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Diffusion-Weighted MRI of Advanced Hepatocellular Carcinoma During Sorafenib Treatment: Initial Results

¹ Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
² Section on Experimental Radiology, University Hospital Tübingen, Tübingen, Germany.
³ Department of Internal Medicine (Hepatology, Gastroenterology), University Hospital Tübingen, Tübingen, Germany.

OBJECTIVE. The objective of our study was to evaluate signal changes of advanced hepatocellular carcinoma in diffusion-weighted MRI in the early-response monitoring of oral therapy with the multikinase inhibitor sorafenib.

CONCLUSION. Hepatocellular carcinoma lesions exhibit characteristic but unusual apparent diffusion coefficient (ADC) changes during sorafenib therapy, consisting of early decrease in ADC after therapy onset followed by a reincrease. The ADC changes seem to reflect the underlying pathophysiologic mechanisms in tumor necrosis (most probably hemorrhagic) induced by this novel targeted agent early after therapy onset and may indicate tumor reactivation in the later follow-up period.

Keywords: diffusion-weighted imaging • hepatocellular carcinoma • sorafenib • treatment monitoring

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