Skip to main content
Erschienen in: European Radiology 2/2011

01.02.2011 | Hepatobiliary-Pancreas

The diffusion-weighted imaging perfusion fraction f is a potential marker of sorafenib treatment in advanced hepatocellular carcinoma: a pilot study

verfasst von: Maïté Lewin, Laetitia Fartoux, Alexandre Vignaud, Lionel Arrivé, Yves Menu, Olivier Rosmorduc

Erschienen in: European Radiology | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

Objective

To determine the total Apparent Diffusion Coefficient (ADC), the pure Diffusion coefficient (D) and the perfusion fraction (f) in advanced hepatocellular carcinoma (HCC) under sorafenib treatment.

Materials and methods

Two target tumors were prospectively analyzed in 12 patients at baseline, 2-weeks and 2-months treatment using b values of 0, 200, 400, 800 s/mm. Repeatability error was estimated on a healthy volunteer.

Results

Lesion sizes, ADC and D values did not significantly change during treatment (overall mean values, respectively, 47.8 ± 31.0 mm, 1.34 ± 0.14 × 10−3 mm2/s and 1.18 ± 0.22 × 10−3 mm2/s). However, f values significantly increased in seven responder patients (+38.39% at 2-weeks, +50.94% at 2-months, P = 0.005) while they decreased in five non responder patients (−41.93% at 2-weeks, P = 0.006). Furthermore, f was inversely correlated with αFP levels (P = 0.032) and responder patients had a higher mean overall survival (OS) than non responder patients (12.29 ± 4.46 vs. 7.80 ± 4.97 months). The % variation of f relative to baseline at 2-months was correlated with OS (P = 0.038) and symptomatic time to progression (P = 0.022).

