Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Table 1 Data derived from the main published studies that have tested correlations between apparent diffusion coefficient values and pathological grade of hepatocellular carcinomas

Study	Number of patients	b values(s/mm2)	mean ADC value(× 10-3 mm2/s)
Nasu et al[23]	99	0, 500	1.45 (WD); 1.46 (MD); 1.36 (PD)
Piana et al[24]	99	0, 500	1.29 (WD); 1.22 (MD); 1.21 (PD)
Saito et al[25]	32	100, 800	1.25 (WD); 1.12 (MD); 1.13 (PD)
Muhi et al[26]	73	500, 800	0.91 (WD); 0.71 (MD); 0.68 (PD)
Nishie et al[27]	80	0, 500, 1000	1.21 (WD); 1.14 (MD); 0.76 (PD)
Heo et al[28]	27	0, 1000	1.20 (WD); 1.10 (MD); 0.90 (PD)
Nakanishi et al[29]	44	0, 50, 1000	1.29 (MD); 1.07 (PD)

ADC: Apparent diffusion coefficient; WD: Well differentiated; MD: Moderately differentiated; PD: Poorly differentiated.

Table 2 Data derived from the main published studies that have correlated apparent diffusion coefficient quantification with the pathological grade of pancreatic ductal adenocarcinomas and neuroendocrine tumors

Study	n	b values(s/mm2)	Histotype	mean ADC value(× 10-3 mm2/s)
Wang et al[43]	21	0, 500	PDAC	2.10 (WD-MD); 1.46 (PD)
Legrand et al[44]	22	Multiple1	PDAC	1.43 (WD); 1.94 (MD-PD)
Rosenkrantz et al[45]	30	0, 500	PDAC	1.78/1.75 (WD-MD); 1.69/1.62 (PD)2
Wang et al[58]	18	0, 50, 500	PanNET	1.75 (G1); 1.00 (G3)
Jang et al[59]	20	0, 800	PanNET	1.48 (G1-G2); 1.04 (G3)
Hwang et al[60]	44	Multiple3	PanNET	1.31 (G1); 1.08 (G2-G3)

¹50, 200, 400, 600, 800 s/mm²;

²Two readers;

³0, 25, 50, 75, 100, 150, 200, 500, 800, 1000 s/mm². n: Number of patients; ADC: Apparent diffusion coefficient; PDAC: Pancreatic ductal adenocarcinoma; WD: Well differentiated; PanNET: Pancreatic neuroendocrine tumor; MD: Moderately differentiated; PD: Poorly differentiated.

Table 3 Data derived from the main published studies that have evaluated apparent diffusion coefficient values before and after trans-arterial treatments of primary and metastatic liver tumors

Study	n	b values (s/mm2)	ADC before treatment(× 10-3 mm2/s)	ADC after treatment(× 10-3 mm2/s)	Histotype	Treatment
Kamel et al[86]	38	0, 500	1.51	1.70	HCC	TACE
Sahin et al[87]	74	0, 50, 400, 800	1.10	1.27	HCC	TACE
Kamel et al[88]	24	0, 50, 750	1.86	2.13	HCC	TACE
Chen et al[89]	20	0, 500	1.56	2.09	HCC	TACE
Yuan et al[90]	41	0, 500	2.22	1.42	HCC	TACE
Deng et al[98]	6	0, 500	1.30	2.23	HCC	TARE
Kamel et al[99]	13	0, 500	1.65	1.95	HCC	TARE
Rhee et al[100]	20	0, 500	1.64	1.82	HCC	TARE
Mannelli et al[102]	36	0, 50, 500	1.64	1.92	HCC	TACE
Kubota et al[103]	25	0, 500	1.271	1.3571/1.2222	HCC	TACE
Liapi et al[120]	26	0, 500	1.51	1.79	Metastases (PanNET)	TACE
Li et al[121]	26	0, 750	1.31	1.59	Metastases (PanNET)	TACE

¹No disease relapse;

²Disease relapse. ADC values are presented as means. n: Number of patients; ADC: Apparent diffusion coefficient; HCC: Hepatocellular carcinoma; PanNET: Pancreatic neuroendocrine tumor; TACE: Trans-arterial chemoembolization; TARE: Trans-arterial radioembolization.

Table 4 Data derived from the main published studies that have correlated functional radiological techniques with response to systemic therapies of hepatic and pancreatic tumors

Study	n	Technique	Imaging biomarker	Histotype	Treatment
Lewin et al[107]	12	IVIM	f increase	HCC	sorafenib
Vouche et al[108]	15	DWI	ADC increase	HCC	90Y TARE ± sorafenib
Hsu et al[109]	31	DCE-MRI	Ktrans decrease	HCC	sorafenib+metronomic tegafur/uracil
Yopp et al[111]	17	DCE-MRI	AUC90/AUC180/Ktrans decrease	HCC	bevacizumab
Jiang et al[112]	23	pCT	BF/BV/PS decrease	HCC	bevacizumab + cytotoxic agents
			MTT increase
Kim et al[113]	10	DCE-MRI/DWI	Ktrans/Kep decrease	HCC	sunitinib
			ADC increase
Sahani et al[114]	23	DCE-MRI/DWI	Ktrans/Kep decrease	HCC	sunitinib
			ADC increase
Kim et al[123]	35	pCT	BF decrease	CRC metastases	XELOX, FOLFOX, FOLFIRI
Schlemmer et al[124]	24	pCT	Perfusion decrease	PanNET metastases	Tyrosine-kinase inhibitors
Anzidei et al[125]	18	pCT, DWI	CP decrease	CRC metastases	Oxaliplatinum, capecitabine, bevacizumab
			ADC increase
De Bruyne et al[127]	19	DCE-MRI	AUC decrease	CRC metastases	Bevacizumab
Vriens et al[129]	23	DCE-MRI	Ktrans decrease	CRC metastases	Cytotoxic therapy
Coenegrachts et al[130]	10	DCE-MRI	Kep increase	CRC metastases	Bevacizumab + FOLFIRI
Deckers et al[126]	20	DWI	ADC decrease	CRC metastases	Chemotherapy
Niwa et al[133]	63	DWI	ADC decrease	PDAC	Gemcitabine
Cuneo et al[134]	12	DWI	ADC increase	PDAC	Chemoradiation
Yao et al[135]	39	pCT	BF decrease	PanNET	Bevacizumab ± everolimus
Miyazaki et al[132]	20	DCE-MRI	Distribution volume increase	PanNET metastases	90Y-octretotide

n: Number of patients; IVIM: Intravoxel incoherent-motion diffusion-weighted imaging; f: Perfusion fraction; HCC: Hepatocellular carcinoma;

⁹⁰Y TARE: ⁹⁰Yttrium trans-arterial radioembolization; DWI: Diffusion-weighted imaging; ADC: Apparent diffusion coefficient; DCE-MRI: Dynamic contrast-enhanced MRI; K^trans: Volume transfer constant; AUC₉₀, AUC₁₈₀: Area under the curve at 90 and 180 s; pCT: Perfusion computed tomography; BF: Blood flow; BV: Blood volume; PS: Permeability surface; MTT: Mean transit time; K_ep: Rate constant; CP: Capillary permeability.