34 x 10 -3 mm 2 /s respectively (p<0.001) [36] . This indicated that the ADC values could be established as a monitoring tool to assess the response of malignant lesions for treatment.…”

Section: Discussionmentioning

confidence: 85%

Characterization of Hepatic Focal Lesions by Diffusion Tensor Imaging and How Far it Can Predict Post-Treatment Response?

Abdelhamid¹,

Tharwat

2021

The Medical Journal of Cairo University

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Background: Liver diseases have been known to be a major health problem principally because of their world-wide distribution. Focal liver disease is a common diagnostic problem referred to radiologists for evaluation owing to its nonspecific clinical presentation and marked interobserver variation on clinical examination. Aim of Study:The purpose of this study is to evaluate the role of diffusion tensor imaging in characterization of hepatic focal lesions and its value in post-treatment response.Patients and Methods: This prospective study included 30 patients previously diagnosed to have hepatic focal lesions (HFLs) by their characteristic triphasic computed tomography (CT), dynamic magnetic resonance imaging (MRI) features and/or biopsy. The study included 43 lesions in 30 patients (16 benign lesions, 23 malignant lesions, and 4 treated malignant lesions). MRI with diffusion tensor imaging (DTI) was performed for all patients. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were evaluated for all lesions.Results: There was a statistically significant difference in ADC values between the benign and malignant lesions (p<0.001) and between the treated malignant and untreated malignant lesions (p=0.002). There was a statistically significant difference in FA values between the benign and malignant lesions (p<0.001) and between the treated malignant and untreated malignant lesions ( p=0.004). The best cut-off ADC value to differentiate between benign and malignant lesions respectively was >1.42x 10 -3 mm 2 /s with 95.7% sensitivity and 82.8% specificity. The best cut-off ADC value to differentiate between treated malignant and malignant lesions respectively was >1.65x 10 -3 mm 2 /s with 97.8% sensitivity and 95.7% specificity. The best cut-off FA value to differentiate between malignant and benign lesions respectively was >0.29 with 95% sensitivity and 70% specificity. The best cut-off FA value to differentiate between treated malignant and untreated malignant lesions respectively was <0.297 with 100% sensitivity and 69.2% specificity. Conclusion: Diffusion tensor imaging is an evolvingtechnique that can be used to characterize different hepatic focal lesions either benign or malignant with significant

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Prognostic Significance of Apparent Diffusion Coefficient in Hepatocellular Carcinoma Patients treated with Stereotactic Ablative Radiotherapy

Cited by 16 publications

References 32 publications

Clinical outcome and pathologic correlation of stereotactic body radiation therapy as a bridge to transplantation for advanced hepatocellular carcinoma: a case series

Clinical outcome and pathologic correlation of stereotactic body radiation therapy as a bridge to transplantation for advanced hepatocellular carcinoma: a case series

Simultaneous Metabolic and Perfusion Imaging Using Hyperpolarized 13C MRI Can Evaluate Early and Dose-Dependent Response to Radiation Therapy in a Prostate Cancer Mouse Model

Characterization of Hepatic Focal Lesions by Diffusion Tensor Imaging and How Far it Can Predict Post-Treatment Response?

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