caa a22 4500 605492433 CHVBK 20210128100515.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00261-014-0295-6 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0295-6 Can volumetric ADC measurement help predict response to Y90 radioembolization in HCC? [Elektronische Daten] [Michael Vouche, Riad Salem, Robert Lewandowski, Frank Miller] Aim: To compare changes in RECIST, anatomical volume, mRECIST, and volumetric diffusion-weighted Imaging parameters (3D apparent diffusion coefficient (ADC) measurements), with pathological analysis of hepatocellular carcinoma (HCC) treated by 90Yttrium radioembolization (Y90). Methods: 21 patients were treated by Y90 as a sole treatment modality for solitary, >2cm HCC that underwent liver transplantation. MRI at baseline, 1 and 3months post-Y90, and tumor pathological findings on explants were reviewed in all patients. Results: Compared to baseline (RECIST/volume: 3.6cm/17.7cm3), RECIST and volume were not modified after Y90 (1month, p=0.28/0.09 RECIST/tumor volume; 3months, p=0.28/0.54). In contrast, mRECIST (3.3-1.4cm, p<0.001), mean ADC (0.185-1.093mm2/s×10−3, p=0.04), and ADC standard deviation (STD) (0.041-0.201mm2/s×10−3, p=0.0496) changed as earlier as 1month post-Y90. ADC STD % change was higher in ADC responding lesions than non-responding lesions at 1month (p=0.002) and 3months (p=0.008). All lesions exhibited necrosis on pathological analysis (11 partially viable, 10 complete pathological necrosis (CPN)) but no imaging criterion was able to predict CPN. mRECIST (±ADC) at 1 (κ±ADC=0.08/0.06) or 3months (κ=−0.06/−0.06) were poor predictors of pathological response. Conclusion: As soon as 1month post-treatment, mRECIST and volumetric ADC performed better than traditional size RECIST or volumetric parameters in detecting imaging response to Y90; however, CPN cannot be predicted by any criteria. Improvements in methodologies to assess response and identification of better surrogates are awaited. Springer Science+Business Media New York, 2014 Hepatocellular carcinoma nationallicence Radioembolization nationallicence Yttrium-90 nationallicence Response assessment nationallicence ADC nationallicence ADC : Apparent diffusion coefficient nationallicence cTACE : Conventional transarterial chemoembolization nationallicence CPN : Complete pathological necrosis nationallicence DWI : Diffusion-weighted imaging nationallicence GRE : Gradient echo nationallicence (m)RECIST : (Modified) response criteria in solid tumors nationallicence MRI : Magnetic resonance imaging nationallicence IQR : Interquartile range nationallicence 99Tc-MAA : 99Technetium-macroaggregated albumin nationallicence STD : Standard deviation nationallicence Y90 : 90Yttrium radioembolization nationallicence Vouche Michael Section of Interventional Radiology and Division of Interventional Oncology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA aut Salem Riad Section of Interventional Radiology and Division of Interventional Oncology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA aut Lewandowski Robert Section of Interventional Radiology and Division of Interventional Oncology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA aut Miller Frank Department of Radiology, Feinberg School of Medicine, Northwestern Memorial Hospital, Northwestern University, 676 North Saint Clair Street Suite 800, 60611, Chicago, IL, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/6(2015-08-01), 1471-1480 0942-8925 40:6<1471 2015 40 261 https://doi.org/10.1007/s00261-014-0295-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0295-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vouche Michael Section of Interventional Radiology and Division of Interventional Oncology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA aut NATIONALLICENCE 700 1- Salem Riad Section of Interventional Radiology and Division of Interventional Oncology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA aut NATIONALLICENCE 700 1- Lewandowski Robert Section of Interventional Radiology and Division of Interventional Oncology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA aut NATIONALLICENCE 700 1- Miller Frank Department of Radiology, Feinberg School of Medicine, Northwestern Memorial Hospital, Northwestern University, 676 North Saint Clair Street Suite 800, 60611, Chicago, IL, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/6(2015-08-01), 1471-1480 0942-8925 40:6<1471 2015 40 261