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Prediction of the histopathological grade of hepatocellular carcinoma using qualitative diffusion-weighted, dynamic, and hepatobiliary phase MRI.

 Chansik An ; Mi-Suk Park ; Ki Whang Kim ; Myeong-Jin Kim ; Yong Eun Chung ; Woo-Suk Chung ; Yeo-Eun Kim ; Hyae-Min Jeon 
 European Radiology, Vol.22(8) : 1701~1708, 2012 
Journal Title
 European Radiology 
Issue Date
OBJECTIVES: To investigate the effectiveness of qualitative diffusion-weighted imaging (DWI), subtraction of unenhanced from arterial phase images, and hepatobiliary phase (HBP) images in estimating the histopathological grade of hepatocellular carcinoma (HCC). METHODS: We retrospectively reviewed gadoxetic acid-enhanced magnetic resonance images of 175 patients with 201 surgically resected HCCs. The signal intensity and its relationship with histopathological grade were assessed for each sequence and a combination of sequences. RESULTS: There was a tendency towards higher grades in tumours showing restricted diffusion on DWI (P < 0.001) or arterial enhancement on subtraction imaging (P < 0.001), but not hepatocyte-defect on HBP images (P = 0.33). When lesions were divided into three groups based on combined findings on DWI and subtraction imaging, a linear trend was observed between group and grade (P < 0.001). The positive predictive value (PPV) of the combination of no restricted diffusion and no arterial enhancement in predicting well-differentiated HCC was 100%, higher than the PPV of individual findings on DWI (74%) or subtraction imaging (81%). CONCLUSIONS: DWI and subtraction imaging are helpful for predicting the histopathological grade of HCC, especially when the two sequences are considered together. KEY POINTS: • Predicting the histopathological grade of hepatocellular carcinoma (HCC) preoperatively is important. • Diffusion-weighted imaging (DWI) and subtraction imaging are recently developed MR techniques. • Retrospective study showed DWI and subtraction imaging helps predict HCC grades. • Management of patients with HCC becomes more appropriate.
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1. 연구논문 > 1. College of Medicine > Dept. of Radiology
Yonsei Authors
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