Evidence map›Paper›PMID 32894356›Full record

ArticleEuropean radiology2021

Post-TACE changes in ADC histogram predict overall and transplant-free survival in patients with well-defined HCC: a retrospective cohort with up to 10 years follow-up.

Mohammadreza Shaghaghi, Mounes Aliyari Ghasabeh, Sanaz Ameli, Maryam Ghadimi, Bita Hazhirkarzar, Roya Rezvani Habibabadi, Pegah Khoshpouri, Ankur Pandey, Pallavi Pandey, Ihab R Kamel

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Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

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0cells of the map it votes in
7citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mohammadreza ShaghaghiThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Mounes Aliyari GhasabehThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Sanaz AmeliThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Maryam GhadimiThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Bita HazhirkarzarThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Roya Rezvani HabibabadiThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Pegah KhoshpouriThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Ankur PandeyThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Pallavi PandeyThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA.
Ihab R KamelThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 600 N. Wolfe Street/MRI 143, Baltimore, MD, 21287, USA. ikamel@jhmi.edu.ORCID http://orcid.org/0000-0003-0511-7796

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the role of change in apparent diffusion coefficient (ADC) histogram after the first transarterial chemoembolization (TACE) in predicting overall and transplant-free survival in well-circumscribed hepatocellular carcinoma (HCC).

methodsInstitution database was searched for HCC patients who got conventional TACE during 2005-2016. One hundred four patients with well-circumscribed HCC and complete pre- and post-TACE liver MRI were included. Volumetric MRI metrics including tumor volume, mean ADC, skewness, and kurtosis of ADC histograms were measured. Univariate and multivariable Cox models were used to test the independent role of change in imaging parameters to predict survival. P values < 0.05 were considered significant.

resultsIn total, 367 person-years follow-up data were analyzed. After adjusting for baseline liver function, tumor volume, and treatment modality, incremental percent change in ADC (ΔADC) was an independent predictor of longer overall and transplant-free survival (p = 0.009). Overall, a decrease in ADC-kurtosis (ΔkADC) showed a strong role in predicting longer survival (p = 0.021). Patients in the responder group (ΔADC ≥ 35%) had the best survival profile, compared with non-responders (ΔADC < 35%) (p < 0.001). ΔkADC, as an indicator of change in tissue homogeneity, could distinguish between poor and fair survival in non-responders (p < 0.001). It was not a measure of difference among responders (p = 0.244). Non-responders with ΔkADC ≥ 1 (homogeneous post-TACE tumor) had the worst survival outcome (HR = 5.70, p < 0.001), and non-responders with ΔkADC < 1 had a fair survival outcome (HR = 2.51, p = 0.029), compared with responders.

conclusionsChanges in mean ADC and ADC kurtosis, as a measure of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in well-circumscribed HCC, in order to monitor early response to TACE and identify patients with treatment failure and poor survival outcome. KEY POINTS: • Changes in the mean and kurtosis of ADC histograms, as the measures of change in tissue heterogeneity, can be used to predict overall and transplant-free survival in patients with well-defined HCC. • A ≥ 35% increase in volumetric ADC after TACE is an independent predictor of good survival, regardless of the change in ADC histogram kurtosis. • In patients with < 35% ADC change, a decrease in ADC histogram kurtosis indicates partial response and fair survival, while ∆kurtosis ≥ 1 correlates with the worst survival outcome.

Indexed as

Carcinoma, HepatocellularChemoembolization, TherapeuticLiver NeoplasmsDiffusion Magnetic Resonance ImagingFollow-Up StudiesHumansRetrospective StudiesTreatment OutcomeCarcinoma, hepatocellularChemoembolization, therapeuticDiffusion magnetic resonance imagingSurvival analysisTreatment outcome

Identifiers

PMID32894356

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