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Diffusion and Perfusion MRI Prediction of Progression-Free Survival in Patients With Hepatocellular Carcinoma Treated With Concurrent Chemoradiotherapy

 Kyung Ah Kim  ;  Mi-Suk Park  ;  Hyun-Jun Ji  ;  Jun Yong Park  ;  Kwang-Hyub Han  ;  Myeong-Jin Kim  ;  Ki Whang Kim 
 Journal of Magnetic Resonance Imaging, Vol.39(2) : 286-292, 2014 
Journal Title
 Journal of Magnetic Resonance Imaging 
Issue Date
Adult ; Aged ; Carcinoma, Hepatocellular/pathology* ; Carcinoma, Hepatocellular/therapy* ; Chemoradiotherapy* ; Diffusion Magnetic Resonance Imaging/methods* ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms/pathology* ; Liver Neoplasms/therapy* ; Magnetic Resonance Angiography/methods* ; Male ; Middle Aged ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; Treatment Outcome
DCE MRI ; apparent diffusion coefficient ; concurrent chemoradiotherapy ; diffusion-weighted image ; hepatocellular carcinoma
PURPOSE: To assess whether MR perfusion and diffusion parameters taken before concurrent chemoradiotherapy (CCRT) are useful imaging biomarkers for predicting progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty patients with locally advanced HCC who had no treatment before CCRT underwent dynamic contrast-enhanced (DCE) and diffusion-weighted MRI. Mean values of the volume transfer constant (K(trans) ), reflex constant (Kep ), extravascular extracellular volume fraction (Ve ) and the apparent diffusion coefficient (ADC) were estimated on a region of interest. The best cutoff value for each factor was assessed to differentiate between patients who had PFS shorter or longer than the median PFS. Patients were dichotomized in terms of the cutoff value. The survival outcome of the two groups and the predictive ability of each factor on PFS were evaluated. RESULTS: Median time to PFS was 179 days. The best cutoff values for ADC, K(trans) , Kep , and Ve was 1.008 × 10(-3) mm(2) s(-1) , 0.108 min(-1) , 0.570 min(-1) , and 0.298%. Patients with higher ADC had significantly longer PFS than those with lower ADC(P < 0.0001). CONCLUSION: The ADC of HCC acquired before CCRT correlated with PFS and was valuable in the prediction of the clinical outcome of HCC treated with CCRT.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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