The Preliminary Clinical Study Of Magnetic Resonance Imaging In Predicting The Efficacy Of Microwave Ablation For Primary Liver Cancer

Part I The Predictive Value of IVIM in the Microwave Ablation Treatment of Hepatocellular Carcinoma.ObjectiveTo investigate the predictive value of IVIM in the microwave ablation treatment of hepatocellular carcinoma.Materials and MethodsA retrospective analysis was performed for 32 patients with hepatocellular carcinoma by the microwave ablation treatment between January 2015 and December 2017,and according to the presence or absence of focal recurrence within half a year,these patients were divided into recurrence group and non recurrence group.All patients underwent MRI scanning before and after the microwave ablation operation.Using whole-volume method,ADC and IVIM related parameters were obtained.The independent samples t-test was used for comparion of various parameters between the recurrence group and non recurrence group.The receiver operating characteristic curve was used for calculating the diagnostic efficiency of each parameter,and the area under the ROC curve was compared by the Z test.ResultsThe maximal diameter of the tumor between the two groups was（36.00±6.841）mm/（31.36±8.061）mm respectively,and the difference between the two groups was statistically significant（t=-2.026,P<0.05）mm.The comparison of ADC and D values between the recurrent group and the non recurrence group was statistically significant,and the area under the ROC curve was 0.802 and 0.820 respectively.The ADC value of 1.365×10^-3mm²/s as a cut off value with sensitivity of 87.5%and specificity of 72%for the prediction of local recurrent.The D value of 1.962×10^-3mm²/s as a cut off value with sensitivity of 81.25%and specificity of 72.22%for the prediction of local recurrent.The diagnostic efficiency of D was higher than that of ADC at 1 month after microwave ablation treatment,but there was no significant difference between them.Conclusion The D values of parients at 1 month after microwave ablation treatment may be useful in predicting recurrence and may help radiologists to monitor tumor response after treatment.Part Ⅱ The Predictive Value of MR Image Texture Analysis in Microwave Ablation of Hepatocellular Carcinoma Objective To investigate the predictive value of MR image（T2WI-SPAIR）texture analysis in the efficacy of microwave ablation for hepatocellular carcinoma.Materials and Methods A retrospective analysis was performed for a total of 38 focal solid hepatic lesions in 34 patients with hepatocellular carcinoma by the microwave ablation treatment between January 2015 and December 2017,and according to the presence or absence of focal recurrence within half a year,these patients were divided into recurrence group and non recurrence group.All patients underwent MRI scanning before the microwave ablation operation.And the area of interest（ROI）was drawn on the T2WI-SPAIR charts by using whole-volume method,related parameters of tumor heterogeneity were obtained.The independent samples t-test was used for comparion of various parameters between the recurrence group and non recurrence group.The receiver operating characteristic curve was used for calculating the diagnostic efficiency of each parameter,and the area under the ROC curve was compared by the Z test.Results The maximal diameter of the tumor between the two groups was（35.93±7.45）mm/（31.22±6.59）mm respectively,and the difference between the two groups was statistically significant（t =-2.047,P <0.05）.In T2WI-SPAIR images,the difference of entropy and skewness between the non recurrence group and the relapse group was statistically significant.The entropy value of 3.99 as a cut off value with sensitivity of 73.33% and specificity of 95.65% for the prediction of local recurrent.The skewness value of-0.163 as a cut off value with sensitivity of 80.00% and specificity of 60.87% for the prediction of local recurrent.The diagnostic efficiency of entropy was higher than that of skewness in T2W-SPAIR images,but there was no significant difference between them.Conclusion MR image（T2WI-SPAIR）texture analysis of parients may be useful in predicting recurrence and may help radiologists to monitor tumor response after treatment.