Conclusion

Contrary to ADC and D, the perfusion fraction f is a valuable marker of sorafenib treatment in advanced HCC.
Literatur
1.
Zurück zum Zitat Llovet JM, Ricci S, Mazzaferro V et al (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359:378–390CrossRefPubMed Llovet JM, Ricci S, Mazzaferro V et al (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359:378–390CrossRefPubMed
2.
Zurück zum Zitat Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125PubMed Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125PubMed
3.
Zurück zum Zitat Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed
4.
Zurück zum Zitat Le Bihan D, Breton E, Lallemand D et al (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 168:497–505PubMed Le Bihan D, Breton E, Lallemand D et al (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 168:497–505PubMed
5.
Zurück zum Zitat Yamada I, Aung W, Himeno Y et al (1999) Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging. Radiology 210:617–623PubMed Yamada I, Aung W, Himeno Y et al (1999) Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging. Radiology 210:617–623PubMed
6.
Zurück zum Zitat Lewin M, Poujol-Robert A, Boëlle PY et al (2007) Diffusion-weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C. Hepatology 46:658–665CrossRefPubMed Lewin M, Poujol-Robert A, Boëlle PY et al (2007) Diffusion-weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C. Hepatology 46:658–665CrossRefPubMed
7.
Zurück zum Zitat Luciani A, Vignaud A, Cavet M et al (2008) Liver cirrhosis: intravoxel incoherent motion MR imaging-pilot study. Radiology 249:891–899CrossRefPubMed Luciani A, Vignaud A, Cavet M et al (2008) Liver cirrhosis: intravoxel incoherent motion MR imaging-pilot study. Radiology 249:891–899CrossRefPubMed
8.
9.
Zurück zum Zitat Kamel IR, Liapi E, Reyes DK et al (2009) Unresectable hepatocellular carcinoma: serial early vascular and cellular changes after transarterial chemobolization as detected with MR imaging. Radiology 250:466–473CrossRefPubMed Kamel IR, Liapi E, Reyes DK et al (2009) Unresectable hepatocellular carcinoma: serial early vascular and cellular changes after transarterial chemobolization as detected with MR imaging. Radiology 250:466–473CrossRefPubMed
10.
Zurück zum Zitat Chen CY, Li CW, Kuo YT et al (2006) Early response of hepatocellular carcinoma to transcatheter arterial chemoembolization: choline levels and MR diffusion constants-initial experience. Radiology 239:448–456CrossRefPubMed Chen CY, Li CW, Kuo YT et al (2006) Early response of hepatocellular carcinoma to transcatheter arterial chemoembolization: choline levels and MR diffusion constants-initial experience. Radiology 239:448–456CrossRefPubMed
11.
Zurück zum Zitat Schraml C, Schwenzer NF, Martirosian P et al (2009) Diffusion-weighted MRI of advanced hepatocellular carcinoma during sorafenib treatment: initial results. AJR Am J Roentgenol 193:W301–W307CrossRefPubMed Schraml C, Schwenzer NF, Martirosian P et al (2009) Diffusion-weighted MRI of advanced hepatocellular carcinoma during sorafenib treatment: initial results. AJR Am J Roentgenol 193:W301–W307CrossRefPubMed
12.
Zurück zum Zitat Jain RK, Duda DG, Willett CG et al (2009) Biomarkers of response and resistance to antiangiogenic therapy. Nat Rev Clin Oncol 6:327–338CrossRefPubMed Jain RK, Duda DG, Willett CG et al (2009) Biomarkers of response and resistance to antiangiogenic therapy. Nat Rev Clin Oncol 6:327–338CrossRefPubMed
13.
14.
Zurück zum Zitat Bruix J, Sherman M, Practice Guidelines Committee, American Association for the Study of Liver Diseases (2005) Management of hepatocellular carcinoma. Hepatology 42:1208–1236CrossRefPubMed Bruix J, Sherman M, Practice Guidelines Committee, American Association for the Study of Liver Diseases (2005) Management of hepatocellular carcinoma. Hepatology 42:1208–1236CrossRefPubMed
15.
Zurück zum Zitat Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumors: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247CrossRefPubMed Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumors: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247CrossRefPubMed
16.
Zurück zum Zitat Llovet JM, Di Bisceglie AM, Bruix J et al (2008) Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 100:698–711CrossRefPubMed Llovet JM, Di Bisceglie AM, Bruix J et al (2008) Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 100:698–711CrossRefPubMed
17.
Zurück zum Zitat Forner A, Ayuso C, Varela M et al (2009) Evaluation of tumor response after locoregional therapies in hepatocellular carcinoma: are response evaluation criteria in solid tumors reliable? Cancer 115:616–623CrossRefPubMed Forner A, Ayuso C, Varela M et al (2009) Evaluation of tumor response after locoregional therapies in hepatocellular carcinoma: are response evaluation criteria in solid tumors reliable? Cancer 115:616–623CrossRefPubMed
18.
