Abstract 2550: Early 3 Hour Imaging Demonstrates Substantial Diffusion Reversal with Lower Infarction Risk Compared to Tissue without Diffusion Reversal

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Andria L Ford ◽  
Hongyu An ◽  
Gyanendra Kumar ◽  
Katie D Vo ◽  
William J Powers ◽  
...  
Keyword(s):  
Lower Risk ◽  
Brain Regions ◽  
Lesion Volume ◽  
Stroke Patients ◽  
Infarct Core ◽  
Adc Value ◽  
Diffusion Weighted Images ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Abnormal Tissue

Background: Literature suggests that diffusion reversal--determined by visually inspecting diffusion-weighted images which reverse on subsequent imaging--is uncommon. However, these studies performed the initial scan 3 to 6 hrs from onset which may miss lesions that have already undergone reversal. We measured apparent diffusion coefficient (ADC) reversal between 2 scans obtained at 3 and 6 hrs from onset comparing infarct probability in reversed regions to brain regions with persistent ADC lesions. Methods: Ischemic stroke patients underwent 3 MRI’s: <4.5 hrs (tp1), at 6 hrs (tp2), and at 1 mo (tp3) after onset. Co-registered maps measured ADC lesions (tp1, tp2) and FLAIR infarct (tp3). Diffusion lesions were manually outlined as hypointense regions on ADC. A population-derived ADC threshold to distinguish abnormal from normal ADC was calculated based on the maximum ADC value capturing >90% of voxels within the outlined lesions. ADC values less than or greater than this threshold were defined as abnormal and normal, respectively. ADC “reversal” was defined as voxels with abnormal tp1 ADC and normal tp2 ADC, whereas ADC “non-reversal” was defined as abnormal ADC on both tp1 and tp2. Final infarcts were outlined as hyperintense regions on tp3 FLAIR. Infarct probability (% of the tp1 ADC lesion which infarcted on tp3) was compared between reversed and non-reversed tissue using a Mann-Whitney test. Leukoariosis or CSF voxels due to infarct atrophy were excluded from the infarct analysis. Results: 39 patients were prospectively scanned at 2.8hr (tp1), 6.4hr (tp2), and 1mo (tp3) after stroke onset (NIHSS=14, 74% received tPA). The population-derived ADC threshold to distinguish between abnormal and normal was 71 × 10 -5 mm 2 /s. Median ADC lesion volume at tp1 was 34ml [15, 70] and at tp2 was 34ml [14, 65]. Median ADC reversal volume was 6.6ml [5, 17], accounting for 34% [11, 44] of the tp1 ADC lesion volume (ADC non-reversal volume was 21ml [6, 50]). 31 of 39 (79%) and 20 of 39 (51%) patients had reversal volumes >10% and >33% of their initial ADC lesion, respectively. Infarct probability was lower (57%) in ADC reversal tissue compared to tissue with non-reversal (82%, p<0.0001) ( Figure ). To confirm that the derived ADC threshold distinguished abnormal tissue on tp1 from normal tissue on tp2, ADC tp1 and tp2 values were compared and differed (66 vs. 77, p<0.0001). Conclusion: While ADC closely approximates infarct core, during early ischemia, a substantial proportion of the initial ADC lesion may reverse. Brain tissue with this MR signature carries a significantly lower risk of infarction than tissue without ADC reversal.

