OBJECTIVE: The purpose of this study was to compare, with histopathologic examination of the liver explant as the reference standard, diffusion-weighted MRI with contrast-enhanced subtraction MRI in the assessment of necrosis of hepatocellular carcinoma (HCC) after trans arterial chemoembolization (TACE). MATERIALS AND METHODS: The cases of 21 patients with HCC who underwent MRI after TACE were evaluated. Two independent observers calculated the apparent diffusion coefficient (ADC) of HCC and measured percentage tumor necrosis on subtraction images. The ADCs of necrotic and viable tumor tissues were compared. ADC and percentage necrosis on subtraction images were correlated with percentage necrosis found at pathologic examination. Receiver operating characteristics analysis was performed on the diagnosis of complete tumor necrosis. RESULTS: Twenty-eight HCCs (mean diameter, 2.3 cm) were evaluated. There were significant differences between the ADC of viable tissue and that of necrotic tumor tissue (1.33 +/- 0.41 vs 2.04 +/- 0.38 x 10(-3) mm(2)/s, p < 0.0001). There was significant moderate correlation between ADC and the pathologic finding of percentage necrosis (r = 0.64, p < 0.001) and significant strong correlation between subtraction image and pathologic percentage necrosis (r = 0.89-0.91, depending on the phase; p < 0.001). In the diagnosis of complete tumor necrosis, ADC had an area under the curve, sensitivity, and specificity of 0.85, 75%, and 87.5% compared with 0.82-0.89, 100%, and 58.3-79.1% for subtraction imaging (p > 0.5 between ADC and subtraction imaging). CONCLUSION: Compared with diffusion-weighted imaging, contrast-enhanced MRI with subtraction technique had more significant correlation with the histopathologic findings in the evaluation of necrosis of HCC after TACE. There was no difference, however, between the two methods in diagnosis of complete tumor necrosis.
OBJECTIVE: The purpose of this study was to compare, with histopathologic examination of the liver explant as the reference standard, diffusion-weighted MRI with contrast-enhanced subtraction MRI in the assessment of necrosis of hepatocellular carcinoma (HCC) after trans arterial chemoembolization (TACE). MATERIALS AND METHODS: The cases of 21 patients with HCC who underwent MRI after TACE were evaluated. Two independent observers calculated the apparent diffusion coefficient (ADC) of HCC and measured percentage tumor necrosis on subtraction images. The ADCs of necrotic and viable tumor tissues were compared. ADC and percentage necrosis on subtraction images were correlated with percentage necrosis found at pathologic examination. Receiver operating characteristics analysis was performed on the diagnosis of complete tumor necrosis. RESULTS: Twenty-eight HCCs (mean diameter, 2.3 cm) were evaluated. There were significant differences between the ADC of viable tissue and that of necrotic tumor tissue (1.33 +/- 0.41 vs 2.04 +/- 0.38 x 10(-3) mm(2)/s, p < 0.0001). There was significant moderate correlation between ADC and the pathologic finding of percentage necrosis (r = 0.64, p < 0.001) and significant strong correlation between subtraction image and pathologic percentage necrosis (r = 0.89-0.91, depending on the phase; p < 0.001). In the diagnosis of complete tumor necrosis, ADC had an area under the curve, sensitivity, and specificity of 0.85, 75%, and 87.5% compared with 0.82-0.89, 100%, and 58.3-79.1% for subtraction imaging (p > 0.5 between ADC and subtraction imaging). CONCLUSION: Compared with diffusion-weighted imaging, contrast-enhanced MRI with subtraction technique had more significant correlation with the histopathologic findings in the evaluation of necrosis of HCC after TACE. There was no difference, however, between the two methods in diagnosis of complete tumor necrosis.
Authors: Lorenzo Mannelli; Jeffrey H Maki; Sherif F Osman; Hersh Chandarana; David J Lomas; William P Shuman; Ken F Linnau; Douglas E Green; Giacomo Laffi; Miriam Moshiri Journal: Curr Urol Rep Date: 2012-02 Impact factor: 3.092
Authors: Francesco Agnello; Giuseppe Salvaggio; Giuseppe Cabibbo; Marcello Maida; Roberto Lagalla; Massimo Midiri; Giuseppe Brancatelli Journal: World J Hepatol Date: 2013-08-27
Authors: Ryan Hickey; Michael Vouche; Daniel Y Sze; Elias Hohlastos; Jeremy Collins; Todd Schirmang; Khairuddin Memon; Robert K Ryu; Kent Sato; Richard Chen; Ramona Gupta; Scott Resnick; James Carr; Howard B Chrisman; Albert A Nemcek; Robert L Vogelzang; Robert J Lewandowski; Riad Salem Journal: J Vasc Interv Radiol Date: 2013-06-25 Impact factor: 3.464
Authors: João Pedro Filipe; Luís Curvo-Semedo; João Casalta-Lopes; Maria Cristina Marques; Filipe Caseiro-Alves Journal: MAGMA Date: 2012-10-06 Impact factor: 2.310
Authors: Jean-Nicolas Vauthey; Elijah Dixon; Eddie K Abdalla; W Scott Helton; Timothy M Pawlik; Bachir Taouli; Antoine Brouquet; Reid B Adams Journal: HPB (Oxford) Date: 2010-06 Impact factor: 3.647