Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up
Objectives To evaluate the role of change in apparent diffusion coefficient (ADC) histogram after the first transarterial chemoembolization (TACE) in predicting overall and transplant-free survival in well-circumscribed hepatocellular carcinoma (HCC). Methods Institution database was searched for HC...
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| Veröffentlicht in: | European radiology 2021-03, Vol.31 (3), p.1378-1390 |
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| creator | Shaghaghi, Mohammadreza Aliyari Ghasabeh, Mounes Ameli, Sanaz Ghadimi, Maryam Hazhirkarzar, Bita Rezvani Habibabadi, Roya Khoshpouri, Pegah Pandey, Ankur Pandey, Pallavi Kamel, Ihab R. |
| description | Objectives
To evaluate the role of change in apparent diffusion coefficient (ADC) histogram after the first transarterial chemoembolization (TACE) in predicting overall and transplant-free survival in well-circumscribed hepatocellular carcinoma (HCC).
Methods
Institution database was searched for HCC patients who got conventional TACE during 2005–2016. One hundred four patients with well-circumscribed HCC and complete pre- and post-TACE liver MRI were included. Volumetric MRI metrics including tumor volume, mean ADC, skewness, and kurtosis of ADC histograms were measured. Univariate and multivariable Cox models were used to test the independent role of change in imaging parameters to predict survival.
P
values |
| doi_str_mv | 10.1007/s00330-020-07237-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2440663561</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2440663561</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-e4e711efbb237e64b13e27a7c348aa9e1a8707cdb691b95dacd887bc1059300c3</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EokvhBTggS1y4GMaxEyfcVqFQpEpwKGfLcSZdV9k42M6u-jYceY4-WV1SQOLAwfLB3_yemY-QlxzecgD1LgIIAQyKfFQhFCsekQ2XomAcavmYbKARNVNNI0_IsxivAaDhUj0lJ6KoGynKakN-fvUxsctte0btzkxXGKmb6PZDS3cuJn8VzJ7OAXtnE_UHDGYcqZl6moKZ4jyaKbEhINK4hIM7mPG-ejbJ4ZQiPbq0o0ccR9bj4Cbs6XnbvqeGBkzBxxltcgek1u98SCu9zDR5yuH2xw2aEOngx9Ef2TI_J08GM0Z88XCfkm8fzy7bc3bx5dPndnvBrFBlYihRcY5D1-WFYCU7LrBQRlkha2Ma5KZWoGzfVQ3vmrI3tq9r1VkOZSMArDglb9bcOfjvC8ak9y7aPIOZ0C9RF1JCVeXd8Yy-_ge99kuYcneZyqlKljVkqlgpm0eOAQc9B7c34UZz0Pce9epRZ4_6l0dd5KJXD9FLt8f-T8lvcRkQKxDzU9YW_v79n9g7qv6qrA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2488774580</pqid></control><display><type>article</type><title>Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Shaghaghi, Mohammadreza ; Aliyari Ghasabeh, Mounes ; Ameli, Sanaz ; Ghadimi, Maryam ; Hazhirkarzar, Bita ; Rezvani Habibabadi, Roya ; Khoshpouri, Pegah ; Pandey, Ankur ; Pandey, Pallavi ; Kamel, Ihab R.</creator><creatorcontrib>Shaghaghi, Mohammadreza ; Aliyari Ghasabeh, Mounes ; Ameli, Sanaz ; Ghadimi, Maryam ; Hazhirkarzar, Bita ; Rezvani Habibabadi, Roya ; Khoshpouri, Pegah ; Pandey, Ankur ; Pandey, Pallavi ; Kamel, Ihab R.</creatorcontrib><description><![CDATA[Objectives
To evaluate the role of change in apparent diffusion coefficient (ADC) histogram after the first transarterial chemoembolization (TACE) in predicting overall and transplant-free survival in well-circumscribed hepatocellular carcinoma (HCC).
Methods
Institution database was searched for HCC patients who got conventional TACE during 2005–2016. One hundred four patients with well-circumscribed HCC and complete pre- and post-TACE liver MRI were included. Volumetric MRI metrics including tumor volume, mean ADC, skewness, and kurtosis of ADC histograms were measured. Univariate and multivariable Cox models were used to test the independent role of change in imaging parameters to predict survival.
P
values < 0.05 were considered significant.
Results
In total, 367 person-years follow-up data were analyzed. After adjusting for baseline liver function, tumor volume, and treatment modality, incremental percent change in ADC (ΔADC) was an independent predictor of longer overall and transplant-free survival (
p
= 0.009). Overall, a decrease in ADC-kurtosis (ΔkADC) showed a strong role in predicting longer survival (
p
= 0.021). Patients in the responder group (ΔADC ≥ 35%) had the best survival profile, compared with non-responders (ΔADC < 35%) (
p
< 0.001). ΔkADC, as an indicator of change in tissue homogeneity, could distinguish between poor and fair survival in non-responders (
p
< 0.001). It was not a measure of difference among responders (
p
= 0.244). Non-responders with ΔkADC ≥ 1 (homogeneous post-TACE tumor) had the worst survival outcome (HR = 5.70,
p
< 0.001), and non-responders with ΔkADC < 1 had a fair survival outcome (HR = 2.51,
p
= 0.029), compared with responders.