Abstract WP83: Validation of a Relative Non-Contrast CT Map to Detect Early Ischemic Changes in Acute Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Margy E McCullough-Hicks ◽  
Soren Christensen ◽  
Aditya Srivatsan ◽  
Gregory W Albers ◽  
Maarten Lansberg
Keyword(s):  
Acute Stroke ◽  
Brain Regions ◽  
Lesion Volume ◽  
Stroke Patients ◽  
Infarct Core ◽  
Test Characteristics ◽  
Contrast Ct ◽  
Sensitivity Specificity ◽  
Early Infarction

Background: Discerning signs of early infarct on the non-contrast CT (NCCT) can be difficult. To facilitate interpretation of the NCCT we previously developed a technique to generate symmetry ratio maps of the NCCT (rNCCT maps) on which subtle (≥5%) differences in density between symmetric brain regions are enhanced. We sought to validate the rNCCT map against other measures of early infarction in a large cohort. Methods: rNCCT maps were generated for 146 ischemic stroke patients. We assessed how often a neurologist’s interpretation of the NCCT was changed when provided with the rNCCT map. The neurologist was blinded to CTP and DWI but was given the infarct hemisphere. In addition, using the 24-hour DWI as the gold standard, we assessed the sensitivity, specificity and volumetric accuracy of the rNCCT-defined infarct core and compared this to the test characteristics of CTP-defined infarct core (CBF<38% threshold). Results: Addition of rNCCT overlay map changed clinician’s initial read 64.4% of the time (95% CI 56-72%); the rNCCT identified new areas of ischemia not appreciated on blinded review 86.2% of the time (95% CI 78-92%) and in 35.1% helped rule out early ischemia where the reader was unsure of its presence (95% CI 26-45%). In the 53 patients with reperfusion and follow-up MRI, specificity of rNCCT for final lesion volume was 99.5% for rNCCT [98.5-99.8%] vs. 99.8% [IQR 98.8-99.9%] for CTP (P=0.08). Sensitivity for rNCCT was 19.9% [7.1-28.1%] vs. 17.5% [4.7-32.2%] for CTP (P=0.56). Conclusions: This study validates the rNCCT map for detection of early ischemic changes. It is more quantitative and objective than a clinician’s read of the NCCT alone. The sensitivity and specificity for detecting early ischemic changes on rNCCT were comparable to those achieved with CTP. This indicates that the rNCCT could be a valuable tool in the evaluation of acute stroke patients.

scholarly journals Non-mass Enhancement in Breast MRI: Characterization with BI-RADS Descriptors and ADC Values

2021 ◽  
Vol 3 (2) ◽  
pp. 77-87
Author(s):  
Wolfgang Buchberger ◽  
Willi Oberaigner ◽  
Christian Kremser ◽  
Kurt Gautsch ◽  
Uwe Siebert
Keyword(s):  
Kinetic Curve ◽  
Breast Mri ◽  
Distribution Patterns ◽  
Adc Value ◽  
Diffusion Weighted Images ◽  
Diffusion Weighted ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Curve Patterns ◽  
Mass Enhancement

Objectives: The purpose of this study was to assess the accuracy of contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging in distinguishing benign from malignant non-mass-like breast lesions. Methods: 103 lesions showing non-mass-like enhancement in 100 consecutive patients were analyzed. Distribution, internal enhancement patterns, and contrast kinetic curve patterns were classified according to the BI-RADS lexicon. Apparent diffusion coefficient (ADC) values were obtained from manually placed regions of interest (ROIs) on diffusion-weighted images. The optimal ADC value threshold for the distinction between benign and malignant lesions was determined by ROC analysis. Univariate and multivariate analyses were performed to identify independent predictors of malignancy, and the probability of malignancy was calculated for various combinations of findings. Histological diagnosis obtained by means of core needle biopsy was used as gold standard. Results: According to the univariate and multivariate analysis, odds ratios for malignancy were significantly elevated for clumped or clustered ring internal enhancement and low ADC values (p < 0.001), whereas distribution patterns and contrast kinetic patterns were not significantly correlated with benignity or malignancy. In non-mass lesions with homogeneous or heterogeneous internal enhancement and ADC values greater than 1.26×10-3mm2/s, no malignancy was detected, while all other combinations of findings had a probability of malignancy ranging from 22.2 to 76.6%. Conclusions: A combination of BI-RADS descriptors of internal enhancement and ADC values is useful for the differential diagnosis of lesions showing non-mass enhancement. Lesions with homogeneous or heterogeneous enhancement and high ADC can be followed up, while all other lesions should be biopsied. Doi: 10.28991/SciMedJ-2021-0302-1 Full Text: PDF

