Pseudoglandular Formation in Hepatocellular Carcinoma Determines Apparent Diffusion Coefficient in Diffusion-Weighted MRI
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To determine the impact of pseudoglandular formation on apparent diffusion coefficient (ADC) values of hepatocellular carcinoma (HCC) in diffusionweighted imaging (DWI), and to validate the results using histopathological grades. Materials and Methods: We assessed 182 HCCs surgically resected from 169 consecutive patients. Each type of tumor pseudoglandular formation was categorized into “non-,” “mixed-,” or “pure-,” based on official histopathology reports. The ADC for each tumor was independently measured, using the largest region of interest on the ADC map. Data were assessed using the analysis of variance test, with Bonferroni correction for post hoc analysis to stratify the relationship of ADCs with pseudoglandular formation, followed by subgroup analysis according to the histopathological tumor grades. Results: The mean ADC was significantly higher in pure pseudoglandular lesions (n = 5, 1.29 ± 0.08 × 10-3 mm2/s) than in non-pseudoglandular lesions (n = 132, 1.08 ± 0.17 × 10-3 mm2/s; P = 0.003) or mixed-pseudoglandular lesions (n = 45, 1.16 ± 0.24 × 10-3 mm2/s; P = 0.034). The ADC values and pseudoglandular formation were significantly correlated in moderately differentiated HCCs (n = 103; r = 0.307, P = 0.007), while well- (n = 19) and poorly-differentiated HCCs (n = 60) did not show significant correlation (r = 0.105 and 0.068, respectively; P = 0.600 and 0.685, respectively). Conclusion: The degree of pseudoglandular formation could be one of the determinants of ADC in DWI of HCCs-especially moderately differentiated HCCs-while its influence does not appear to be significant in well- or poorly differentiated HCCs.
Abstract
Purpose: To determine the impact of pseudoglandular formation on apparent diffusion coefficient (ADC) values of hepatocellular carcinoma (HCC) in diffusionweighted imaging (DWI), and to validate the results using histopathological grades. Materials and Methods: We assessed 182 HCCs surgically resected from 169 consecutive patients. Each type of tumor pseudoglandular formation was categorized into “non-,” “mixed-,” or “pure-,” based on official histopathology reports. The ADC for each tumor was independently measured, using the largest region of interest on the ADC map. Data were assessed using the analysis of variance test, with Bonferroni correction for post hoc analysis to stratify the relationship of ADCs with pseudoglandular formation, followed by subgroup analysis according to the histopathological tumor grades. Results: The mean ADC was significantly higher in pure pseudoglandular lesions (n = 5, 1.29 ± 0.08 × 10-3 mm2/s) than in non-pseudoglandular lesions (n = 132, 1.08 ± 0.17 × 10-3 mm2/s; P = 0.003) or mixed-pseudoglandular lesions (n = 45, 1.16 ± 0.24 × 10-3 mm2/s; P = 0.034). The ADC values and pseudoglandular formation were significantly correlated in moderately differentiated HCCs (n = 103; r = 0.307, P = 0.007), while well- (n = 19) and poorly-differentiated HCCs (n = 60) did not show significant correlation (r = 0.105 and 0.068, respectively; P = 0.600 and 0.685, respectively). Conclusion: The degree of pseudoglandular formation could be one of the determinants of ADC in DWI of HCCs-especially moderately differentiated HCCs-while its influence does not appear to be significant in well- or poorly differentiated HCCs.
