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Application of magnetic resonance diffusion-weighted imaging in prognostic evaluation of microwave ablation of hepatocellular carcinoma
LIU Tiefang  ZANG Xiao  LI Meng  HU Jianxing  ZHANG Dekang  ZHANG Zhaohe 

Cite this article as: Liu TF, Zang X, Li M, et al. Application of magnetic resonance diffusion-weighted imaging in prognostic evaluation of microwave ablation of hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(6): 112-116. DOI:10.12015/issn.1674-8034.2022.06.022.


[Abstract] Objective To investigate the application value of magnetic resonance diffusion-weighted imaging (MR-DWI) in the prognostic assessment of patients with hepatocellular carcinoma (HCC) that underwent microwave ablation (MVA).Materials and Methods Sixty two consecutive patients with HCC treated by MVA in the Department of Interventional Ultrasound, PLA General Hospital from October 2016 to August 2017 [35 males, 25 females, age (57.8±3.56) years old] were retrospectively enrolled in our study. All patients underwent MR-DWI examination within 1 week before and after MVA, and regular follow-up. To analyze the value of DWI in the prognostic evaluation of MVA for HCC.Results A total of 73 lesions in 62 patients with primary liver cancer were completely ablated. During follow-up, 23 cases had early recurrence and metastasis (13 cases of local recurrence, 8 cases of intrahepatic metastasis, and 2 cases of extrahepatic metastasis). The area under the ROC curve of the apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) for evaluating early recurrence and metastasis after microwave elimination are 0.901 and 0.875 respectively, and the best diagnostic cut-off value is 1.27×10-3 mm2/s (sensitivity: 93.1%, specificity: 90.6%), 0.364 (sensitivity: 87.9%, specificity: 89.5%); according to the follow-up results, the enrolled patients were divided into early recurrence group and no-early recurrence group. The ADC value of patients in no-early recurrence group [(1.43±1.52)×10-3 mm2/s] was significantly higher than that of the early recurrence and metastasis group [(1.15±0.94)×10-3 mm2/s] (P<0.05); eADC value in no-recurrence group (0.42±0.04) was significantly higher than that of early recurrence group (0.32±0.04), and the difference was statistically significant (P<0.05). Multivariate analysis showed that ADC value and eADC value and safety margin after ablation were independent predictors of recurrence-free survival (RFS) after MVA of liver cancer.Conclusions The preoperative ADC value and eADC value have certain clinical value in predicting the early recurrence and metastasis of liver cancer after MVA.
[Keywords] hepatocellular carcinoma;diffusion weighted imaging;exponential apparent diffusion coefficient;apparent diffusion coefficient;microwave ablation;recurrence-free survival;magnetic resonance imaging

LIU Tiefang1   ZANG Xiao1   LI Meng1   HU Jianxing1   ZHANG Dekang1   ZHANG Zhaohe2*  

1 Department of Medical Imaging, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China

2 Department of Interventional Ultrasound, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China

Zhang ZH, E-mail: zhangzhaohe88888@sina.com

Conflicts of interest   None.

Received  2021-11-22
Accepted  2022-05-23
DOI: 10.12015/issn.1674-8034.2022.06.022
Cite this article as: Liu TF, Zang X, Li M, et al. Application of magnetic resonance diffusion-weighted imaging in prognostic evaluation of microwave ablation of hepatocellular carcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(6): 112-116.DOI:10.12015/issn.1674-8034.2022.06.022

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