Role of Apparent Diffusion Coefficient (ADC) Mapping in Assessment of Therapeutic Response of Hepatocellular Carcinoma Post Trans-Catheter Arterial Chemoembolization
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- Category: Vol. 89, September 2021
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Role of Apparent Diffusion Coefficient (ADC) Mapping in Assessment of Therapeutic Response of Hepatocellular Carcinoma Post Trans-Catheter Arterial Chemoembolization, MONA A.S.M. ABO ELENIN, ZENAT A. EL SABBAGH and MOHAMED M.M. ABDEL AZIZ
Abstract
Background: Trans-arterial chemoembolization (TACE) is widely used as an interventional procedure in treatment of HCCs. ADC value can be used in evaluating its efficacy in order to rule out or in residual tumor tissue. Aim of Study: To assess the role of DWI and ADC value in evaluating HCCs post TACE. Patients and Methods: A retrospective analytical study on 25 patients with hepatocellular carcinoma (HCC); to assess therapeutic response of (HCC) cases after TACE by ADC mapping MRI technique in comparison to dynamic contrast study (DCE-MRI), to evaluate its accuracy, sensitivity and specificity in detecting treatment response/residual tumor. Results: Comparative study between the 2 groups revealed; highly significant increase in ADC value, in active group; compared to inactive group; with highly significant statistical difference (p<0.01). Comparative study between DCE-MRI and DWI/ADC assessments revealed; non-significant differ-ence in sensitivity, specificity, PPV and NPV in HCC patients; with non-significant difference (p>0.05). Spearman's correla-tion analysis shows that; AFP level had a highly significant negative correlation with ADC value; with highly significant statistical difference (p<0.01). By using ROC-curve analysis, DWI/ADC value at a cutoff point (91.33) detected patients with residual active lesions, with good accuracy (84%), sensitivity 84% and specificity 83% (p=0.0001). Conclusion: ADC maps can be used as a quantitative value to differentiate between active and inactive tumors and in monitoring response to treatment in oncological patients.