Value of Gd-EOB-DTPA-Enhanced MRI and Diffusion-Weighted Imaging in Detecting Residual Hepatocellular Carcinoma After Drug-Eluting Bead Transarterial Chemoembolization.
RATIONALE AND OBJECTIVES
To investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in diagnosing residual hepatocellular carcinoma (HCC) after drug-eluting bead transarterial chemoembolization (DEB-TACE).


MATERIALS AND METHODS
Sixty-two patients (50 men, 12 women; mean age, 56.8 ± 1.4 years) with 74 HCCs who underwent Gd-EOB-DTPA-enhanced MRI and DWI in 1-2-month intervals after DEB-TACE were retrospectively studied. Imaging features derived from Gd-EOB-DTPA-enhanced MRI and DWI were analyzed and compared between residual HCCs and necrotic tumors. The sensitivity and specificity of Gd-EOB-DTPA-enhanced MRI and DWI with quantitative apparent diffusion coefficient (ADC) values in diagnosing residual HCCs were calculated and compared, based on the reference standard of pathology and/or angiography.


RESULTS
Thirty-three residual HCCs and 41 necrotic tumors were diagnosed. Residual HCCs presented characteristics of arterial hypervascularity (90.91%) and DWI hyperintensity (78.78%), which were of importance in differentiating necrotic tumors (p< 0.05). DWI showed lower sensitivity (78.79% vs. 96.97%, p< 0.001) and specificity (78.05% vs. 100%, p< 0.001) than Gd-EOB-DTPA-enhanced MRI in diagnosing residual HCCs after DEB-TACE. Residual HCCs had a significantly higher mean ADC value than necrotic tumors (1.30 ± 0.32 × 10-3 mm2/s vs. 1.55 ± 0.50 × 10-3 mm2/s, p< 0.001). Receiver operating characteristic curve analysis for identifying residual HCCs demonstrated that the threshold ADC value of 1.25 × 10-3 mm2/s had 84.85% sensitivity and 87.80% specificity.


CONCLUSION
Gd-EOB-DTPA-enhanced MRI is superior to DWI in diagnosing residual HCCs after DEB-TACE, and arterial hypervascularity and DWI hyperintensity are important imaging features in distinguishing residual HCCs from necrotic tumors.
['Liu|Hai-Feng|HF|', 'Xu|Yong-Sheng|YS|', 'Liu|Zhao|Z|', 'Che|Kuan-Yu|KY|', 'Sheng|Ye|Y|', 'Ding|Jiu-Le|JL|', 'Zhang|Jing-Gang|JG|', 'Lei|Jun-Qiang|JQ|', 'Xing|Wei|W|']
D006528:Carcinoma, Hepatocellular D016461:Chemoembolization, Therapeutic D003287:Contrast Media D005260:Female D019786:Gadolinium DTPA D006801:Humans D008113:Liver Neoplasms D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D004364:Pharmaceutical Preparations D012189:Retrospective Studies D012680:Sensitivity and Specificity
Gd-EOB-DTPA-enhanced MRI Diffusion-weighted imaging (DWI) Hepatocellular carcinoma (HCC) Drug-eluting bead transarterial chemoembolization (DEB-TACE)