Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma

Table 1 Summary of locoregional therapy studies

Ref.	Country	Subject number	Key findings
Juan et al[46], 2019	China	20	After TACE, the ADC and Dslow values of HCC increased significantly, and the value of Dfast decreased significantly; the f value did not change markedly.
Wu et al[47], 2019	China	55	Compared with nonresponders, the mean, median, and 25th percentile of the PF, ADC, and ADCtotal were higher in responders, while the skewness and kurtosis of PF, kurtosis of ADC and ADCtotal were lower
Lin et al[48], 2016	China	118	Before TACE, significant differences in ADC, Dslow and Dfast were observed between the effective and ineffective groups. After TACE, the effective group exhibited lower Dfast and higher ADC and Dslow values than the ineffective group. The tumor regression rate was negatively correlated with Dfast but positively correlated with ADC and Dslow
Park et al[50], 2014	Korea	44	The preoperative D* value was significantly increased in the good lipiodol uptake group compared with the poor uptake group after TACE, while the ADC, D, and f values were not significantly different between these two groups
Jia F et al[51], 2020	China	56	ROC curve analyses revealed that the combined model including APT SIs and D values was better able to predict the tumor response to TACE than the individual parameters
Wu L et al[52], 2017	China	30	The ADCtotal ratio and D ratio measured 24-48 h after TACE were independent predictors of the response to TACE of patients with HCC and showed stronger associations with PFS than mRECIST criteria
Hectors et al[53], 2020	United States	24	The ADC and D values of HCC were significantly increased at six weeks after radioembolization, while the D* values were significantly reduced, with no significant change in f values
Server et al[54], 2019	Turkey	15	The ADC and D values after LRT were significantly higher than those measured before treatment, while the f values were significantly lower than those recorded before LRT. In the responder group, the ADC and D values were significantly increased after LRT, whereas the f values were significantly reduced

TACE: Transarterial chemoembolization; ADC: Apparent diffusion coefficient; HCC: Hepatocellular carcinoma; PF: Perfusion fraction; ROC: Receiver operating characteristic; APT: Amide proton transfer; SIs: Signal intensities; PFS: Progression-free survival; LRT: Locoregional therapy.