Apparent Diffusion Coefficient Quantification in Determining the Histological Diagnosis of Malignant Liver Lesions

Abstract

Purpose: Diffusion Weighted Imaging is an established diagnostic tool for accurate differential diagnosis between benign and malignant liver lesions. The aim of our study was to evaluate the role of Histogram Analysis of ADC quantification in determining the histological diagnosis as well as the grade of malignant liver tumours. To our knowledge, there is no study evaluating the role of Histogram Analysis of ADC quantification in determining the histological diagnosis as well as the grade of malignant liver tumours. Methods: During five years, 115 patients with known liver lesions underwent Diffusion Weighted Imaging in 3Tesla MR scanner prior to core needle biopsy. Histogram analyses of ADC in regions of interest were drawn and were correlated with biopsy histological diagnosis and grading.Results: Histogram analysis of ADC values shows that 5th and 30th percentile parameters have statistically significant potency of discrimination between primary and secondary lesions groups (p values 0.0036 and 0.0125 respectively). Skewness of the histogram can help discriminate between good and poor differentiated (p value 0.17). Discrimination between primary malignancy site in metastases failed for the present number of patients in each subgroup.Conclusion: Statistical parameters reflecting the shape of the left side of the ADC histogram can be useful for discriminating between primary and secondary lesions and also between well differentiated versus moderate or poor. For the secondary malignancies, they failed to predict the original site of tumour.

Histogram Analysis of Diffusion Kurtosis Magnetic Resonance Imaging for Diagnosis of Hepatic Fibrosis

“…Fibrotic hepatic tissue tends to yield limited diffusivity and lower D values compared with normal liver parenchyma ( 23 25 ), which explains the role of minimum 25th percentile of D value in providing useful information from the dispersion of D values and is sensitive to subtle changes in D induced by the structural abnormality in liver fibrosis characterization. Moreover, such an analysis based on individual percentiles minimizes the effect of outliers, especially from pixels at the boundaries of liver or from noise ( 26 ). We hypothesized that histogram analysis of DKI-D map especially the 25th percentile of D provides deeper insight into the distribution and heterogeneity than routine mean value, for further assessment of liver fibrosis.…”

Histogram analyses of diffusion kurtosis indices and apparent diffusion coefficient in assessing liver regeneration after ALPPS and a comparative study with portal vein ligation

“…The regenerative liver tissue tends to yield cellular hypertrophy with larger hepatocyte size, leading to more limited diffusivity and lower D values; this may explain why particularly the minimum 25 th percentile D values may be sensitive to subtle changes in D induced by cellular hypertrophy. Moreover, such an analysis based on individual percentiles can minimize the effect of outliers, especially from pixels at the boundaries of liver or from noise . Thus, we hypothesized that histogram analysis of diffusion kurtosis indices, especially the D values, may provide qualitative and quantitative microstructural information in liver regeneration assessment.…”

“…Moreover, such an analysis based on individual percentiles can minimize the effect of outliers, especially from pixels at the boundaries of liver or from noise. 27 Thus, we hypothesized that histogram analysis of diffusion kurtosis indices, especially the D values, may provide qualitative and quantitative microstructural information in liver regeneration assessment. Meanwhile, no significant correlations were found between the histogram parameters and the expression of proliferative indexes; this may partly be explained by the overlap in structural heterogeneity with influence of complex cellular topology in liver proliferation.…”

Comparison of free breathing and respiratory triggered diffusion-weighted imaging sequences for liver imaging

“…In our study, the ADC histograms for each lesion were, by qualitative assessments, inferior for FB-DWI and superior for SMS-DWI and PACE-DWI. Recently, ADC histograms and calculated percentiles of the histograms have been used to differentiate types of metastases in the liver, tumor types[21], and tumor genomic profiles[22]. We found that the ADC histogram of PACE-DWI was superior to that of SMS-DWI, probably because of the improved SNR that results from longer scan time and better motion management through respiratory triggering.…”