Sheng Li1, Sili Shi1, Aiping Li2, Huihui Liu3, Lili Cai4. 1. Department of Radiology, Renmin Hospital, Hubei University of Medicine, 442000, China. 2. Department of Pain, Renmin Hospital, Hubei University of Medicine, 442000, China. 3. Department of Nephrology, Renmin Hospital, Hubei University of Medicine, 442000, China. 4. Department of Geratology, Renmin Hospital, Hubei University of Medicine, 442000, China.
Abstract
OBJECTIVE: To determine the feasibility and role of diffusion-weighted magnetic resonance imaging (DWI) in the assessment of high-intensity focused ultrasound (HIFU) for the treatment of primary liver cancer. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Radiology, Renmin Hospital, Hubei University of Medicine, China, from July 2016 to March 2018. METHODOLOGY: Forty-eight patients with primary liver cancer underwent conventional magnetic resonance plain scans, dynamic contrast-enhanced scans, and DWI before and two weeks after HIFU treatment, to compare and analyse the changes in apparent diffusion coefficient (ADC) and signal intensity (SI) in four regions of interest (the centre and the surrounding of the lesion, liver tissues around the lesion, back muscles) before and after HIFU treatment. RESULTS: Before HIFU treatment, the lesion showed high signals on the original DWI image, and the ADC image showed cool colours. Two weeks after HIFU treatment, the lesion showed low signals on the original DWI image, and ADC image showed warm colours; the ADC values of the centre and the surrounding of the lesion were significantly higher than those before treatment (both p<0.001); SI values of centre and surrounding of the lesion were significantly lower than those before treatment (both p<0.001). One case (2.08%) each of residual tumor tissue and recurrence were observed and followed up for 3 months. CONCLUSION: DWI can make a relatively accurate judgment on the therapeutic effect of HIFU for the treatment of primary liver cancer. Increased ADC values and reduced SI values can be used as markers for the evaluation of coagulative necrosis of primary liver cancer after HIFU treatment. In addition, DWI combined with dynamic contrast-enhanced MRI can make up for their own shortcomings.
OBJECTIVE: To determine the feasibility and role of diffusion-weighted magnetic resonance imaging (DWI) in the assessment of high-intensity focused ultrasound (HIFU) for the treatment of primary liver cancer. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Radiology, Renmin Hospital, Hubei University of Medicine, China, from July 2016 to March 2018. METHODOLOGY: Forty-eight patients with primary liver cancer underwent conventional magnetic resonance plain scans, dynamic contrast-enhanced scans, and DWI before and two weeks after HIFU treatment, to compare and analyse the changes in apparent diffusion coefficient (ADC) and signal intensity (SI) in four regions of interest (the centre and the surrounding of the lesion, liver tissues around the lesion, back muscles) before and after HIFU treatment. RESULTS: Before HIFU treatment, the lesion showed high signals on the original DWI image, and the ADC image showed cool colours. Two weeks after HIFU treatment, the lesion showed low signals on the original DWI image, and ADC image showed warm colours; the ADC values of the centre and the surrounding of the lesion were significantly higher than those before treatment (both p<0.001); SI values of centre and surrounding of the lesion were significantly lower than those before treatment (both p<0.001). One case (2.08%) each of residual tumor tissue and recurrence were observed and followed up for 3 months. CONCLUSION: DWI can make a relatively accurate judgment on the therapeutic effect of HIFU for the treatment of primary liver cancer. Increased ADC values and reduced SI values can be used as markers for the evaluation of coagulative necrosis of primary liver cancer after HIFU treatment. In addition, DWI combined with dynamic contrast-enhanced MRI can make up for their own shortcomings.