Evaluating the efficacy of interventional hepatocellular carcinoma via dynamic contrast-enhanced magnetic resonance imaging: A retrospective study

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is a common malignant tumor. Early diagnosis and treatment are crucial for improving patient prognosis. Interventional therapy is an important treatment method for HCC. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), an effective imaging assessment technique, can monitor changes in tumor blood flow in real time and provide important information for evaluating treatment effects.

AIM

To determine the clinical effectiveness of diffusion-weighted imaging (DWI) in conjunction with DCE-MRI in evaluating the therapeutic response to interventional therapy for HCC.

METHODS

Between February 2023 and March 2024, 120 HCC patients who received interventional therapy at First Affiliated Hospital of Naval Military Medical University were retrospectively analyzed. Patients were divided into two groups: (1) 71 received effective treatment; and (2) 49 received ineffective treatment. Fifty-two males and 19 females, with an average age of 53.16 ± 8.47 years, composed the effective group. The mean age of the ineffective group, which consisted of 18 females and 31 males, was 53.21 ± 8.69 years. All patients had regular MRI, DCE-MRIs, and DWIs taken before and three weeks after the intervention. The tumor volume, extracellular volume fraction (Ve), transport constant (Ktrans), apparent diffusion coefficient (ADC), and rate constant (Kep) are among the important imaging parameters that were examined.

RESULTS

The ADC significantly increased to (1.23 ± 0.14) × 10^-3 mm²/second (t = 10.970, P < 0.05), the tumor volume decreased to 10.67 ± 2.48 cm³ (t = 26.683, P < 0.05), the Ktrans significantly decreased to 0.18 ± 0.07 minute^-1 (t = 9.090, P < 0.05), the Kep significantly decreased to 0.31 ± 0.06 minute^-1 (t = 11.829, P < 0.05), and the Ve significantly increased to 0.40 ± 0.05 (t = 6.252, P < 0.05) following the intervention. The ADC [(0.35 ± 0.08) × 10^-3 mm²/second], Ktrans (0.24 ± 0.06 minute^-1), Kep (0.47 ± 0.12 minute^-1), Ve (0.46 ± 0.13), and tumor volume (10.57 ± 2.34 cm³) substantially differed between the effective treatment group and the ineffective group (all P < 0.05). According to the receiver operating characteristic (ROC) analysis, therapeutic success was predicted by an ADC difference greater than 0.380 × 10^-3 mm²/second, with an area under the ROC curve of 0.953 (95%CI: 0.898-0.983, P < 0.001), a sensitivity of 91.84%, and a specificity of 91.55%. With a sensitivity and specificity of 89.80% and 88.73%, respectively, an area under the ROC curve of 0.933 (95%CI: 0.872-0.970, P < 0.001) was obtained for a Ktrans difference greater than 0.250 minute^-1.

CONCLUSION

There is substantial clinical relevance in combining DCE-MRI with DWI to assess how well HCC patients respond to interventional treatments. For patients with HCC, changes in imaging parameters before and after treatment offer objective information that shows the effectiveness of the therapy and can direct future clinical management and treatment planning.

Keywords: Liver cancer; Enhanced magnetic resonance; Diffusion-weighted imaging; Interventional therapy; Application value

Core Tip: To evaluate the efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in interventional therapy for hepatocellular carcinoma (HCC). DCE-MRI, as an advanced imaging technique, can provide dynamic information on tumor blood flow, perfusion and microvascular permeability, which is highly important for the diagnosis and therapeutic evaluation of HCC. By analyzing the DCE-MRI data of patients, this study focused on investigating the changes in blood flow and drug delivery characteristics of tumors before and after interventional therapy. The research results show that DCE-MRI can effectively reflect the effect of interventional treatment for HCC and provide a more accurate basis for evaluating clinical efficacy. Furthermore, the high-resolution and multiparameter characteristics of DCE-MRI enable it to demonstrate unique advantages in monitoring the process of tumor treatment, especially in the early assessment of small liver cancer.