Apparent diffusion coefficient quantification as an early imaging biomarker of response and predictor of survival following yttrium-90 radioembolization for unresectable infiltrative hepatocellular carcinoma with portal vein thrombosis.
Purpose: To investigate early diffusion-weighted imaging (DWI) at 30-days post-yttrium-90 (Y-90) radioembolization as a predictor of treatment response and survival in unresectable infiltrative hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT).Materials and Methods: In a prospective s...
| Publicado en: | Abdominal Imaging Vol. 39; no. 5; pp. 969 - 979 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Oct2014
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109755884&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109755884 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09428925 O52 jtl: Abdominal Imaging issn: 09428925 maglogo: N pubinfo: dt: Oct2014 vid: 39 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 109755884 NLM24740759 2012735313 10.1007/s00261-014-0127-8 NLM24740759 109755884 ppf: 969 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Apparent diffusion coefficient quantification as an early imaging biomarker of response and predictor of survival following yttrium-90 radioembolization for unresectable infiltrative hepatocellular carcinoma with portal vein thrombosis. aug: au: Kokabi, Nima Camacho, Juan C Xing, Minzhi Qiu, Deqiang Kitajima, Hiroumi Mittal, Pardeep K Kim, Hyun S affil: Division of Interventional Radiology & Image Guided Medicine, Department of Radiology, Emory University School of Medicine, Suite AG05, 1364 Clifton Road, NE, Atlanta, GA, 30322, USA, nkokabi@emory.edu. sug: subj: Carcinoma, Hepatocellular Radiotherapy Magnetic Resonance Imaging Methods Embolization, Therapeutic Methods Liver Neoplasms Radiotherapy Venous Thrombosis Radiotherapy Radioisotopes Therapeutic Use Carcinoma, Hepatocellular Complications Female Human Liver Neoplasms Complications Male Middle Age Portal Vein Predictive Value of Tests Prospective Studies Radiopharmaceuticals Therapeutic Use Survival Analysis Treatment Outcomes Venous Thrombosis Complications Middle Aged: 45-64 years Female Male ab: Purpose: To investigate early diffusion-weighted imaging (DWI) at 30-days post-yttrium-90 (Y-90) radioembolization as a predictor of treatment response and survival in unresectable infiltrative hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT).Materials and Methods: In a prospective study, 18 consecutive patients with unresectable infiltrative HCC and PVT underwent Y-90 therapy. MR imaging was obtained pre Y-90, and at 1 and 3 months post-therapy with DWI fat-suppressed tri-directional diffusion gradient (b = 50, 400, 800 s/mm(2)). Response was evaluated using target mRECIST and EASL. Relative change in apparent diffusion coefficient (ADC) value of tumors was evaluated. Statistical analysis using receiver operator characteristic curves was performed. Paired t test and Pearson correlation coefficient (r) were used to assess intra- and inter-observer variability. Survival analysis was performed using Kaplan-Meier estimation and log-rank test.Results: Mean ADC values of all HCC's at baseline and at 30-days post-Y90 therapy was 0.86 × 10(-3) and 1.17×10(-3) mm(2)/s, respectively (p < 0.001). Tumors with objective response by mRECIST had significantly increased ADC value when compared to "non-responders" (1.27 vs. 1.05×10(-3) mm(2)/s, p = 0.002). A >30% increase in ADC value at 30-days was found to be at least 90% sensitive in predicting response at 90 days. A >30% increase in ADC value at 30-days predicted significantly prolonged survival.Conclusion: A 30% increase in ADC value at 30-days measured post Y90 is a reproducible early imaging response biomarker predicting tumor response and prolonged survival following Y-90 therapy in infiltrative HCC with PVT. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|