Yusuke Ogihara1,2, Yoshio Kitazume2, Yoshihiro Iwasa2, Shinichi Taura3, Yoshiro Himeno4, Tomo Kimura5, Seishi Sawano6, Shigehiko Terada7, Minoru Tanabe8, Yukihisa Saida2, Ukihide Tateishi2. 1. 1 Department of Radiology, JA Toride Medical Center , Ibaraki , Japan. 2. 2 Department of Diagnostic Radiology, Medical Hospital, Tokyo Medical and Dental University , Tokyo , Japan. 3. 3 Department of Radiology, Ome Municipal General Hospital , Tokyo , Japan. 4. 4 Department of Radiology, Japanese Red Cross Musashino Hospital , Tokyo , Japan. 5. 5 Diagnostic Imaging Center, Ochanomizu Surugadai Clinic , Tokyo , Japan. 6. 6 Department of Radiology, Advanced Imaging Center Yaesu Clinic , Tokyo , Japan. 7. 7 Medical Scanning Ochanomizu , Tokyo , Japan. 8. 8 Department of Hepato-Biliary-Pancreatic Surgery, Medical Hospital, Tokyo Medical and Dental University , Tokyo , Japan.
Abstract
OBJECTIVE: To evaluate the usefulness of quantitative diffusion-weighted (DW) imaging acquired by multivendor magnetic resonance units for predicting grade of hepatocellular carcinoma (HCC). METHODS: 83 patients with 100 histologically diagnosed HCCs who underwent pre-operative liver DW imaging with b = 0 and1000 s mm-2 or b = 0 and800 s mm-2 at any of six institutions were included. Two radiologists independently measured the apparent diffusion coefficient (ADC) of the lesion as well as non-ADC parameters, such as the relative contrast ratio and the contrast-to-noise ratio (CNR) between the lesion and the liver parenchyma on high b-value DW images. The diagnostic performance of the DW parameters in discriminating poorly-differentiated HCCs was compared using receiver operating characteristic (ROC) analysis. RESULTS: The areas under the receiver operating characteristic curves for the CNR (86.4% [95% confidence interval (CI) (77.2-95.6] and 83.9% [95% CI 71.2-96.6] for b = 1000 and 800 s mm-2, respectively] and the relative contrast ratio (85.3% [95% CI 75.5-94.8] and 83.5% [95% CI 70.5-96.4]) tended to be superior to the ADC [71.1% [95% CI (56.9-85.2)] and 75.7% [95% CI (55.1-96.2)]; p < 0.05 for CNR vs ADC for b = 1000 s mm-2, but not significant for other parameters) for discrimination of poorly-differentiated HCCs. CONCLUSION: All DW parameters could discriminate HCC grade. Non-ADC parameters might be more useful than the ADC for predicting poorly-differentiated HCCs. Advances in knowledge: The utility of quantitative DW parameters for predicting HCC grade was demonstrated by using multivendor MR units.
OBJECTIVE: To evaluate the usefulness of quantitative diffusion-weighted (DW) imaging acquired by multivendor magnetic resonance units for predicting grade of hepatocellular carcinoma (HCC). METHODS: 83 patients with 100 histologically diagnosed HCCs who underwent pre-operative liver DW imaging with b = 0 and1000 s mm-2 or b = 0 and800 s mm-2 at any of six institutions were included. Two radiologists independently measured the apparent diffusion coefficient (ADC) of the lesion as well as non-ADC parameters, such as the relative contrast ratio and the contrast-to-noise ratio (CNR) between the lesion and the liver parenchyma on high b-value DW images. The diagnostic performance of the DW parameters in discriminating poorly-differentiated HCCs was compared using receiver operating characteristic (ROC) analysis. RESULTS: The areas under the receiver operating characteristic curves for the CNR (86.4% [95% confidence interval (CI) (77.2-95.6] and 83.9% [95% CI 71.2-96.6] for b = 1000 and 800 s mm-2, respectively] and the relative contrast ratio (85.3% [95% CI 75.5-94.8] and 83.5% [95% CI 70.5-96.4]) tended to be superior to the ADC [71.1% [95% CI (56.9-85.2)] and 75.7% [95% CI (55.1-96.2)]; p < 0.05 for CNR vs ADC for b = 1000 s mm-2, but not significant for other parameters) for discrimination of poorly-differentiated HCCs. CONCLUSION: All DW parameters could discriminate HCC grade. Non-ADC parameters might be more useful than the ADC for predicting poorly-differentiated HCCs. Advances in knowledge: The utility of quantitative DW parameters for predicting HCC grade was demonstrated by using multivendor MR units.
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