scholarly journals Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

2021 ◽  
Author(s):  
Alexey Surov ◽  
Hans-Jonas Meyer ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Jasan Omari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Lymph Nodes ◽  
Meta Analysis ◽  
Adc Value ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background Our aim was to provide data regarding use of diffusion-weighted imaging (DWI) for distinguishing metastatic and non-metastatic lymph nodes (LN) in rectal cancer. Methods MEDLINE library, EMBASE, and SCOPUS database were screened for associations between DWI and metastatic and non-metastatic LN in rectal cancer up to February 2021. Overall, 9 studies were included into the analysis. Number, mean value, and standard deviation of DWI parameters including apparent diffusion coefficient (ADC) values of metastatic and non-metastatic LN were extracted from the literature. The methodological quality of the studies was investigated according to the QUADAS-2 assessment. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian, and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean DWI values including 95% confidence intervals were calculated for metastatic and non-metastatic LN. Results ADC values were reported for 1376 LN, 623 (45.3%) metastatic LN, and 754 (54.7%) non-metastatic LN. The calculated mean ADC value (× 10−3 mm2/s) of metastatic LN was 1.05, 95%CI (0.94, 1.15). The calculated mean ADC value of the non-metastatic LN was 1.17, 95%CI (1.01, 1.33). The calculated sensitivity and specificity were 0.81, 95%CI (0.74, 0.89) and 0.67, 95%CI (0.54, 0.79). Conclusion No reliable ADC threshold can be recommended for distinguishing of metastatic and non-metastatic LN in rectal cancer.

scholarly journals Differentiating Benign from Malignant Sinonasal Lesions: Feasibility of Diffusion Weighted MRI

2017 ◽  
Vol 21 (04) ◽  
pp. 358-365 ◽  
Author(s):  
Khaled El-Gerby ◽  
Mohammad El-Anwar
Keyword(s):  
Predictive Value ◽  
Quantitative Methods ◽  
Malignant Tumors ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Tumor Tissues ◽  
Apparent Diffusion ◽  
Diagnostic Role ◽  
Adc Values ◽  
Histopathological Results

Introduction Appearance of nasal masses on routine CT and MRI are not pathognomonic. We utilized the apparent diffusion coefficient (ADC) value obtained from diffusion weighted image (DWI) to detect the differences in the microstructures of tumor and non-tumor tissues. Objective The objective of our study was to evaluate the diagnostic role of DWI and ADC values in differentiating between malignant and benign sinonasal lesions and its correlation with histopathological results as the reference standard. Methods Patients with nasal and / or paranasal mass underwent CT, MRI, and DWI before any surgical intervention. We used diagnostic sinonasal endoscopy and biopsy to confirm the diagnosis after MRI. Results When we used ADC value of (1.2 × 10–3 mm2/s) as a cut-off value for differentiating benign from malignant sinonasal lesions, we achieved 90% accuracy, 100% sensitivity, 88.4% specificity, 77.8% positive predictive value, and 100% negative predictive value. At this cut-off, benign lesions show statistically significant higher ADC value than malignant tumors. Conclusion DW MRI and ADC value calculation are promising quantitative methods helping to differentiate between malignant and benign sinonasal lesions. Thus, they are effective methods compared with other conventional methods with short imaging time thus it is recommended to be incorporated into routine evaluations.

scholarly journals NI-14 EVALUATION OF PREOPERATIVE APPARENT DIFFUSION COEFFICIENT (ADC) OF PERITUMORAL LESION FOR PREDICTING SITE PRONE TO RECURRENCE IN PATIENTS WITH GLIOBLASTOMA

