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European Radiology
Published in: European Radiology 10/2019

01-10-2019 | Magnetic Resonance Imaging | Oncology

IVIM improves preoperative assessment of microvascular invasion in HCC

Authors: Yi Wei, Zixing Huang, Hehan Tang, Liping Deng, Yuan Yuan, Jiaxing Li, Dongbo Wu, Xiaocheng Wei, Bin Song

Published in: European Radiology | Issue 10/2019

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Abstract

Purpose

To prospectively evaluate the potential role of intravoxel incoherent motion (IVIM) and conventional radiologic features for preoperative prediction of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).

Methods

Institutional review board approval and written informed consent were obtained for this study. A cohort comprising 115 patients with 135 newly diagnosed HCCs between January 2016 and April 2017 were evaluated. Two radiologists independently reviewed the radiologic features and the apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), and pseudodiffusion component fraction (f) were also measured. Interobserver agreement was checked and univariate and multivariate logistic regressions were used for screening the risk factors. Receiver operating characteristics (ROC) curve analyses were performed to evaluate the diagnostic performance.

Results

Features significantly related to MVI of HCC at univariate analysis were reduced ADC (odds ratio, 0.341; 95% CI, 0.211–0.552; p < 0.001), D (odds ratio, 0.141; 95% CI, 0.067–0.299; p < 0.001), and irregular circumferential enhancement (odds ratio, 9.908; 95% CI, 3.776–25.996; p < 0.001). At multivariate analysis, only D value (odds ratio, 0.096; 95% CI, 0.025–0.364; p < 0.001) was the independent risk factor for MVI of HCC. The mean D value for MVI of HCC showed an area under ROC curves of 0.815 (95% CI, 0.740–0.877).

Conclusion

IVIM model–derived D value is superior to ADC measured with mono-exponential model for evaluating the MVI of HCC. Among MR imaging features, tumor margin, enhancement pattern, tumor capsule, and peritumoral enhancement were not predictive for MVI.

Key Points

• Diffusion MRI is useful for non-invasively evaluating the microvascular invasion of hepatocellular carcinoma.
• IVIM model is advantageous over mono-exponential model for assessing the microvascular invasion of hepatocellular carcinoma.
• Decreased D value was the independent risk factor for predicting MVI of HCC.
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Metadata
Title
IVIM improves preoperative assessment of microvascular invasion in HCC
Authors
Yi Wei
Zixing Huang
Hehan Tang
Liping Deng
Yuan Yuan
Jiaxing Li
Dongbo Wu
Xiaocheng Wei
Bin Song
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06088-w

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