Rahul Anil Sheth MD, Presenter: Nothing to Disclose

Quanzheng Li PhD, Abstract Co-Author: Nothing to Disclose

Suvranu Ganguli MD, Abstract Co-Author: Research Grant, Merit Medical Systems, Inc Consultant, Boston Scientific Corporation

Rahmi Oklu MD, PhD, Abstract Co-Author: Nothing to Disclose

To investigate pre-procedure intratumoral apparent diffusion coefficient (ADC) in patients with hepatocellular carcinoma (HCC) undergoing drug-eluting bead transarterial chemoembolization (DEB-TACE) as a predictor for response to therapy.

An Institutional Review Board (IRB) approved retrospective evaluation of patients undergoing doxorubicin DEB-TACE for HCC was performed. Patients with no prior history of locoregional therapy and with MRI examinations that included diffusion weighted imaging performed within 3 months prior to and following their initial DEB-TACE procedure between 2012 – 2014 were included. MRI imaging features including size, contrast enhancement pattern, T2 signal intensity, and ADC value were measured on the pre- and post-MRI studies for tumors between 10mm and 80mm in maximal dimension. Patient characteristics including age, gender, cause of liver disease, Childs-Pugh score, and mortality were recorded as well.

A total of 23 patients with 35 tumors were identified. Based upon their ADC values, tumors were classified as “low ADC” (ADC 0.001 mm2/sec; n = 21). There was no statistically significant difference in patient age, gender, cause of liver disease, or tumor size between the two groups. However, there was a statistically significant (p < 0.005, Mann-Whitney test) difference in percent ADC change between the pre- and post-MRI examinations, an imaging finding that predicts progression free survival. Tumors with low ADC on pre-procedure imaging demonstrated significantly less interval increase in ADC value following DEB-TACE than tumors with intrinsically high ADC value.

ADC value may serve as a pre-procedure indicator for response to DEB-TACE in patients with HCC.

Predicting response to minimally invasive oncologic interventions can assist in proper patient selection, patient counseling, treatment planning, and selection of the most appropriate locoregional therapy.

Sheth, R, Li, Q, Ganguli, S, Oklu, R, Pre-procedure Apparent Diffusion Coefficient as a Predictor of Response to Drug-eluting Bead Transarterial Chemoembolization of Hepatocellular Carcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045602.html