Yi-Hsuan Chuang1, Hsin-You Ou1, Chun-Yen Yu1, Chao-Long Chen2, Ching-Chun Weng1, Leo Leung-Chit Tsang1, Hsien-Wen Hsu1, Wei-Xiong Lim1, Tung-Liang Huang1, Yu-Fan Cheng3. 1. Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Dapi Rd, Niaosong Dist, Kaohsiung, Taiwan, Republic of China. 2. Liver Transplantation Program, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. 3. Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Dapi Rd, Niaosong Dist, Kaohsiung, Taiwan, Republic of China. prof.chengyufan@gmail.com.
Abstract
BACKGROUND: Tumor recurrence is the major risk factor affecting post-transplant survival. In this retrospective study, we evaluate the prognostic values of magnetic resonance (MR) diffusion-weighted imaging (DWI) in liver transplantation for hepatocellular carcinoma (HCC). METHODS: From April 2014 to September 2016, 106 HCC patients receiving living donor liver transplantation (LDLT) were enrolled. Nine patients were excluded due to postoperative death within 3 months and incomplete imaging data. The association between tumor recurrence, explant pathologic findings, and DWI parameters was analyzed (tumor-to-liver diffusion weighted imaging ratio, DWIT/L; apparent diffusion coefficients, ADC). The survival probability was calculated using the Kaplan-Meier method. RESULTS: Sixteen of 97 patients (16%) developed tumor recurrence during the follow-up period (median of 40.9 months; range 5.2-56.5). In those with no viable tumor (n = 65) on pretransplant imaging, recurrence occurred only in 5 (7.6%) patients. Low minimum ADC values (p = 0.001), unfavorable tumor histopathology (p < 0.001) and the presence of microvascular invasion (p < 0.001) were risk factors for tumor recurrence, while ADCmean (p = 0.111) and DWIT/L (p = 0.093) showed no significant difference between the groups. An ADCmin ≤ 0.88 × 10- 3 mm2/s was an independent factor associated with worse three-year recurrence-free survival (94.4% vs. 23.8%) and overall survival rates (100% vs. 38.6%). CONCLUSIONS: Quantitative measurement of ADCmin is a promising prognostic indicator for predicting tumor recurrence after liver transplantation.
BACKGROUND:Tumor recurrence is the major risk factor affecting post-transplant survival. In this retrospective study, we evaluate the prognostic values of magnetic resonance (MR) diffusion-weighted imaging (DWI) in liver transplantation for hepatocellular carcinoma (HCC). METHODS: From April 2014 to September 2016, 106 HCCpatients receiving living donor liver transplantation (LDLT) were enrolled. Nine patients were excluded due to postoperative death within 3 months and incomplete imaging data. The association between tumor recurrence, explant pathologic findings, and DWI parameters was analyzed (tumor-to-liver diffusion weighted imaging ratio, DWIT/L; apparent diffusion coefficients, ADC). The survival probability was calculated using the Kaplan-Meier method. RESULTS: Sixteen of 97 patients (16%) developed tumor recurrence during the follow-up period (median of 40.9 months; range 5.2-56.5). In those with no viable tumor (n = 65) on pretransplant imaging, recurrence occurred only in 5 (7.6%) patients. Low minimum ADC values (p = 0.001), unfavorable tumor histopathology (p < 0.001) and the presence of microvascular invasion (p < 0.001) were risk factors for tumor recurrence, while ADCmean (p = 0.111) and DWIT/L (p = 0.093) showed no significant difference between the groups. An ADCmin ≤ 0.88 × 10- 3 mm2/s was an independent factor associated with worse three-year recurrence-free survival (94.4% vs. 23.8%) and overall survival rates (100% vs. 38.6%). CONCLUSIONS: Quantitative measurement of ADCmin is a promising prognostic indicator for predicting tumor recurrence after liver transplantation.
Authors: Alexey Surov; Maciej Pech; Jazan Omari; Frank Fischbach; Robert Damm; Katharina Fischbach; Maciej Powerski; Borna Relja; Andreas Wienke Journal: Liver Cancer Date: 2021-01-27 Impact factor: 11.740
Authors: Osman Öcal; Michael Ingrisch; Muzaffer Reha Ümütlü; Bora Peynircioglu; Christian Loewe; Otto van Delden; Vincent Vandecaveye; Bernhard Gebauer; Christoph J Zech; Christian Sengel; Irene Bargellini; Roberto Iezzi; Alberto Benito; Maciej Pech; Peter Malfertheiner; Jens Ricke; Max Seidensticker Journal: Br J Cancer Date: 2021-10-22 Impact factor: 7.640
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