Conclusions
Changes in mean ADC and ADC kurtosis, as a measure of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in well-circumscribed HCC, in order to monitor early response to TACE and identify patients with treatment failure and poor survival outcome.
Key Points
• Changes in the mean and kurtosis of ADC histograms, as the measures of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in patients with well-defined HCC.
• A ≥ 35% increase in volumetric ADC after TACE is an independent predictor of good survival, regardless of the change in ADC histogram kurtosis.
• In patients with < 35% ADC change, a decrease in ADC histogram kurtosis indicates partial response and fair survival, while ∆kurtosis ≥ 1 correlates with the worst survival outcome.]]></description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-020-07237-2</identifier><identifier>PMID: 32894356</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Brownian motion ; Carcinoma, Hepatocellular - diagnostic imaging ; Carcinoma, Hepatocellular - therapy ; Chemoembolization ; Chemoembolization, Therapeutic ; Diagnostic Radiology ; Diffusion coefficient ; Diffusion Magnetic Resonance Imaging ; Follow-Up Studies ; Hepatocellular carcinoma ; Heterogeneity ; Histograms ; Homogeneity ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Kurtosis ; Liver ; Liver cancer ; Liver Neoplasms - diagnostic imaging ; Liver Neoplasms - therapy ; Magnetic Resonance ; Magnetic resonance imaging ; Medical prognosis ; Medicine ; Medicine & Public Health ; Neuroradiology ; Patients ; Radiology ; Retrospective Studies ; Survival ; Survival analysis ; Tissues ; Transplants & implants ; Treatment Outcome ; Tumors ; Ultrasound</subject><ispartof>European radiology, 2021-03, Vol.31 (3), p.1378-1390</ispartof><rights>European Society of Radiology 2020</rights><rights>European Society of Radiology 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-e4e711efbb237e64b13e27a7c348aa9e1a8707cdb691b95dacd887bc1059300c3</citedby><cites>FETCH-LOGICAL-c375t-e4e711efbb237e64b13e27a7c348aa9e1a8707cdb691b95dacd887bc1059300c3</cites><orcidid>0000-0003-0511-7796</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-020-07237-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-020-07237-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32894356$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shaghaghi, Mohammadreza</creatorcontrib><creatorcontrib>Aliyari Ghasabeh, Mounes</creatorcontrib><creatorcontrib>Ameli, Sanaz</creatorcontrib><creatorcontrib>Ghadimi, Maryam</creatorcontrib><creatorcontrib>Hazhirkarzar, Bita</creatorcontrib><creatorcontrib>Rezvani Habibabadi, Roya</creatorcontrib><creatorcontrib>Khoshpouri, Pegah</creatorcontrib><creatorcontrib>Pandey, Ankur</creatorcontrib><creatorcontrib>Pandey, Pallavi</creatorcontrib><creatorcontrib>Kamel, Ihab R.</creatorcontrib><title>Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description><![CDATA[Objectives
To evaluate the role of change in apparent diffusion coefficient (ADC) histogram after the first transarterial chemoembolization (TACE) in predicting overall and transplant-free survival in well-circumscribed hepatocellular carcinoma (HCC).
Methods
Institution database was searched for HCC patients who got conventional TACE during 2005–2016. One hundred four patients with well-circumscribed HCC and complete pre- and post-TACE liver MRI were included. Volumetric MRI metrics including tumor volume, mean ADC, skewness, and kurtosis of ADC histograms were measured. Univariate and multivariable Cox models were used to test the independent role of change in imaging parameters to predict survival.
P
values < 0.05 were considered significant.
Results
In total, 367 person-years follow-up data were analyzed. After adjusting for baseline liver function, tumor volume, and treatment modality, incremental percent change in ADC (ΔADC) was an independent predictor of longer overall and transplant-free survival (
p
= 0.009). Overall, a decrease in ADC-kurtosis (ΔkADC) showed a strong role in predicting longer survival (
p
= 0.021). Patients in the responder group (ΔADC ≥ 35%) had the best survival profile, compared with non-responders (ΔADC < 35%) (
p
< 0.001). ΔkADC, as an indicator of change in tissue homogeneity, could distinguish between poor and fair survival in non-responders (
p
< 0.001). It was not a measure of difference among responders (
p
= 0.244). Non-responders with ΔkADC ≥ 1 (homogeneous post-TACE tumor) had the worst survival outcome (HR = 5.70,
p
< 0.001), and non-responders with ΔkADC < 1 had a fair survival outcome (HR = 2.51,
p
= 0.029), compared with responders.