Zurück zum Zitat Koh DM, Blackledge M, Collins DJ et al (2009) Reproducibility and changes in the apparent diffusion coefficients of solid tumours treated with combretastatin A4 phosphate and bevacizumab in a two-centre phase I clinical trial. Eur Radiol 19:2728–2738CrossRefPubMed Koh DM, Blackledge M, Collins DJ et al (2009) Reproducibility and changes in the apparent diffusion coefficients of solid tumours treated with combretastatin A4 phosphate and bevacizumab in a two-centre phase I clinical trial. Eur Radiol 19:2728–2738CrossRefPubMed
19.
Zurück zum Zitat Lewin M, Arrivé L, Lacombe C et al (2010) Diffusion-weighted MR imaging of liver pathology: principles and clinical applications. J Radiol 91:11–26CrossRefPubMed Lewin M, Arrivé L, Lacombe C et al (2010) Diffusion-weighted MR imaging of liver pathology: principles and clinical applications. J Radiol 91:11–26CrossRefPubMed
20.
Zurück zum Zitat Taouli B, Vilgrain V, Dumont E et al (2003) Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology 226:71–78CrossRefPubMed Taouli B, Vilgrain V, Dumont E et al (2003) Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology 226:71–78CrossRefPubMed
21.
Zurück zum Zitat Parikh T, Drew SJ, Lee VS et al (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822CrossRefPubMed Parikh T, Drew SJ, Lee VS et al (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822CrossRefPubMed
22.
Zurück zum Zitat Gourtsoyianni S, Papanikolaou N, Yarmenitis S et al (2008) 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 18:486–492CrossRefPubMed Gourtsoyianni S, Papanikolaou N, Yarmenitis S et al (2008) 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 18:486–492CrossRefPubMed
23.
Zurück zum Zitat Namimoto T, Yamashita Y, Sumi S et al (1997) Focal liver masses: characterization with diffusion-weighted echo-planar MR imaging. Radiology 204:739–744PubMed Namimoto T, Yamashita Y, Sumi S et al (1997) Focal liver masses: characterization with diffusion-weighted echo-planar MR imaging. Radiology 204:739–744PubMed
24.
Zurück zum Zitat Kim T, Murakami T, Takahashi S et al (1999) Diffusion-weighted single-shot echoplanar MR imaging for liver disease. AJR Am J Roentgenol 173:393–398PubMed Kim T, Murakami T, Takahashi S et al (1999) Diffusion-weighted single-shot echoplanar MR imaging for liver disease. AJR Am J Roentgenol 173:393–398PubMed
25.
Zurück zum Zitat Bruegel M, Holzapfel K, Gaa J et al (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18:477–485CrossRefPubMed Bruegel M, Holzapfel K, Gaa J et al (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18:477–485CrossRefPubMed
26.
Zurück zum Zitat Kamel IR, Bluemke DA, Ramsey D et al (2003) Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol 181:708–710PubMed Kamel IR, Bluemke DA, Ramsey D et al (2003) Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol 181:708–710PubMed
27.
Zurück zum Zitat Mannelli L, Kim S, Hajdu CH et al (2009) Assessment of tumor necrosis of hepatocellular carcinoma after chemoembolization: diffusion-weighted and contrast-enhanced MRI with histopathologic correlation of the explanted liver. AJR Am J Roentgenol 193:1044–1052CrossRefPubMed Mannelli L, Kim S, Hajdu CH et al (2009) Assessment of tumor necrosis of hepatocellular carcinoma after chemoembolization: diffusion-weighted and contrast-enhanced MRI with histopathologic correlation of the explanted liver. AJR Am J Roentgenol 193:1044–1052CrossRefPubMed
28.
Zurück zum Zitat Horger M, Lauer UM, Schraml C et al (2009) Early MRI response monitoring of patients with advanced hepatocellular carcinoma under treatment with the multikinase inhibitor sorafenib. BMC Cancer 9:208CrossRefPubMed Horger M, Lauer UM, Schraml C et al (2009) Early MRI response monitoring of patients with advanced hepatocellular carcinoma under treatment with the multikinase inhibitor sorafenib. BMC Cancer 9:208CrossRefPubMed
29.
Zurück zum Zitat Jain RK (2005) Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science 307:58–62CrossRefPubMed Jain RK (2005) Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science 307:58–62CrossRefPubMed
30.
Zurück zum Zitat Mitsuhashi N, Kobayashi S, Doki T et al (2008) Clinical significance of a-fetoprotein: involvement in proliferation, angiogenesis, and apoptosis of hepatocellular carcinoma. J Gastroenterol Hepatol 23:e189–e197CrossRefPubMed Mitsuhashi N, Kobayashi S, Doki T et al (2008) Clinical significance of a-fetoprotein: involvement in proliferation, angiogenesis, and apoptosis of hepatocellular carcinoma. J Gastroenterol Hepatol 23:e189–e197CrossRefPubMed
31.
Zurück zum Zitat Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30:52–60CrossRefPubMed Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30:52–60CrossRefPubMed
Metadaten
Titel
The diffusion-weighted imaging perfusion fraction f is a potential marker of sorafenib treatment in advanced hepatocellular carcinoma: a pilot study
verfasst von
Maïté Lewin
Laetitia Fartoux
Alexandre Vignaud
Lionel Arrivé
Yves Menu
Olivier Rosmorduc
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 2/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1914-4

Weitere Artikel der Ausgabe 2/2011

European Radiology 2/2011 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.