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Apparent diffusion coefficient value of diffusion-weighted imaging for hepatocellular carcinoma: correlation with the histologic differentiation and the expression of vascular endothelial growth factor.

Heo SH, Jeong YY, Shin SS, Kim JW, Lim HS, Lee JH, Koh YS, Cho CK, Kang HK - Korean J Radiol (2010)

Bottom Line: There was a significant correlation between the differentiation and the ADC value of the HCCs (r = -0.51, p = 0.012).The VEGF expression did not show correlation with the ADC value of the HCCs (r = 0.07, p = 0.74).Therefore, DWI with ADC measurement may be a valuable tool for noninvasively predicting the differentiation of HCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam, Korea.

ABSTRACT

Objective: To evaluate whether the histopathological differentiation and the expression of vascular endothelial growth factor (VEGF) of hepatocellular carcinoma (HCC) do show correlation with the apparent diffusion coefficient (ADC) value on diffusion-weighted imaging (DWI).

Materials and methods: Twenty-seven HCCs from 27 patients who had undergone preoperative liver MRI (1.5T) and surgical resection were retrospectively reviewed. DWI was obtained with a single-shot, echo-planar imaging sequence in the axial plane (b values: 0 and 1,000 sec/mm(2)). On DWIs, the ADC value of the HCCs was measured by one radiologist, who was kept 'blinded' to the histological findings. Histopathologically, the differentiation was classified into well (n = 9), moderate (n = 9) and poor (n = 9). The expression of VEGF was semiquantitatively graded as grade 0 (n = 8), grade 1 (n = 9) and grade 2 (n = 10). We analyzed whether the histopathological differentiation and the expression of VEGF of the HCC showed correlation with the ADC value on DWI.

Results: The mean ADC value of the poorly-differentiated HCCs (0.9 +/- 0.13x10(-3) mm(2)/s) was lower than those of the well-differentiated HCCs (1.2 +/- 0.22x10(-3) mm(2)/s) (p = 0.031) and moderately-differentiated HCCs (1.1 +/- 0.01x10(-3) mm(2)/s) (p = 0.013). There was a significant correlation between the differentiation and the ADC value of the HCCs (r = -0.51, p = 0.012). The mean ADC of the HCCs with a VEGF expression grade of 0, 1 and 2 was 1.1 +/- 0.17, 1.1 +/- 0.21 and 1.1 +/- 0.18x10(-3) mm(2)/s, respectively. The VEGF expression did not show correlation with the ADC value of the HCCs (r = 0.07, p = 0.74).

Conclusion: The histopathological differentiation of HCC shows inverse correlation with the ADC value. Therefore, DWI with ADC measurement may be a valuable tool for noninvasively predicting the differentiation of HCC.

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Related in: MedlinePlus

Method of apparent diffusion coefficient measurement. Apparent diffusion coefficient values were obtained by using five ROIs with uniform size (42 pixels) on apparent diffusion coefficient map (A), placed on area corresponding to enhancing solid portion of HCCs demonstrated on contrast-enhanced T1-weighted image (B). ROIs were carefully placed on solid portion to avoid cystic or necrotic portion.
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Figure 1: Method of apparent diffusion coefficient measurement. Apparent diffusion coefficient values were obtained by using five ROIs with uniform size (42 pixels) on apparent diffusion coefficient map (A), placed on area corresponding to enhancing solid portion of HCCs demonstrated on contrast-enhanced T1-weighted image (B). ROIs were carefully placed on solid portion to avoid cystic or necrotic portion.

Mentions: The ADC values were measured on an ADC map by one radiologist with five years of abdominal MRI experience and who was unaware of the histological findings of the HCCs. The ADC value was automatically calculated by a computer program included in the GE workstation software. The HCCs were identified on the T2-weighted FSE images and the contrast-enhanced T1-weighted GRE images. The image of the mid section of an HCC among several images of each series was selected to minimize the partial volume averaging effect and motion artifacts. The ADC value of the HCC was measured on an ADC map, and the slice's location was identical to that of the selected image on the T2-weighted FSE images and the contrast-enhanced T1-weighted GRE images, respectively. Five regions of interest (ROIs) with a uniform size of 42 pixels were placed in the solid portion of the HCCs that corresponded to the enhancing portion identified on the contrast-enhanced T1-weighted GRE image (Fig. 1). The ROIs were not positioned in the cystic or necrotic portion identified on the T2-weighted FSE images and the contrast-enhanced T1-weighted GRE images because this might have an influence on the quantitative data. The mean ± standard deviation (SD) of the ADC values of the HCCs was calculated.


