Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging for Prediction of Early Arterial Blood Flow Stasis in Radioembolization of Breast Cancer Liver Metastases

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• 作者：Claus Christian Pieper ; MD^a ; ^{claus.christian.pieper@ukb.uni-bonn.de" class="auth_mail" title="E-mail the corresponding author} ; Winfried Albert Willinek ; MD^a ; Carsten Meyer ; MD^a ; Hojjat Ahmadzadehfar ; MD^b ; Guido Matthias Kukuk ; MD^a ; Alois Martin Sprinkart ; MSc^a ; Wolfgang Block ; PhD^a ; Hans Heinz Schild ; MD^a ; Petra Mü ; rtz ; PhD^a
• 关键词：ADC ; apparent diffusion coefficient ; D&prime ; estimated true diffusion coefficient ; DWI ; diffusion-weighted imaging ; f&prime ; estimated perfusion fraction ; IVIM ; intravoxel incoherent motion ; LdBM ; liver dominant breast metastases ; ROC ; receiver operating characteristic ; ROI ; region of interest ; TARE ; transarterial radioembolization ; 90Y ; yttrium-90
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：27
• 期：9
• 页码：1320-1328
• 全文大小：617 K

文摘

To retrospectively evaluate predictive value of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for early arterial blood flow stasis during transarterial radioembolization (TARE) of liver dominant breast metastases (LdBM).

Materials and Methods

Preinterventional 1.5T DWI (b0, b1, b2 = 0, 50, 800 s/mm²) data for 28 liver lobes of 18 female patients treated by resin-based radioembolization (10 bilobar and 8 unilobar treatments) were analyzed. Apparent diffusion coefficient (ADC) (0, 800) and an estimation of the true diffusion coefficient D′ and of the perfusion fraction f′ were calculated for the 2 largest metastases. Response rate at 3 months and survival were analyzed. Procedures without full dose application because of early stasis were assigned to group A (n = 15), and procedures with full dose application were assigned to group B (n = 13).

Results

Metastases in group A showed significantly lower f′ (0.035 ± 0.018 vs 0.076 ± 0.015, P < .0001) and a trend toward lower ADC(0, 800) with values given in 10⁻⁶ mm²/s (1,066 ± 141 vs 1,189 ± 176, P = .051); no group difference was shown for D′. Groups were best discriminated by weighted mean f′ values of the 2 largest metastases with accuracy of 100%. Mean tumor diameter before and after TARE was 51 mm ± 18 and 50 mm ± 24 in group A and 47 mm ± 27 and 48 mm ± 32 for group B. Imaging response did not differ between groups (P = .545). Overall survival did not differ significantly between group A (230 d) and B (155 d) (P = .124).

Conclusions

Perfusion-sensitive IVIM parameter f′ may predict early blood flow stasis in patients undergoing TARE for LdBM. Determination of this parameter before intervention may increase awareness of the interventionalist and increase safety of microsphere administration.