Pre-TACE kurtosis of ADCtotal derived from histogram analysis for diffusion-weighted imaging is the best independent predictor of prognosis in hepatocellular carcinoma
To determine the feasibility of pre-TACE IVIM imaging based on histogram analysis for predicting prognosis in the treatment of unresectable hepatocellular carcinoma (HCC).
Materials and methods
Fifty-five patients prospectively underwent 1.5T MRI 1 week before TACE. Histogram metrics for IVIM parameters and ADCs maps between responders and non-responders with mRECIST assessment were compared. Kaplan–Meier, log-rank tests and Cox proportional hazard regression model were used to correlate variables with time to progression (TTP).
Mean (p = 0.022), median (p = 0.043), and 25th percentile (p < 0.001) of perfusion fraction (PF), mean (p < 0.001), median (p < 0.001), 25th percentile (p < 0.001) and 75th percentile (p = 0.001) of ADC(0,500), mean (p = 0.005), median (p = 0.008) and 25th percentile (p = 0.039) of ADCtotal were higher, while skewness and kurtosis of PF (p = 0.001, p = 0.005, respectively), kurtosis of ADC(0,500) and ADCtotal (p = 0.005, p = 0.001, respectively) were lower in responders compared to non-responders. Multivariable analysis demonstrated that mRECIST was associated with TTP independently, and kurtosis of ADCtotal had the best predictive performance for disease progression.
Pre-TACE kurtosis of ADCtotal is the best independent predictor for TTP.
• mRECIST was associated with TTP independently.
• Lower kurtosis and higher mean for ADCs tend to have good response.
• Pre-TACE kurtosis of ADC total is the best independent predictor for TTP.
KeywordsMagnetic resonance imaging Diffusion Hepatocellular carcinoma Therapy Prognosis
Apparent diffusion coefficient
True diffusion coefficient
Intravoxel incoherent motion
Time to progression
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Mengsu Zeng.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
Shengxiang Rao kindly provided statistical advice for this manuscript.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
- 28.Choi Y, Kim SH, Youn IK, Kang BJ, Park WC, Lee A (2017) Rim sign and histogram analysis of apparent diffusion coefficient values on diffusion-weighted MRI in triple-negative breast cancer: Comparison with ER-positive subtype. PLoS One 12:e177903Google Scholar