Apparent diffusion coefficient value of diffusion-weighted imaging for hepatocellular carcinoma: correlation with the histologic differentiation and the expression of vascular endothelial growth factor.

Heo SH, Jeong YY, Shin SS, Kim JW, Lim HS, Lee JH, Koh YS, Cho CK, Kang HK - Korean J Radiol (2010)

Method of apparent diffusion coefficient measurement. Apparent diffusion coefficient values were obtained by using five ROIs with uniform size (42 pixels) on apparent diffusion coefficient map (A), placed on area corresponding to enhancing solid portion of HCCs demonstrated on contrast-enhanced T1-weighted image (B). ROIs were carefully placed on solid portion to avoid cystic or necrotic portion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864856&req=5

Figure 1: Method of apparent diffusion coefficient measurement. Apparent diffusion coefficient values were obtained by using five ROIs with uniform size (42 pixels) on apparent diffusion coefficient map (A), placed on area corresponding to enhancing solid portion of HCCs demonstrated on contrast-enhanced T1-weighted image (B). ROIs were carefully placed on solid portion to avoid cystic or necrotic portion.
Mentions: The ADC values were measured on an ADC map by one radiologist with five years of abdominal MRI experience and who was unaware of the histological findings of the HCCs. The ADC value was automatically calculated by a computer program included in the GE workstation software. The HCCs were identified on the T2-weighted FSE images and the contrast-enhanced T1-weighted GRE images. The image of the mid section of an HCC among several images of each series was selected to minimize the partial volume averaging effect and motion artifacts. The ADC value of the HCC was measured on an ADC map, and the slice's location was identical to that of the selected image on the T2-weighted FSE images and the contrast-enhanced T1-weighted GRE images, respectively. Five regions of interest (ROIs) with a uniform size of 42 pixels were placed in the solid portion of the HCCs that corresponded to the enhancing portion identified on the contrast-enhanced T1-weighted GRE image (Fig. 1). The ROIs were not positioned in the cystic or necrotic portion identified on the T2-weighted FSE images and the contrast-enhanced T1-weighted GRE images because this might have an influence on the quantitative data. The mean ± standard deviation (SD) of the ADC values of the HCCs was calculated.

Bottom Line: There was a significant correlation between the differentiation and the ADC value of the HCCs (r = -0.51, p = 0.012).The VEGF expression did not show correlation with the ADC value of the HCCs (r = 0.07, p = 0.74).Therefore, DWI with ADC measurement may be a valuable tool for noninvasively predicting the differentiation of HCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam, Korea.

ABSTRACT

Objective: To evaluate whether the histopathological differentiation and the expression of vascular endothelial growth factor (VEGF) of hepatocellular carcinoma (HCC) do show correlation with the apparent diffusion coefficient (ADC) value on diffusion-weighted imaging (DWI).

Materials and methods: Twenty-seven HCCs from 27 patients who had undergone preoperative liver MRI (1.5T) and surgical resection were retrospectively reviewed. DWI was obtained with a single-shot, echo-planar imaging sequence in the axial plane (b values: 0 and 1,000 sec/mm(2)). On DWIs, the ADC value of the HCCs was measured by one radiologist, who was kept 'blinded' to the histological findings. Histopathologically, the differentiation was classified into well (n = 9), moderate (n = 9) and poor (n = 9). The expression of VEGF was semiquantitatively graded as grade 0 (n = 8), grade 1 (n = 9) and grade 2 (n = 10). We analyzed whether the histopathological differentiation and the expression of VEGF of the HCC showed correlation with the ADC value on DWI.

Results: The mean ADC value of the poorly-differentiated HCCs (0.9 +/- 0.13x10(-3) mm(2)/s) was lower than those of the well-differentiated HCCs (1.2 +/- 0.22x10(-3) mm(2)/s) (p = 0.031) and moderately-differentiated HCCs (1.1 +/- 0.01x10(-3) mm(2)/s) (p = 0.013). There was a significant correlation between the differentiation and the ADC value of the HCCs (r = -0.51, p = 0.012). The mean ADC of the HCCs with a VEGF expression grade of 0, 1 and 2 was 1.1 +/- 0.17, 1.1 +/- 0.21 and 1.1 +/- 0.18x10(-3) mm(2)/s, respectively. The VEGF expression did not show correlation with the ADC value of the HCCs (r = 0.07, p = 0.74).

Conclusion: The histopathological differentiation of HCC shows inverse correlation with the ADC value. Therefore, DWI with ADC measurement may be a valuable tool for noninvasively predicting the differentiation of HCC.

Show MeSH
Related in: MedlinePlus