Conclusions
Changes in mean ADC and ADC kurtosis, as a measure of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in well-circumscribed HCC, in order to monitor early response to TACE and identify patients with treatment failure and poor survival outcome.
Key Points
• Changes in the mean and kurtosis of ADC histograms, as the measures of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in patients with well-defined HCC.
• A ≥ 35% increase in volumetric ADC after TACE is an independent predictor of good survival, regardless of the change in ADC histogram kurtosis.
• In patients with < 35% ADC change, a decrease in ADC histogram kurtosis indicates partial response and fair survival, while ∆kurtosis ≥ 1 correlates with the worst survival outcome.]]></description><subject>Brownian motion</subject><subject>Carcinoma, Hepatocellular - diagnostic imaging</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Chemoembolization</subject><subject>Chemoembolization, Therapeutic</subject><subject>Diagnostic Radiology</subject><subject>Diffusion coefficient</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Follow-Up Studies</subject><subject>Hepatocellular carcinoma</subject><subject>Heterogeneity</subject><subject>Histograms</subject><subject>Homogeneity</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Kurtosis</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - diagnostic imaging</subject><subject>Liver Neoplasms - therapy</subject><subject>Magnetic Resonance</subject><subject>Magnetic resonance imaging</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Patients</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Tissues</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kcFu1DAQhi0EokvhBTggS1y4GMaxEyfcVqFQpEpwKGfLcSZdV9k42M6u-jYceY4-WV1SQOLAwfLB3_yemY-QlxzecgD1LgIIAQyKfFQhFCsekQ2XomAcavmYbKARNVNNI0_IsxivAaDhUj0lJ6KoGynKakN-fvUxsctte0btzkxXGKmb6PZDS3cuJn8VzJ7OAXtnE_UHDGYcqZl6moKZ4jyaKbEhINK4hIM7mPG-ejbJ4ZQiPbq0o0ccR9bj4Cbs6XnbvqeGBkzBxxltcgek1u98SCu9zDR5yuH2xw2aEOngx9Ef2TI_J08GM0Z88XCfkm8fzy7bc3bx5dPndnvBrFBlYihRcY5D1-WFYCU7LrBQRlkha2Ma5KZWoGzfVQ3vmrI3tq9r1VkOZSMArDglb9bcOfjvC8ak9y7aPIOZ0C9RF1JCVeXd8Yy-_ge99kuYcneZyqlKljVkqlgpm0eOAQc9B7c34UZz0Pce9epRZ4_6l0dd5KJXD9FLt8f-T8lvcRkQKxDzU9YW_v79n9g7qv6qrA</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Shaghaghi, Mohammadreza</creator><creator>Aliyari Ghasabeh, Mounes</creator><creator>Ameli, Sanaz</creator><creator>Ghadimi, Maryam</creator><creator>Hazhirkarzar, Bita</creator><creator>Rezvani Habibabadi, Roya</creator><creator>Khoshpouri, Pegah</creator><creator>Pandey, Ankur</creator><creator>Pandey, Pallavi</creator><creator>Kamel, Ihab R.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0511-7796</orcidid></search><sort><creationdate>20210301</creationdate><title>Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up</title><author>Shaghaghi, Mohammadreza ; Aliyari Ghasabeh, Mounes ; Ameli, Sanaz ; Ghadimi, Maryam ; Hazhirkarzar, Bita ; Rezvani Habibabadi, Roya ; Khoshpouri, Pegah ; Pandey, Ankur ; Pandey, Pallavi ; Kamel, Ihab R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-e4e711efbb237e64b13e27a7c348aa9e1a8707cdb691b95dacd887bc1059300c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Brownian motion</topic><topic>Carcinoma, Hepatocellular - diagnostic imaging</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Chemoembolization</topic><topic>Chemoembolization, Therapeutic</topic><topic>Diagnostic Radiology</topic><topic>Diffusion coefficient</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Follow-Up Studies</topic><topic>Hepatocellular carcinoma</topic><topic>Heterogeneity</topic><topic>Histograms</topic><topic>Homogeneity</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Kurtosis</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - diagnostic imaging</topic><topic>Liver Neoplasms - therapy</topic><topic>Magnetic Resonance</topic><topic>Magnetic resonance imaging</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Patients</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Tissues</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaghaghi, Mohammadreza</creatorcontrib><creatorcontrib>Aliyari Ghasabeh, Mounes</creatorcontrib><creatorcontrib>Ameli, Sanaz</creatorcontrib><creatorcontrib>Ghadimi, Maryam</creatorcontrib><creatorcontrib>Hazhirkarzar, Bita</creatorcontrib><creatorcontrib>Rezvani Habibabadi, Roya</creatorcontrib><creatorcontrib>Khoshpouri, Pegah</creatorcontrib><creatorcontrib>Pandey, Ankur</creatorcontrib><creatorcontrib>Pandey, Pallavi</creatorcontrib><creatorcontrib>Kamel, Ihab R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaghaghi, Mohammadreza</au><au>Aliyari Ghasabeh, Mounes</au><au>Ameli, Sanaz</au><au>Ghadimi, Maryam</au><au>Hazhirkarzar, Bita</au><au>Rezvani Habibabadi, Roya</au><au>Khoshpouri, Pegah</au><au>Pandey, Ankur</au><au>Pandey, Pallavi</au><au>Kamel, Ihab R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>31</volume><issue>3</issue><spage>1378</spage><epage>1390</epage><pages>1378-1390</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract><![CDATA[Objectives
To evaluate the role of change in apparent diffusion coefficient (ADC) histogram after the first transarterial chemoembolization (TACE) in predicting overall and transplant-free survival in well-circumscribed hepatocellular carcinoma (HCC).
