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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2012

01-04-2012 | Hepatobiliary Tumors

Relationship Between Diffusion-Weighted Magnetic Resonance Imaging and Histological Tumor Grading of Hepatocellular Carcinoma

Authors: Mitsuru Nakanishi, MD, PhD, Makoto Chuma, MD, PhD, Shuhei Hige, MD, PhD, Tokuhiko Omatsu, MD, PhD, Hideki Yokoo, MD, PhD, Kazuaki Nakanishi, MD, PhD, Toshiya Kamiyama, MD, PhD, Kanako Kubota, MD, PhD, Hironori Haga, MD, PhD, Yoshihiro Matsuno, MD, PhD, Yuya Onodera, MD, PhD, Mototsugu Kato, MD, PhD, Masahiro Asaka, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2012

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Abstract

Background

Intrahepatic and extrahepatic recurrence remains a significant problem for hepatocellular carcinoma (HCC). The aim of this study was to determine the usefulness of diffusion-weighted magnetic resonance imaging (DWI) for histological tumor grading and preoperative prediction of early HCC recurrence within 6 months of operation.

Methods

A total of 44 patients who had undergone hepatic resection for HCC (50 nodules) were reviewed retrospectively. DWI was performed within 30 days before hepatectomy, and apparent diffusion coefficients (ADCs) were measured using 2 methods: mean ADC and minimum-spot ADC. Relationships between ADCs and histological differentiation and between ADCs and early recurrence of HCC were analyzed.

Results

Mean ADC was significantly lower in poorly differentiated HCC (n = 18, 1.07 ± 0.15 × 10−3 mm2/s) than in moderately differentiated HCC (n = 29, 1.29 ± 0.21 × 10−3 mm2/s; P < .05). Minimum-spot ADC was significantly lower in poorly differentiated HCC (n = 18, 0.69 ± 0.19 × 10−3 mm2/s) than in well-differentiated HCC (n = 3, 1.15 ± 0.10 × 10−3 mm2; P < .01) or in moderately differentiated HCC (n = 29, 0.98 ± 0.18 × 10−3 mm2/s; P < .0001). Of 34 patients who were able to be observed for >6 months after resection, 9 showed early recurrence. Minimum-spot ADC was significantly lower in patients with early recurrence (n = 9, 0.64 ± 0.24 × 10−3 mm2/s) than in patients without early recurrence (n = 25, 0.88 ± 0.19 × 10−3 mm2/s; P < .05). On multivariate analysis, minimum-spot ADC was a significant risk factor for early recurrence (P < .05).

Conclusion

Quantitative measurement of ADC of HCC with magnetic resonance diffusion weighted imaging is a promising functional imaging tool in the prediction of histological grade and early recurrence before treatment.
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Metadata
Title
Relationship Between Diffusion-Weighted Magnetic Resonance Imaging and Histological Tumor Grading of Hepatocellular Carcinoma
Authors
Mitsuru Nakanishi, MD, PhD
Makoto Chuma, MD, PhD
Shuhei Hige, MD, PhD
Tokuhiko Omatsu, MD, PhD
Hideki Yokoo, MD, PhD
Kazuaki Nakanishi, MD, PhD
Toshiya Kamiyama, MD, PhD
Kanako Kubota, MD, PhD
Hironori Haga, MD, PhD
Yoshihiro Matsuno, MD, PhD
Yuya Onodera, MD, PhD
Mototsugu Kato, MD, PhD
Masahiro Asaka, MD, PhD
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-2066-8

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