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Diagnostics 2015, 5(4), 546-563; doi:10.3390/diagnostics5040546

The Role of Diffusion-Weighted Imaging (DWI) in Locoregional Therapy Outcome Prediction and Response Assessment for Hepatocellular Carcinoma (HCC): The New Era of Functional Imaging Biomarkers

1
Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT 06510, USA
2
Division of Interventional Radiology and Image-guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
3
Yale Cancer Center, Yale School of Medicine, New Haven, CT 06519, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Philippe L. Pereira
Received: 19 October 2015 / Revised: 12 November 2015 / Accepted: 19 November 2015 / Published: 30 November 2015
(This article belongs to the Special Issue Diagnosis of Hepatocellular Carcinoma)
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Abstract

Reliable response criteria are critical for the evaluation of therapeutic response in hepatocellular carcinoma (HCC). Current response assessment is mainly based on: (1) changes in size, which is at times unreliable and lag behind the result of therapy; and (2) contrast enhancement, which can be difficult to quantify in the presence of benign post-procedural changes and in tumors presenting with a heterogeneous pattern of enhancement. Given these challenges, functional magnetic resonance imaging (MRI) techniques, such as diffusion-weighted imaging (DWI) have been recently investigated, aiding specificity to locoregional therapy response assessment and outcome prediction. Briefly, DWI quantifies diffusion of water occurring naturally at a cellular level (Brownian movement), which is restricted in multiple neoplasms because of high cellularity. Disruption of cellular integrity secondary to therapy results in increased water diffusion across the injured membranes. This review will provide an overview of the current literature on DWI therapy response assessment and outcome prediction in HCC following treatment with locoregional therapies. View Full-Text
Keywords: diffusion-weighted MRI (magnetic resonance imaging); hepatocellular carcinoma; locoregional therapies; imaging biomarker; therapy outcome diffusion-weighted MRI (magnetic resonance imaging); hepatocellular carcinoma; locoregional therapies; imaging biomarker; therapy outcome
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Ludwig, J.M.; Camacho, J.C.; Kokabi, N.; Xing, M.; Kim, H.S. The Role of Diffusion-Weighted Imaging (DWI) in Locoregional Therapy Outcome Prediction and Response Assessment for Hepatocellular Carcinoma (HCC): The New Era of Functional Imaging Biomarkers. Diagnostics 2015, 5, 546-563.

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