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii28-ii28
Author(s):  
Kenichiro Matsuda ◽  
Kaori Sakurada ◽  
Takamasa Kayama ◽  
Yukihiko Sonoda
Keyword(s):  
Radiation Treatment ◽  
Extent Of Resection ◽  
High Signal ◽  
Adc Value ◽  
Postoperative Mri ◽  
Retrospective View ◽  
Signal Region ◽  
Contrast Enhanced ◽  
Apparent Diffusion ◽  
Adc Values

Abstract PURPOSE In the surgery of glioblastoma (GBM), the maximum safe resection is desired in order to prevent recurrence. The purpose of this study is to make it possible to evaluate the site in which the recurrence after resection of the tumor occur, according to the findings in preoperative MRI, and to avoid the recurrence. METHOD The 26 initial cases with GBM treated in our department was investigated. Preoperative MRI, postoperative MRI, and follow-up MRI during the course were analyzed in a retrospective view. In the FLAIR high-signal area around the contrast-enhanced tumor body in preoperative MRI, we investigated the relationship between the site and the ADC value, from the standpoint of whether a recurrence occurred or not. RESULTS For preoperative MRI of 26 patients, the FLAIR high-signal region was set to a total of 54 ROI, and several values, such as the ADC values, were measured. In the preoperative images, ADC were higher in the site where the no recurrence occurred during the postoperative course and lower in the site where the recurrence occurred. CONCLUSION In the FLAIR high-signal area around the tumor in preoperative images, ADC value is useful in evaluating whether it has tendency to develop the recurrence in the future course or not. It was suggested that significant recurrence occurs at part with low-ADC value. It is considered useful for the planning of the extent of resection in the surgery and the irradiation range in radiation treatment.

Influence of menstrual status and pathological type on the apparent diffusion coefficient in cervical cancer: a primary study

2020 ◽  
pp. 028418512092689
Author(s):  
Yue Dong ◽  
Rui Tong Dong ◽  
Xiao Miao Zhang ◽  
Qing Ling Song ◽  
Tao Yu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Primary Study ◽  
Adc Value ◽  
Cervical Cancers ◽  
Menstrual Status ◽  
Pathological Type ◽  
Apparent Diffusion ◽  
Adc Values

Background Apparent diffusion coefficient (ADC) value is an important quantitative parameter in the research of cervical cancer, affected by some factors. Purpose To investigate the effect of pathological type and menstrual status on the ADC value of cervical cancer. Material and Methods A total of 352 individuals with pathologically confirmed cervical cancer between January 2015 to December 2017 were retrospectively enrolled in this study, including 317 cases with squamous cell carcinomas (SCC) and 35 cases with adenocarcinomas (AC); 177 patients were non-menopausal and 175 were menopausal. All patients underwent a routine 3.0-T magnetic resonance imaging (MRI) scan and diffusion-weighted imaging (DWI) examination using b-values of 0, 800, and 1000 s/mm2. Three parameters including mean ADC (ADCmean), maximum ADC (ADCmax), and minimum ADC (ADCmin) of cervical cancer lesions were measured and retrospectively analyzed. Independent samples t-test was used to compare the difference of ADC values in different menstrual status and pathological types. Results In all menopausal and non-menopausal patients, the ADCmean and ADCmin values of SCC were lower than those of AC ( P<0.05), the ADCmax of two pathological types showed no statistical difference ( P > 0.05). In menopausal patients, the ADCmean, ADCmax, and ADCmin values of SCC were not statistically different compared with those of AC ( P > 0.05). The ADCmean, ADCmax, and ADCmin values of different pathological types cervical cancers in non-menopausal patients were all higher than those in menopausal patients ( P<0.05). Conclusion The ADC values of the cervical cancers were different in different pathological types and were also affected by menstrual status.

scholarly journals Assessment of Apparent Diffusion Coefficient Values as Predictor of Aggressiveness in Peripheral Zone Prostate Cancer: Comparison with Gleason Score

