7 886

Cited 0 times in

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

 Chansik An  ;  Mi-Suk Park  ;  Hyae-Min Jeon  ;  Yeo-Eun Kim  ;  Woo-Suk Chung  ;  Yong Eun Chung  ;  Myeong-Jin Kim  ;  Ki Whang Kim 
 EUROPEAN RADIOLOGY, Vol.22(8) : 1701-1708, 2012 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Hepatocellular/diagnosis* ; Diffusion ; Diffusion Magnetic Resonance Imaging/methods* ; Female ; Gadolinium DTPA/pharmacology ; Hepatocytes/pathology ; Humans ; Image Processing, Computer-Assisted/methods ; Liver Neoplasms/diagnosis* ; Male ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Reproducibility of Results ; Subtraction Technique
Hepatocellular carcinoma ; Gd-EOB-DTPA ; Diffusion-weighted MRI ; Subtraction technique ; Tumor grading
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.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Yeo Eun(김여은)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Chung, Woo Seok(정우석)
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.