Role of diffusion-weighted magnetic resonance imaging in the evaluation of hepatocellular carcinoma response to transcatheter arterial chemoembolization using drug eluting beads; correlation with dynamic MRI

Abstract

AimTo evaluate accuracy of DWI in evaluating HCC response to DEB TACE and compare the results with DCE MRI. Material and methods42 patients with 59 lesions underwent precontrast abdominal MRI, DWI, ADC map with ADC value measurement and DCE MRI. The qualitative DWI and ADC values were correlated to the DCE MR findings. ResultsComparing the qualitative DWI findings to DCE MRI, showed sensitivity of 83.9%, specificity of 64.3%, positive predictive value of 72.2%, and negative predictive value of 78.3% and overall accuracy of 74.5%. The measured ADC values showed significant difference (P value <0.05) between the ADC values measured in the active tumoral areas and necrotic areas with no significant difference between areas of active tumoral enhancement in the different groups. ROC analysis for ADC values showed area under curve 0.7 and maximum combined sensitivity and specificity of 79% and 69.6% respectively at cutoff ADC value of 1.395 mm2/sec. ConclusionDWI is useful highly sensitive technique in evaluation of HCC response to DEB TACE, yet it has low specificity related to high number of false positive results preventing using it solely. Also, DWIs is a reliable method in differentiation between active tumor residue/recurrence and benign perilesional enhancement.