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Shayan Sirat Maheen Anwar ◽  
Zahid Anwar Khan ◽  
Rana Shoaib Hamid ◽  
Fahd Haroon ◽  
Raza Sayani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Gleason Score ◽  
Case Series ◽  
Adc Value ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion Coefficient Value ◽  
Apparent Diffusion ◽  
Adc Values

Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants were positive for malignancy. 89 lesions with proven malignancy showed diffusion restriction. The mean ADC value for disease with a Gleason score of 6 was 935 mm2/s (SD=248.4 mm2/s); Gleason score of 7 was 837 mm2/s (SD=208.5 mm2/s); Gleason score of 8 was 614 mm2/s (SD=108 mm2/s); and Gleason score of 9 was 571 mm2/s (SD=82 mm2/s). Inverse relationship was observed between Gleason score and mean ADC values. Conclusion. DWI and specifically quantitative ADC values may help differentiate between low-risk (Gleason score, 6), intermediate-risk (Gleason score, 7), and high-risk (Gleason score 8 and 9) prostate cancers, indirectly determining the aggressiveness of the disease.

scholarly journals Evaluation of apparent diffusion coefficient in endometrial carcinoma compared to normal endometrium: a retrospective study

2021 ◽  
Author(s):  
Anu Sarah Easo ◽  
Rajeev Anand ◽  
Mini Issac
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Retrospective Study ◽  
Apparent Diffusion Coefficient ◽  
Normal Endometrium ◽  
Adc Value ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Endometrial Cancers

Background: To determine whether diffusion-weighted imaging (DWI) with measurement of apparent diffusion coefficient (ADC) will help in differentiating endometrial cancer from normal endometrium and to determine whether the grades of endometrial cancer will show significant difference in ADC values.Methods: This is a retrospective study done in MOSC medical college hospital Kolencherry. on patients on whom preoperative MRI was done before hysterectomy. Cases from July 2017 to March 2021 were included. Study cases included 40 females with pathologically confirmed endometrial cancer and 30 females with pathologically proven normal endometrium in cases of uterine leiomyoma and cervical cancer. The exclusion criteria for the study were patients with endometrial cancer in whom surgery was not done within 2 weeks of MRI, patients who were treated with chemotherapy or radiotherapy before surgery, patients who had hydrometra or pyometra.Results: The mean ADC value (10−3 mm2/second) of endometrial cancer was 0.77±0.04, which was significantly lower (p<0.05) than that of normal endometrium (1.323±0.05). The ADC values of different grades of endometrial cancers did not show any statistically significant difference (p>0.05).Conclusions: Our study showed that ADC measurement can differentiate between normal endometrium and endometrial cancer. The ADC values of different grades of endometrial cancers did not show any statistically significant difference.  

scholarly journals Use of apparent diffusion coefficients in evaluating the response of vestibular schwannomas to Gamma Knife surgery

2012 ◽  
Vol 117 (Special_Suppl) ◽  
pp. 63-68 ◽  
Author(s):  
Chun-Chao Chuang ◽  
Cheng-Siu Chang ◽  
Yu-Sheng Tyan ◽  
Keh-Shih Chuang ◽  
Hsien-Tang Tu ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Diffusion Coefficients ◽  
Tumor Volume ◽  
Imaging Studies ◽  
Adc Value ◽  
Apparent Diffusion Coefficients ◽  
Apparent Diffusion ◽  
Adc Values ◽  
The Mean

