Value of hepatic diffusion‑weighted magnetic resonance imaging in evaluating liver fibrosis following transarterial chemoembolization with low doses of chemotherapy

Li,Hong; Li,Na; Xiang,Qin; Zhou,Yan

doi:10.3892/etm.2014.1767

Value of hepatic diffusion‑weighted magnetic resonance imaging in evaluating liver fibrosis following transarterial chemoembolization with low doses of chemotherapy

Authors:
- Hong Li
- Na Li
- Qin Xiang
- Yan Zhou
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Affiliations: Department of Radiology, Renhe Hospital, Three Gorges University, Yichang, Hubei 443001, P.R. China
Published online on: June 6, 2014 https://doi.org/10.3892/etm.2014.1767
Pages: 642-646

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Abstract

The aim of the present study was to investigate the value of apparent diffusion coefficients (ADCs) measured with magnetic resonance (MR) diffusion‑weighted imaging (DWI) in evaluating liver fibrosis and curative effects on hepatocellular carcinoma (HCC) following transcatheter arterial chemoembolization (TACE) with low doses of chemotherapy. In total, 84 patients with HCC not recommended for surgical resection underwent TACE. The patients were divided into small dose (n=46) and conventional dose (n=38) chemotherapy groups, and underwent MR‑DWI prior to and following TACE. Examination of the four liver fibrosis indexes, hyaluronate, laminin, human procollagen type‑III and collagen type‑IV, as well as ADC values (b=600 sec/mm2), was conducted in the two groups. With small dose chemotherapy, the ADC values were not significantly different preoperatively and postoperatively (P>0.05). By contrast, with a conventional dose, statistically significant differences were observed between the preoperative and postoperative ADC values (P<0.01). ADC values in the small and conventional dose chemotherapy groups prior to the first cycle of TACE were 1.613±0.133x10‑3 and 1.488±0.248x10‑3 mm2/sec, respectively, while following four cycles of TACE, the ADC values were 1.598±0.147x10‑3 and 1.206±0.222x10‑3 mm2/sec, respectively. With regard to chemotherapy, the ADC values before and after TACE were significantly different (P<0.05). A significant negative correlation was observed between the ADC values and the fibrosis stage (P<0.05). Therefore, hepatic MR‑DWI plays a key role in evaluating liver fibrosis following TACE with low doses of chemotherapy, resulting in improved curative effects of TACE.

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1	Bakan AA, Inci E, Bakan S, Gokturk S and Cimilli T: Utility of diffusion-weighted imaging in the evaluation of liver fibrosis. Eur Radiol. 22:682–687. 2012. View Article : Google Scholar : PubMed/NCBI
2	Yin M, Talwalkar JA, Glaser KJ, et al: Dynamic postprandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease. AJR Am J Roentgenol. 197:64–70. 2011. View Article : Google Scholar : PubMed/NCBI
3	Do RK, Chandarana H, Felker E, et al: Diagnosis of liver fibrosis and cirrhosis with diffusion-weighted imaging: value of normalized apparent diffusion coefficient using the spleen as reference organ. AJR Am J Roentgenol. 195:671–676. 2010. View Article : Google Scholar
4	Papanikolaou N, Gourtsoyianni S, Yarmenitis S, Maris T and Gourtsoyiannis N: Comparison between two-point and four-point methods for quantification of apparent diffusion coefficient of normal liver parenchyma and focal lesions. Value of normalization with spleen. Eur J Radiol. 73:305–309. 2010. View Article : Google Scholar
5	Sandrasegaran K, Akisik FM, Lin C, et al: Value of diffusion-weighted MRI for assessing liver fibrosis and cirrhosis. AJR Am J Roentgenol. 193:1556–1560. 2009. View Article : Google Scholar : PubMed/NCBI
6	Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A and Gourtsoyiannis N: Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol. 18:486–492. 2008. View Article : Google Scholar
7	Taouli B, Tolia AJ, Losada M, et al: Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience. AJR Am J Roentgenol. 189:799–806. 2007. View Article : Google Scholar : PubMed/NCBI
8	Ismail MH and Pinzani M: Reversal of liver fibrosis. Saudi J Gastroenterol. 15:72–79. 2009. View Article : Google Scholar
9	Faria SC, Ganesan K, Mwangi I, et al: MR imaging of liver fibrosis: current state of the art. Radiographics. 29:1615–1635. 2009. View Article : Google Scholar : PubMed/NCBI
10	Eccles CL, Haider EA, Haider MA, Fung S, Lockwood G and Dawson LA: Change in diffusion weighted MRI during liver cancer radiotherapy: preliminary observations. Acta Oncol. 48:1034–1043. 2009. View Article : Google Scholar : PubMed/NCBI
11	Lewin M, Poujol-Robert A, Boëlle PY, et al: Diffusion-weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C. Hepatology. 46:658–665. 2007. View Article : Google Scholar : PubMed/NCBI
12	Wang Y, Ganger DR, Levitsky J, et al: Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusion-weighted imaging. AJR Am J Roentgenol. 196:553–561. 2011. View Article : Google Scholar : PubMed/NCBI
13	Sun J, Shi YX, Zhang ZY, Zhang ZQ, Wu JT and Wan HY: Combination of MRI ADC value and biochemical indicators for the assessment of fibrosis in chronic hepatitis: Preliminary results. Lin Chuang Fang She Xue Za Zhi. 43:616–619. 2010.(In Chinese).
14	Binkovitz LA, El-Youssef M, Glaser KJ, Yin M, Binkovitz AK and Ehman RL: Pediatric MR elastography of hepatic fibrosis: principles, technique and early clinical experience. Pediatr Radiol. 42:402–409. 2012. View Article : Google Scholar : PubMed/NCBI
15	Kamel IR, Bluemke DA, Ramsey D, et al: Role of diffusion weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol. 181:708–710. 2003. View Article : Google Scholar : PubMed/NCBI
16	Kamada K, Nakanishi T, Kitamoto M, et al: Long-term prognosis of patients undergoing transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: comparison of cisplatin lipiodol suspension and doxorubicin hydrochloride emulsion. J Vasc Interv Radiol. 12:847–854. 2001. View Article : Google Scholar
17	Aguirre DA, Behling CA, Alpert E, Hassanein TI and Sirlin CB: Liver fibrosis: noninvasive diagnosis with double contrast material-enhanced MR imaging. Radiology. 239:425–437. 2006. View Article : Google Scholar : PubMed/NCBI
18	Aubé C, Racineux PX, Lebigot J, et al: Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: preliminary results. J Radiol. 85:301–306. 2004.(In French).
19	Koinuma M, Ohashi I, Hanafusa K and Shibuya H: Apparent diffusion coefficient measurements with diffusion-weighted magnetic resonance imaging for evaluation of hepatic fibrosis. J Magn Reson Imaging. 22:80–85. 2005. View Article : Google Scholar
20	Taouli B and Koh DM: Diffusion-weighted MR imaging of the liver. Radiology. 254:47–66. 2010. View Article : Google Scholar : PubMed/NCBI