Preoperative histogram analysis of intravoxel incoherent motion (IVIM) for predicting microvascular invasion in patients with single hepatocellular carcinoma. Issue 105 (August 2018)

• Record Type: Journal Article
• Authors: Li, Hongxiang; Zhang, Jing; Zheng, Zeyu; Guo, Yihao; Chen, Maodong; Xie, Caiqin; Zhang, Zhongping; Mei, Yingjie; Feng, Yanqiu; Xu, Yikai
• Is Part Of: European journal of radiology. Issue 105(2018)
• Page Start: 65
• Page End: 71
• Publication Date: 2018-08
• Subjects: HCC hepatocellular carcinoma -- MVI microvascular invasion -- CT computed tomography -- MRI magnetic resonance imaging -- ADC apparent diffusion coefficient -- ROI region of interest -- IVIM intravoxel incoherent motion -- DWI diffusion-weighted imaging -- AFP α-fetoprotein -- ICCs interclass correlation coefficients -- ROC receiver operating characteristic -- AUCs areas under the ROC curves -- TE echo time; Microvascular invasion -- Hepatocellular carcinoma -- Intravoxel incoherent motion; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2018.05.032
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Histogram analysis of IVIM through whole tumor volume could be become a novel tool for predicting MVI in single HCC. Molecular diffusion may play a dominant role in predicting MVI of HCC as compared with perfusion components. The 5th percentile of D was the most promising index in preoperative assessment of MVI in single HCC. Abstract: Purpose: To evaluate the value of intravoxel incoherent motion (IVIM) histogram analysis based on whole tumor volume in predicting microvascular invasion (MVI) of single hepatocellular carcinoma (HCC). Materials and Methods: The study enrolled 41 patients with pathologically proven HCCs who underwent IVIM diffusion-weighted imaging with nine b values and contrast-enhanced magnetic resonance imaging (MRI). Histogram parameters including mean; skewness; kurtosis; and percentiles (5th, 10th, 25th, 50th, 75th, 90th, 95th) were derived from apparent diffusion coefficient (ADC), perfusion fraction (f), true diffusion coefficient (D), and pseudo diffusion coefficient (D*). Quantitative histogram parameters and clinical data were compared between HCCs with and without MVI. For significant parameters, receiver operating characteristic (ROC) curves were further plotted to compare the diagnosis performance for identifying MVI. Results: The mean, 5th, 10th, 25th, 50th, and 75th percentiles of D, and the 5th, 10th, and 25th percentiles of ADC between HCCs with and without MVI were statistically significant (all P＜0.05). The histogram parameters of D* and f showed no statistically significant differences between HCCs with and without MVI (all P＞0.05). The areas under the ROC curves (AUCs) were 0.707–0.874 for D and 0.668–0.720 for ADC. The largest AUC of D (5th percentile) showed significantly higher accuracy than that of ADC or tumor size (P = 0.009–0.046). With a cut-off of 0.403 × 10 −3 mm²/s, the 5th percentile of D value provided a sensitivity of 81% and a specificity of 85% in the prediction of MVI. Conclusions: Histogram analysis of IVIM based on whole tumor volume can be useful for predicting MVI. The 5th percentile of D was most useful value to predict MVI of HCC.