摘要Objective:The aim of this study was to predict tumor progression in patients with hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA) using histogram analysis of apparent diffusion coefficients (ADC).Methods:Breath-hold diffusion weighted imaging (DWI) was performed in 64 patients (33 progressive and 31 stable) with biopsy-proven HCC prior to RFA.All patients had pre-treatment magnetic resonance imaging (MR.I)and follow-up computed tomography (CT) or MRI.The ADC values (ADC10,ADC30,ADCmedian and ADCmax) were obtained from the histogram's 10th,30th,50th and 100th percentiles.The ratios of ADC10,ADC30,ADCmedian and ADCmax to the mean non-lesion area-ADC (RADC10,RADC30,RADCmedian,and RADCmax) were calculated.The two patient groups were compared.Key predictive factors for survival were determined using the univariate and multivariate analysis of the Cox model.The Kaplan-Meier survival analysis was performed,and pairs of survival curves based on the key factors were compared using the log-rank test.Results:The ADC30,ADCmedian,ADCmax,RADC30,RADCmedian,and RADCmax were significantly larger in the progressive group than in the stable group (P＜0.05).The median progression-free survival (PFS) was 22.9 months for all patients.The mean PFS for the stable and progressive groups were 47.7±1.3 and 9.8±1.3 months,respectively.Univariate analysis indicated that RADC10,RADC30,and RADCmedian were significantly correlated with the PFS [hazard ratio (HR)=31.02,43.84,and 44.29,respectively,P＜0.05 for all].Multivariate analysis showed that RADCmedian was the only independent predictor of tumor progression (P=0.04).And the cutoff value of RADCmedian was 0.71.Conclusions:Pre-RFA ADC histogram analysis might serve as a useful biomarker for predicting tumor progression and survival in patents with HCC treated with RFA.