Intravoxel incoherent motion (IVIM) in diffusion-weighted imaging (DWI) for Hepatocellular carcinoma: correlation with histologic grade
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Vincenza Granata1, Roberta Fusco1, Orlando Catalano1, Benedetta Guarino1, Francesco Granata2, Fabiana Tatangelo3, Antonio Avallone4, Mauro Piccirillo5, Raffaele Palaia5, Francesco Izzo5, Antonella Petrillo1
1Department of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale – IRCCS di Napoli”, Naples, I-80131, Italy
2Department of Civil and Mechanical Engineering, “Università degli Studi di Cassino e del Lazio Meridionale”, Cassino 03043, Italy
3Departement of Pathology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale – IRCCS di Napoli”, Naples, I-80131, Italy
4Department of Gastrointestinal Oncology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale – IRCCS di Napoli”, Naples, I-80131, Italy
5Department of Hepatobiliary Surgical Oncology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale – IRCCS di Napoli”, Naples, I-80131, Italy
Roberta Fusco, email: firstname.lastname@example.org
Keywords: HCC, magnetic resonance imaging, diffusion weighted imaging, histologic grade
Received: July 06, 2016 Accepted: September 29, 2016 Published: October 15, 2016
Purpose: To assess the correlation between DWI diffusion parameters obtained using Intravoxel Incoherent Motion Method (IVIM) and histological grade of Hepatocellular carcinoma (HCC).
Results: According to Edmondson-Steiner grade lesions were classified with grade 1 (14), grade 2 (30), grade 3 (18), and grade 4 (0). Apparent Diffusion Coefficient (ADC), perfusion fraction (fp), tissue diffusion coefficient (Dt) median values were statistically different in HCC groups with 1, 2, 3 histological grade (p<0.001). A significant correlation was reported between ADC, fp, Dt and histologic grade respectively of 0.687, 0.737 and 0.674. Receiver operating characteristic (ROC) analysis demonstrated that an ADC of 2.11x10-3 mm2/sec, an fp of 47.33% and an Dt of 0.94x10-3 mm2/sec were the optimal cutoff values to differentiate high histological grade (3) versus low histological grade (1-2), with a sensitivity and specificity for ADC of 100% and 100%, for fp of 100% and 89%, for Dt of 100% and 74%, respectively.
Material and Methods: A retrospective approved study was performed including 34 patients with 62 HCCs. IVIM was performed to obtain ADC, fp, pseudo-diffusion coefficient (Dp), Dt coefficients. Kruskal Wallis, Spearman Correlation Coefficient, ROC analysis were performed.
Conclusions: ADC and IVIM-derived fp showed significantly better diagnostic performance in differentiating high-grade from low-grade HCC, and significant correlation was observed between ADC, fp, Dt and histological grade.
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