참고문헌 (23)
- Rampone B, "Current management strategy of hepatocellular carcinoma", World J Gastroenterol, 15, pp.3210~3216 (2009)[DOI]
- Torre LA, "Global cancer statistics, 2012", CA Cancer J Clin, 65, pp.87~108 (2015)[DOI]
- Jensen JH, "Diffusional kurtosis imaging: the quantification of nongaussian water diffusion by means of magnetic resonance imaging", Magn Reson Med, 53, pp.1432~1440 (2005)[DOI]
- Kele PG, "Diffusion weighted imaging in the liver", World J Gastroenterol, 16, pp.1567~1576 (2010)[DOI]
- Parikh T, "Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging", Radiology, 246, pp.812~822 (2008)[DOI]
- Lowenthal D, "Detection and characterisation of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging", Eur Radiol, 21, pp.832~840 (2011)[DOI]
- Lee MH, "Gadoxetic acid-enhanced hepatobiliary phase MRI and high-b-value diffusion-weighted imaging to distinguish well-differentiated hepatocellular carcinomas from benign nodules in patients with chronic liver disease", AJR Am J Roentgenol, 197, pp.W868~W875 (2011)[DOI]
- Inchingolo R, "Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver", Eur Radiol, 25, pp.1087~1096 (2015)[DOI]
- Muhi A, "High-b-value diffusion-weighted MR imaging of hepatocellular lesions: estimation of grade of malignancy of hepatocellular carcinoma", J Magn Reson Imaging, 30, pp.1005~1011 (2009)[DOI]
- 허숙희, "Apparent Diffusion Coefficient Value of Diffusion-Weighted Imaging for Hepatocellular Carcinoma: Correlation with the Histologic Differentiation and the Expression of Vascular Endothelial Growth Factor", Korean Journal of Radiology, 11(3), pp.295~303 (2010), 대한영상의학회
- Nishie A, "Diagnostic performance of apparent diffusion coefficient for predicting histological grade of hepatocellular carcinoma", Eur J Radiol, 80, pp.e29~e33 (2011)[DOI]
- Chang WC, "Histological grade of hepatocellular carcinoma correlates with arterial enhancement on gadoxetic acid-enhanced and diffusion-weighted MR images", Abdom Imaging, 39, pp.1202~1212 (2014)[DOI]
- Chen J, "Preoperative evaluation of the histological grade of hepatocellular carcinoma with diffusion-weighted imaging: a metaanalysis", PLoS One, 10, pp.e0117661~ (2015)[DOI]
- Guo W, "Histological grade of hepatocellular carcinoma predicted by quantitative diffusion-weighted imaging", Int J Clin Exp Med, 8, pp.4164~4169 (2015)
- Tang Y, "Diffusion-weighted imaging of hepatocellular carcinomas: a retrospective analysis of correlation between apparent diffusion coefficients and histological grade", Abdom Radiol (NY), 41, pp.1539~1545 (2016)[DOI]
- Li X, "Correlations between the minimum and mean apparent diffusion coefficient values of hepatocellular carcinoma and tumor grade", J Magn Reson Imaging, 44, pp.1442~1447 (2016)[DOI]
- Noworolski SM, "Dynamic contrast-enhanced MRI and MR diffusion imaging to distinguish between glandular and stromal prostatic tissues", Magn Reson Imaging, 26, pp.1071~1080 (2008)[DOI]
- Wang Y, "Diffusion-weighted magnetic resonance imaging of pancreatic adenocarcinomas: association with histopathology and tumor grade", J Magn Reson Imaging, 33, pp.136~142 (2011)[DOI]
- Yu JS, "Added value of diffusion-weighted imaging in the MRI assessment of perilesional tumor recurrence after chemoembolization of hepatocellular carcinomas", J Magn Reson Imaging, 30, pp.153~160 (2009)[DOI]
- Theise ND, "WHO classification of tumours of the digestive system", pp.205~216 (2010), International Agency for Research on Cancer
- Woo S, "Intravoxel incoherent motion diffusion-weighted MR imaging of hepatocellular carcinoma: correlation with enhancement degree and histologic grade", Radiology, 270, pp.758~767 (2014)[DOI]
- Granata V, "Intravoxel incoherent motion (IVIM) in diffusion-weighted imaging (DWI) for hepatocellular carcinoma: correlation with histologic grade", Oncotarget, 7, pp.79357~79364 (2016)
- Shan Q, "Evaluating histologic differentiation of hepatitis B virus-related hepatocellular carcinoma using intravoxel incoherent motion and AFP levels alone and in combination", Abdom Radiol (NY), 42, pp.2079~2088 (2017)[DOI]