Diffusion weighted magnetic resonance imaging of liver: Principles, clinical applications and recent updates

Table 3 Role of diffusion-weighted magnetic resonance in assessment of treatment response[75-79]

Ref.	Treatment modality	Tumor type	DW-MR parameter evaluated	Study results/teaching point
Chapiro et al[79]	TACE	HCC	(3D) quantitative enhancement-based and DW volumetric MR	High accuracy and intermethod agreement of 3D quantitative techniques in the assessment of tumor necrosis after TACE is clinically relevant
				High diagnostic performance of qEASL criteria and qADC may help in triaging patients for repeat treatment after a TACE session
Mannelli et al[87]	TACE	HCC	ADC measured with DWI in treatment response	Pre TACE ADC obtained at 0, 50, 500 s/mm2b values before and after treatment may be used to predict HCC response to TACE
Park et al[42]	Radiotherapy	HCC	DW MR vs conventional MR for treatment response	Improved detection of viable tumor when DW MR is added to conventional sequences
Yu et al[76]	Radiation therapy	HCC	DW MR	Change in ADC value before and after RT is related to local progression free survival. Hence ADC value and RECIST may substitute for mRECIST in patients who cannot receive contrast agents
Schraml et al[77]	Radiofrequency	n = 16 HCC, 1 = cholangiocarcinoma, and 37 = metastases (28 colorectal cancer, 3 melanoma, 3 breast cancer, 1 pancreatic cancer, 1 gastric cancer, esophageal cancer)	DW MR and mean ADC values	ADC-based evaluation of signal alterations adjacent to the ablation zone may contribute to the identification of local tumor progression and nontumoral post- treatment tissue changes
	Ablation

HCC: Hepatocellular carcinoma; DW MR: Diffusion-weighted magnetic resonance; TACE: Trans-arterial chemoembolization.