Diffusion-weighted magnetic resonance imaging to predict response of hepatocellular carcinoma to chemoembolization

Johnathan C. Chung, Neel K. Naik, Robert J. Lewandowski, Jie Deng, Mary F. Mulcahy, Laura M. Kulik, Kent T. Sato, Robert K. Ryu, Riad Salem, Andrew C. Larson, Reed A. Omary

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


AIM: To investigate whether intra-procedural diffusionweighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during transcatheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 ± 11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Anatomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm2) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm2/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (α = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of ±5%, ±10%, and ±15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 ± 0.29 mm2/s vs 1.65 ± 0.35 × 10-3 mm2/s, P < 0.014). CONCLUSION: Intra-procedural ADC changes of > 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE.

Original languageEnglish (US)
Pages (from-to)3161-3167
Number of pages7
JournalWorld Journal of Gastroenterology
Issue number25
StatePublished - Jul 7 2010


  • Apparent diffusion coefficient
  • Diffusion-weighted imaging
  • Functional imaging biomarker
  • Hepatocellular carcinoma
  • Transcatheter arterial chemoembolization

ASJC Scopus subject areas

  • Gastroenterology


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