CardioVascular and Interventional Radiology

, Volume 40, Issue 6, pp 852–859 | Cite as

Predicting Treatment Response of Colorectal Cancer Liver Metastases to Conventional Lipiodol-Based Transarterial Chemoembolization Using Diffusion-Weighted MR Imaging: Value of Pretreatment Apparent Diffusion Coefficients (ADC) and ADC Changes Under Therapy

  • Maximilian Lahrsow
  • Moritz H. Albrecht
  • Matthew W. Bickford
  • Thomas J. Vogl
Clinical Investigation
First Online:
Received:
Accepted:

Abstract

Purpose

To use absolute pretreatment apparent diffusion coefficients (ADC) derived from diffusion-weighted MR imaging (DWI) to predict response to repetitive cTACE for unresectable liver metastases of colorectal carcinoma (CRLM) at 1 and 3 months after start of treatment.

Materials and Methods

Fifty-five metastases in 34 patients were examined with DWI prior to treatment and 1 month after initial cTACE. Treatment was performed in 4-week intervals. Response was evaluated at 1 and 3 months after start of therapy. Metastases showing a decrease of ≥30% in axial diameter were classified as responding lesions.

Results

One month after initial cTACE, seven lesions showed early response. There was no significant difference in absolute pretreatment ADC values between responding and non-responding lesions (p = 0.94). Three months after initial cTACE, 17 metastases showed response. There was a significant difference (p = 0.021) between absolute pretreatment ADC values of lesions showing response (median 1.08 × 10−3 mm2/s) and no response (median 1.30 × 10−3 mm2/s). Pretreatment ADC showed fair diagnostic value to predict response (AUC 0.7). Lesions showing response at 3 months also revealed a significant increase in ADC between measurements before treatment and at one month after initial cTACE (p < 0.001). Applying an increase in ADC of 12.17%, response at 3 months after initial cTACE could be predicted with a sensitivity and specificity of 77 and 74%, respectively (AUC 0.817). Furthermore, there was a strong and significant correlation (r = 0.651, p < 0.001) between percentage change in size after third cTACE and percentage change in ADC.

Conclusion

In patients with CRLM, ADC measurements are potential biomarkers for assessing response to cTACE.

Keywords

Conventional transarterial chemoembolization (cTACE) Colorectal cancer liver metastases (CRLM) Diffusion-weighted imaging (DWI) Apparent diffusion coefficient (ADC) 
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Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional RadiologyUniversity Hospital FrankfurtFrankfurt am MainGermany
  2. 2.Department of Radiology and Radiological ScienceMedical University of South CarolinaCharlestonUSA

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