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

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.