Diffusion-weighted magnetic resonance imaging to predict response of hepatocellular carcinoma to chemoembolization

Table 1 Patient demographic data (n = 16)

Demographics	n
Sex
Male	15
Female	1
Age
> 65 yr	7
≤ 65 yr	9
Ethnicity
Caucasian	9
Asian	3
Hispanic	2
African American	1
Other	1
Etiology of liver disease1
Alcoholic hepatitis	4
Hepatitis B	4
Hepatitis C	8
Hemochromatosis	1
Auto-immune hepatitis	1
Cryptogenic cirrhosis	1
ECOG class
0	7
1	9
Tumor distribution
Solitary	3
Multifocal	13
Extrahepatic metastases
Yes	2
No	14
Infiltrative tumor
Yes	0
No	16
Portal vein thrombosis
Yes	1
No	15
Tumor burden
> 50% of liver volume	0
< 50% of liver volume	16

¹Two patients had both hepatitis C and alcoholic hepatitis; one patient had both hepatitis B and alcoholic hepatitis. ECOG: Eastern Cooperative Oncology Group.

Table 2 HCC staging (n = 16)

Staging system	n
Child–Pugh
A	7
B	9
C	0
CLIP
0	1
1	5
2	10
Okuda
I	7
II	9
III	0

HCC: Hepatocellular carcinoma; CLIP: Cancer of the liver italian program.

Table 3 Liver function tests (mean ± SD)

Serum test	Baseline	1 mo	3 mo
AFP (ng/mL)	1633 ± 5997	5599 ± 21080	1264 ± 2684
AST (U/L)	62.6 ± 23.9	66.2 ± 32.1	80.7 ± 64.5
ALT (U/L)	52.6 ± 31.0	54.8 ± 39.1	53.1 ± 49.4
Alkaline phosphatase (U/L)	160 ± 75.0	203 ± 107	173 ± 68.8
Total bilirubin (mg/dL)	1.38 ± 0.644	1.28 ± 0.75	2.23 ± 2.22

AFP: α-fetoprotein; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.

Table 4 Utility of intra-procedural ADC %Δ to predict 1-mo HCC response n (%)

ADC %Δ threshold	Sensitivity	Specificity	PPV	NPV
±5	77	67	91	40
±10	54	67	88	25
±15	46	100	100	30

ADC: Apparent diffusion coefficient; PPV: Positive predictive value; NPV: Negative predictive value.