Diagnostic Accuracy of the Apparent Diffusion Coefficient for Microvascular Invasion in Hepatocellular Carcinoma: A Meta-analysis

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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Questionable correlation of the apparent diffusion coefficient with the histological grade and microvascular invasion in small hepatocellular carcinoma

Clinical Radiology ◽

10.1016/j.crad.2019.01.019 ◽

2019 ◽

Vol 74 (5) ◽

pp. 406.e19-406.e27

Author(s):

J.G. Kim ◽

K.M. Jang ◽

G.S. Min ◽

T.W. Kang ◽

D.I. Cha ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Histological Grade ◽

Microvascular Invasion ◽

Small Hepatocellular Carcinoma ◽

Apparent Diffusion

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Early detection treatment response for head and neck carcinomas using intravoxel incoherent motion-magnetic resonance imaging: a meta-analysis

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20190507 ◽

2020 ◽

pp. 20190507

Author(s):

Qingxu Song ◽

Fang Li ◽

Xin Chen ◽

Jianbo Wang ◽

Hong Liu ◽

...

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Diagnostic Accuracy ◽

Head And Neck ◽

Treatment Response ◽

Meta Analysis ◽

Intravoxel Incoherent Motion ◽

Perfusion Fraction ◽

Apparent Diffusion ◽

Pre Treatment

Objectives: To evaluate the diagnostic accuracy of intravoxel incoherent motion-MRI (IVIM-MRI) for predicting the treatment response in head and neck squamous cell carcinomas (HNSCC) patients. Methods: A comprehensive literature search was performed to identify original articles on diagnostic performance of IVIM in predicting treatment response in HNSCC patients receiving chemoradiotherapy. The IVIM parameters studied were diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient. Summary estimates of diagnostic accuracy were obtained by using a random-effects model. Of 65 studies screened, 8 studies with 347 patients were finally included. Results: The pooled sensitivities and specificities were 76% [95% confidence interval (CI) 69–82%] and 81% (95% CI 70–89%) for pre-treatment D, and 70% (95% CI 58–80%) and 82% (95% CI 66–92%) for △D, respectively. In addition, the sensitivities and specificities ranged from 41.7 to 94% and 67 to 100% for pre-treatment f, and from 55.7 to 76.5% and 72.2 to 93.3% for pre-treatment apparent diffusion coefficient, respectively. Conclusions: The diffusion-related coefficients pre-treatment D and △D demonstrated good accuracy in predicting early treatment response in HNSCC patients. However, because of the variability in reference test and other limitations of included literature, further investigation is needed before implementing any IVIM strategy into clinical practice.

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Utility of diffusion weighted imaging with the quantitative apparent diffusion coefficient in diagnosing residual or recurrent hepatocellular carcinoma after transarterial chemoembolization: a meta-analysis

Cancer Imaging ◽

10.1186/s40644-019-0282-9 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Zhao Liu ◽

Jin-Ming Fan ◽

Chen He ◽

Zhi-Fan Li ◽

Yong-Sheng Xu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Transarterial Chemoembolization ◽

Diffusion Weighted Imaging ◽

Meta Analysis ◽

Adc Value ◽

Recurrent Hepatocellular Carcinoma ◽

Diffusion Weighted ◽

Apparent Diffusion

Abstract Background Accurate and early diagnosis of residual tumors or intrahepatic recurrences after TACE is critically needed for determining the success of treatments and for guiding subsequent therapeutic planning. This meta-analysis was performed to assess the efficacy of diffusion weighted imaging (DWI) with the quantitative apparent diffusion coefficient (ADC) value in diagnosing residual or recurrent hepatocellular carcinoma after transarterial chemoembolization (TACE). Materials and methods A comprehensive literature search of PubMed, Embase, Web of Science, Scopus and the Cochrane Library database, from inception to July 2019, was conducted to select original studies on diagnosing residual or recurrent HCCs after TACE using DWI sequence with its ADC value. Two researchers independently chose study, extracted data, conducted meta-analysis, and evaluated methodological quality according to Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results Twelve studies comprising 624 patients and 712 tumors were finally included. The pooled sensitivity, specificity and AUC value of DWI in diagnosing residual or recurrent HCCs after TACE were 85% (95%CI: 74–92%), 83% (95%CI: 75–88%) and 0.90 (95%CI: 0.87–0.92), respectively. Residual or recurrent HCCs have significantly lower ADC value than necrotic tumors (MD = -0.48, 95%CI: − 0.69~ − 0.27, P < 0.01). Conclusion This study demonstrated that DWI performed better in diagnosing residual or recurrent HCCs after TACE, and ADC value may serve as alternatives for further evaluation of residual or recurrent leisions in HCC patients after TACE.

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Apparent diffusion coefficient for differentiating between benign and malignant hepatic focal lesions

Egyptian Liver Journal ◽

10.1186/s43066-020-00068-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Sherif Abugamra ◽

Aya Yassin ◽

Asmaa Saber Mostafa Abdel-Rehim ◽

Dina Sayed Sheha

Keyword(s):

Hepatocellular Carcinoma ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Focal Lesion ◽

Benign Lesions ◽

Focal Lesions ◽

Significant Difference ◽

Apparent Diffusion ◽

Malignant Lesions ◽

The Mean

Abstract Background The aim of this study was to prospectively evaluate the role of diffusion weight MRI (DWI) in the characterization of hepatic focal lesions by using apparent diffusion coefficient (ADC). Thirty patients (18 women, 12 men; mean age 48.5 years) with hepatic focal lesions were included in this study. Patients underwent DW MR imaging with the SPLICE sequence. ADC of each focal lesion carcinoma was calculated from DW MR Images obtained with low and high b values. ADCs were compared among pathological types of focal lesions. Results Among the 30 patients included in the study, 46 focal lesions were detected. Twenty-four lesions were metastatic lesions from primary cancer, 7 lesions were hepatocellular carcinoma (HCC), 9 lesions were hemangiomas, and 6 lesions were simple cysts. There was highly significant difference between the mean ADC of the malignant lesions (metastasis and HCC) and the mean ADC of benign lesions (hemangiomas and cysts). The ADC of malignant lesion was much less than that of benign lesion. The mean ADC of malignant lesions (n = 31) was 0.73 ± 0.19 × 10−3 mm2/s, and the mean ADC of benign lesions (n = 15) was 1.94 ± 0.68 × 10−3 mm2/s (p value < 0.001). There was no significant difference between the cysts and hemangiomas. There was no statistically significant difference between the metastases and hepatocellular carcinoma. Conclusion ADCs values were able to differentiate benign from malignant lesions. ADC should be considered in the work up of patients with hepatic focal lesions.

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

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03986-8 ◽

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.

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