Sunyoung Lee1,2, Seong Hyun Kim3, Jeong Ah Hwang1,4, Ji Eun Lee1,5, Sang Yun Ha6. 1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Korea. 2. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. 3. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Korea. kshyun@skku.edu. 4. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, 31 Soonchunhyang6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31151, Korea. 5. Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14584, Korea. 6. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Korea.
Abstract
OBJECTIVES: To assess a correlation between the preoperative diffusion-weighted imaging (DWI) and early recurrence (<2 years) and to determine the best DWI parameters as the risk factor of early recurrence after surgery in single hepatocellular carcinoma (HCC). METHODS: The study included 114 patients with surgically resected single HCC (≤5 cm) who underwent preoperative magnetic resonance imaging (MRI) with DWI. Radiologists evaluated the diffusion restriction of the tumours using qualitative assessment and the mean and minimum apparent diffusion coefficient values (ADCmean and ADCmin) of the tumours using quantitative measurement. Clinical and laboratory findings and DWI parameters as a risk factor for early recurrence were identified by using Cox proportional hazards model. RESULTS: No significant difference was observed in early recurrence rates of HCCs between those with and those without diffusion restriction (p = 0.484). Early recurrence rates of HCCs with ADCmean and ADCmin values lower than the optimal cut-offs (1.023 and 0.773 × 10-3 mm2/s, respectively) were significantly higher compared with those with values higher than the optimal cut-offs (p = 0.001 and p < 0.001, respectively). In the multivariable analysis, tumour size [hazard ratio (HR) per centimetre, 2.011; 95% CI, 1.304-3.102; p = 0.002] and ADCmin ≤0.773 × 10-3 mm2/s (HR, 13.339; 95% CI, 4.422-40.240; p < 0.001) were independent risk factors for early HCC recurrence. CONCLUSIONS: DWI is a promising imaging tool for early recurrence of HCC. Among qualitative and quantitative assessments of DWI, ADCmin is a significant risk factor for early recurrence after surgery in single HCC. KEY POINTS: • The performance of minimum apparent diffusion coefficient (ADCmin) is significantly better than that of mean apparent diffusion coefficient (ADCmean) for identifying early recurrence. • ADCmin is a significantly independent risk factor of early HCC recurrence after surgery. • ADCmin correlates with early recurrence after curative resection of single HCC, reflecting histopathological features of the tumours including histological grade and microvascular invasion.
OBJECTIVES: To assess a correlation between the preoperative diffusion-weighted imaging (DWI) and early recurrence (<2 years) and to determine the best DWI parameters as the risk factor of early recurrence after surgery in single hepatocellular carcinoma (HCC). METHODS: The study included 114 patients with surgically resected single HCC (≤5 cm) who underwent preoperative magnetic resonance imaging (MRI) with DWI. Radiologists evaluated the diffusion restriction of the tumours using qualitative assessment and the mean and minimum apparent diffusion coefficient values (ADCmean and ADCmin) of the tumours using quantitative measurement. Clinical and laboratory findings and DWI parameters as a risk factor for early recurrence were identified by using Cox proportional hazards model. RESULTS: No significant difference was observed in early recurrence rates of HCCs between those with and those without diffusion restriction (p = 0.484). Early recurrence rates of HCCs with ADCmean and ADCmin values lower than the optimal cut-offs (1.023 and 0.773 × 10-3 mm2/s, respectively) were significantly higher compared with those with values higher than the optimal cut-offs (p = 0.001 and p < 0.001, respectively). In the multivariable analysis, tumour size [hazard ratio (HR) per centimetre, 2.011; 95% CI, 1.304-3.102; p = 0.002] and ADCmin ≤0.773 × 10-3 mm2/s (HR, 13.339; 95% CI, 4.422-40.240; p < 0.001) were independent risk factors for early HCC recurrence. CONCLUSIONS: DWI is a promising imaging tool for early recurrence of HCC. Among qualitative and quantitative assessments of DWI, ADCmin is a significant risk factor for early recurrence after surgery in single HCC. KEY POINTS: • The performance of minimum apparent diffusion coefficient (ADCmin) is significantly better than that of mean apparent diffusion coefficient (ADCmean) for identifying early recurrence. • ADCmin is a significantly independent risk factor of early HCC recurrence after surgery. • ADCmin correlates with early recurrence after curative resection of single HCC, reflecting histopathological features of the tumours including histological grade and microvascular invasion.
Entities:
Keywords:
Diffusion-weighted imaging; Early recurrence; Hepatocellular carcinoma; Magnetic resonance imaging
Authors: Nazario Portolani; Arianna Coniglio; Sara Ghidoni; Mara Giovanelli; Anna Benetti; Guido Alberto Massimo Tiberio; Stefano Maria Giulini Journal: Ann Surg Date: 2006-02 Impact factor: 12.969
Authors: Harriet C Thoeny; Frederik De Keyzer; Vincent Vandecaveye; Feng Chen; Xihe Sun; Hilde Bosmans; Robert Hermans; Eric K Verbeken; Chris Boesch; Guy Marchal; Willy Landuyt; Yicheng Ni Journal: Radiology Date: 2005-09-28 Impact factor: 11.105
Authors: Tejas Parikh; Stephen J Drew; Vivian S Lee; Samson Wong; Elizabeth M Hecht; James S Babb; Bachir Taouli Journal: Radiology Date: 2008-01-25 Impact factor: 11.105
Authors: Jie Deng; Thomas K Rhee; Kent T Sato; Riad Salem; Kenneth Haines; Tatjana Paunesku; Mary F Mulcahy; Frank H Miller; Reed A Omary; Andrew C Larson Journal: Invest Radiol Date: 2006-04 Impact factor: 6.016
Authors: Lina Zhang; Jingbiao Chen; Hang Jiang; Dailin Rong; Ning Guo; Hao Yang; Jie Zhu; Bing Hu; Bingjun He; Meng Yin; Sudhakar K Venkatesh; Richard L Ehman; Jin Wang Journal: Eur J Radiol Date: 2022-05-05 Impact factor: 4.531
Authors: Likun Cao; Jie Chen; Ting Duan; Min Wang; Hanyu Jiang; Yi Wei; Chunchao Xia; Xiaoyue Zhou; Xu Yan; Bin Song Journal: Quant Imaging Med Surg Date: 2019-04
Authors: Seung Baek Hong; Sang Hyun Choi; So Yeon Kim; Ju Hyun Shim; Seung Soo Lee; Jae Ho Byun; Seong Ho Park; Kyung Won Kim; Suk Kim; Nam Kyung Lee Journal: Liver Cancer Date: 2021-03-11 Impact factor: 11.740
Authors: Alexey Surov; Maciej Pech; Jazan Omari; Frank Fischbach; Robert Damm; Katharina Fischbach; Maciej Powerski; Borna Relja; Andreas Wienke Journal: Liver Cancer Date: 2021-01-27 Impact factor: 11.740