Methods
Institution database was searched for HCC patients who got conventional TACE during 2005–2016. One hundred four patients with well-circumscribed HCC and complete pre- and post-TACE liver MRI were included. Volumetric MRI metrics including tumor volume, mean ADC, skewness, and kurtosis of ADC histograms were measured. Univariate and multivariable Cox models were used to test the independent role of change in imaging parameters to predict survival.
P
values < 0.05 were considered significant.
Results
In total, 367 person-years follow-up data were analyzed. After adjusting for baseline liver function, tumor volume, and treatment modality, incremental percent change in ADC (ΔADC) was an independent predictor of longer overall and transplant-free survival (
p
= 0.009). Overall, a decrease in ADC-kurtosis (ΔkADC) showed a strong role in predicting longer survival (
p
= 0.021). Patients in the responder group (ΔADC ≥ 35%) had the best survival profile, compared with non-responders (ΔADC < 35%) (
p
< 0.001). ΔkADC, as an indicator of change in tissue homogeneity, could distinguish between poor and fair survival in non-responders (
p
< 0.001). It was not a measure of difference among responders (
p
= 0.244). Non-responders with ΔkADC ≥ 1 (homogeneous post-TACE tumor) had the worst survival outcome (HR = 5.70,
p
< 0.001), and non-responders with ΔkADC < 1 had a fair survival outcome (HR = 2.51,
p
= 0.029), compared with responders.
Conclusions
Changes in mean ADC and ADC kurtosis, as a measure of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in well-circumscribed HCC, in order to monitor early response to TACE and identify patients with treatment failure and poor survival outcome.
Key Points
• Changes in the mean and kurtosis of ADC histograms, as the measures of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in patients with well-defined HCC.
• A ≥ 35% increase in volumetric ADC after TACE is an independent predictor of good survival, regardless of the change in ADC histogram kurtosis.
• In patients with < 35% ADC change, a decrease in ADC histogram kurtosis indicates partial response and fair survival, while ∆kurtosis ≥ 1 correlates with the worst survival outcome.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32894356</pmid><doi>10.1007/s00330-020-07237-2</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-0511-7796</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2021-03, Vol.31 (3), p.1378-1390 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2440663561 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Brownian motion Carcinoma, Hepatocellular - diagnostic imaging Carcinoma, Hepatocellular - therapy Chemoembolization Chemoembolization, Therapeutic Diagnostic Radiology Diffusion coefficient Diffusion Magnetic Resonance Imaging Follow-Up Studies Hepatocellular carcinoma Heterogeneity Histograms Homogeneity Humans Imaging Internal Medicine Interventional Radiology Kurtosis Liver Liver cancer Liver Neoplasms - diagnostic imaging Liver Neoplasms - therapy Magnetic Resonance Magnetic resonance imaging Medical prognosis Medicine Medicine & Public Health Neuroradiology Patients Radiology Retrospective Studies Survival Survival analysis Tissues Transplants & implants Treatment Outcome Tumors Ultrasound |
| title | Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T10%3A09%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Post-TACE%20changes%20in%20ADC%20histogram%20predict%20overall%20and%20transplant-free%20survival%20in%20patients%20with%20well-defined%20HCC:%20a%20retrospective%20cohort%20with%20up%20to%2010%C2%A0years%20follow-up&rft.jtitle=European%20radiology&rft.au=Shaghaghi,%20Mohammadreza&rft.date=2021-03-01&rft.volume=31&rft.issue=3&rft.spage=1378&rft.epage=1390&rft.pages=1378-1390&rft.issn=0938-7994&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-020-07237-2&rft_dat=%3Cproquest_cross%3E2440663561%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2488774580&rft_id=info:pmid/32894356&rfr_iscdi=true |