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Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study

 Seung Up Kim  ;  Young Chul Kim  ;  Ji Soo Choi  ;  Kyung Sik Kim  ;  Gi Hong Choi  ;  Jin Sub Choi  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Eun Hee Choi  ;  Young Nyun Park  ;  Chae Yoon Chon  ;  Kwang-Hyub Han  ;  Myeong-Jin Kim 
 MAGNETIC RESONANCE IMAGING, Vol.28(6) : 802-811, 2010 
Journal Title
Issue Date
Adult ; Aged ; Area Under Curve ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/surgery* ; Carcinoma, Hepatocellular/virology ; Diffusion Magnetic Resonance Imaging/methods* ; Female ; Hepatic Insufficiency/diagnosis* ; Hepatitis B/complications* ; Humans ; Hyperbilirubinemia/complications ; Hyperbilirubinemia/diagnosis ; Liver/pathology ; Liver/surgery ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Neoplasms/complications ; Liver Neoplasms/surgery* ; Liver Neoplasms/virology ; Male ; Middle Aged ; Observer Variation ; Pilot Projects ; Postoperative Complications/diagnosis* ; Predictive Value of Tests ; Preoperative Care/methods* ; Prospective Studies ; ROC Curve ; Reproducibility of Results ; Survival Analysis
Fibrosis ; Cirrhosis ; Chronic hepatitis B ; Hepatitis B virus ; Diffusion-weighted magnetic resonance imaging ; Apparent diffusion coefficient ; Liver stiffness measurement ; Transient elastography ; Hepatectomy ; Hepatocellular carcinoma
Liver fibrosis determines the functional liver reserve. Several studies have reported that the apparent diffusion coefficient (ADC) values of diffusion-weighted magnetic resonance imaging (DW-MRI) can assess liver fibrosis. We investigated whether DW-MRI predicts postoperative hepatic insufficiency and liver fibrosis in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Twenty-six patients with HBV-related HCC who received preoperative DW-MRI on a 3-T MRI system were enrolled between July and December 2008. ADC values were measured twice by two observers. Three "b values" were used: 50, 400 and 800 s/mm(2). Postoperative hepatic insufficiency was defined as persistent hyperbilirubinemia (total bilirubin level >5 mg/dl for more than 5 days after surgery) or postoperative death without other causes. The mean age (21 men and 5 women) was 51.4 years. Three patients experienced postoperative hepatic insufficiency. liver stiffness measurement predicted postoperative hepatic insufficiency, advanced fibrosis (F3-4), and cirrhosis significantly [area under the receiving operator characteristic curve (AUROC)=0.942, 0.771 and 0.818, respectively, with P=.047, 0.048 and 0.006, respectively]; ADC values of DW-MRI, however, did not (AUROC=0.797, 0.648 and 0.491, respectively, with P=.100, 0.313 and 0.938, respectively). Reliability of ADC values between right and left hepatic lobes (rho=0.868 and rho=0.910 in the first and second measures of Observer A; rho=0.865 and rho=0.831 in the first and second measures of Observer B) was high and the intra- and interobserver reliability (rho=0.958 in observer A and rho=0.977 in observer B; rho=0.929 in the first measure and rho=0.978 in the second measure between the two observers) were high. All reliability was significant (P<.001). Our results suggest that DW-MRI on a 3-T MRI system is not suitable for predicting postoperative hepatic insufficiency, advanced liver fibrosis, and cirrhosis in patients with HBV-related HCC, despite significantly high reliability
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Do Young(김도영)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Young Chul(김영철)
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Eun Hee(최은희)
Choi, Ji Soo(최지수)
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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