Object Cellular density is a major factor responsible for changes in apparent diffusion coefficients (ADCs). The authors hypothesized that loss of tumor cells after Gamma Knife surgery (GKS) might alter ADC values. Magnetic resonance imaging, including diffusion-weighted (DW) imaging, was performed to detect cellular changes in brain tumors so that the authors could evaluate the tumor response to GKS as well as the efficacy of the procedure. Methods The authors conducted a prospective trial involving 31 patients harboring solid or cystic vestibular schwannomas (VSs) that were treated with GKS. The patients underwent serial MR imaging, including DW imaging, before GKS and at multiple intervals following the procedure. The authors observed the patients over time, evaluating MR imaging findings and clinical outcomes at 6-month intervals. The ADCs were calculated from echo-planar DW images, and mean ADC values were compared at each follow-up. Results The mean follow-up period was 36.5 months (range 18–60 months). Imaging studies showed a reduction in tumor volume in 19 patients (61.3%) and tumor growth arrest in 9 patients (29%). In the remaining 3 patients (9.7%), tumor enlargement was documented at 18, 36, and 42 months. The mean ADC value before GKS for all solid VSs was 1.06 ± 0.17 × 10−3 mm2/second, which significantly increased 6 months after GKS and continued to increase with time (p = 0.0086). The mean ADC value for treated solid tumors as of the last mean follow-up of 36 months (range 18–60 months) was 1.72 ± 0.26 × 10−3 mm2/second (range 1.50–2.09 × 10−3 mm2/second), which was significantly higher than that before GKS (p = 0.0001). Tumor volumes were positively related to ADC values (p = 0.03). The mean ADC value before GKS for all cystic VSs was 2.09 ± 0.24 × 10−3 mm2/second (range 1.80–2.58 × 10−3 mm2/second). The mean ADC value for treated cystic tumors as of the last mean follow-up of 38 months (range 18–48 months) was 1.89 ± 0.22 × 10−3 mm2/second. In 3 patients harboring solid VSs, the tumor enlarged after GKS but the ADC values were higher than those before GKS. The authors considered these tumors to be controlled and continued follow-up in the patients. Conclusions Apparent diffusion coefficient values may be useful for evaluating treatment results before any definite volume change is detected on imaging studies and for distinguishing radiation-induced necrosis from tumor recurrence in cases in which other imaging results are not definitive, as in cases of increased tumor volume or no volume change. The authors suggest that ADC measurements be included during routine MR imaging examinations for the evaluation of GKS results.

scholarly journals Apparent diffusion coefficient can predict therapy response of hepatocellular carcinoma to transcatheter arterial chemoembolization

2021 ◽  
Author(s):  
Ralph Drewes ◽  
Constanze Heinze ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Katja Woidacki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Transcatheter Arterial Chemoembolization ◽  
Meta Analysis ◽  
Therapy Response ◽  
Adc Value ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Arterial Chemoembolization

Aim: The goal of this meta-analysis was to assess the apparent diffusion coefficient (ADC) as a pre- and posttreatment (ΔADC) predictive imaging biomarker of response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: SCOPUS database, EMBASE database and MEDLINE library were scanned for connections between pre- and posttreatment ADC values of HCC and response to TACE. Six studies qualified for inclusion. The following parameters were collected: authors, publication year, study design, number of patients, drugs for TACE, mean ADC value, standard deviation, measure method, b-values and Tesla-strength. The QUADAS-2 instrument was employed to check the methodological quality of each study. The meta-analysis was performed by utilizing RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance were used to regard heterogeneity. Mean ADC values and 95% confidence intervals were computed. Results: Six studies (n=271 patients with 293 HCC nodules) were included. The pretreatment mean ADC in the responder group was 1.20 x 10-3 mm2/s (0.98, 1.42) and 1.14 x 10-3 mm2/s (0.89, 1.39) in the non-responder group. The analysis of post TACE ADC value changes (ΔADC) revealed a threshold of ≥ 20% to identify treatment responders. No suitable pretreatment ADC threshold to predict therapy response or discriminate between responders and non-responders before therapy could be discovered. Conclusion: ΔADC can facilitate early objective response evaluation through post-therapeutic ADC alterations ≥ 20%. Pretreatment ADC cannot predict response to TACE.

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