The Added Value of Apparent Diffusion Coefficient Measurement in the Evaluation of Hepatocellular Carcinoma after Locoregional Therapy Utilizing LI-RADS Treatment Response Algorithm

Document Type : Original Article


The Department of Diagnostic Radiology, Faculty of Medicine, Mansoura University1, Department of Internal Medicine, Faculty of Medicine, Horus University2, Department of Medical Oncology, Oncology Center, Mansoura University3 and Department of Internal Medicine, Faculty of Medicine, Mansoura University4


Abstract Background: To evaluate the additional utility of apparent diffusion coefficient measurement to the treatment response al-gorithm of the Liver Imaging Reporting and Data System ver-sion 2018. Aim of Study: For the purpose of assessing therapeutic re-sponse following locoregional hepatocellular carcinoma treatment. Material and Methods: 110 patients with previously treat-ed HCC who underwent liver magnetic resonance imaging (MRI) were included in this retrospective analysis. According to the LR-TR grading system, treated hepatocellular carcinomas were divided into 3 groups: LR-TR nonviable, LR-TR equivo-cal, and LR-TR viable. Two blinded reviewers independently determined the ADCmean measures of the treated lesions. Results: According to both observers, the ADC mean values for viable HCC were 1.04±0.18 and 1.026±0.17 x 10-3mm2/s, non-viable HCC was 1.48±0.19 and 1.47±0.19 x 10-3mm2/s, and equivocal HCC was 1.29±0.18 and 1.29±0.18 x 10-3mm2/s. With respect to viable HCC (r=0.93), non-viable HCC (r=0.805), and equivocal HCC (r=0.98), there was greatsimilarity between the two assessments. Both observers utilized the same ADC mean cut-off value of 1.355 and 1.251 x 10-3mm2/s with (AUC) of 0.8 and 0.92 to distinguish between viable and non-viable HCC. With an AUC of 0.853 and 0.87, the ADC mean cut-off values utilized to distinguish between viable and equivocal HCC were 1.206 and 1.1125 x 10-3 mm2/s, respectively. With AUC values of 0.82 and 0.76, the ADC mean cut-off values utilized to distinguish between non-viable and equivocal HCC were 1.426 and 1.372 x 10-3mm2/s, respectively. Conclusions: The LI-RADS-v2018 TR algorithm may per-form better and be used in clinical settings if ADC measure-ment is included.