Hypointense hepatocellular carcinomas on apparent diffusion coefficient mapping: Pathological features and metastatic recurrence after hepatectomy

Abstract

Hypointense HCC on ADC mapping are characterized by poor histological differentiation and more frequent microscopic portal invasion, and are significantly associated with metastatic recurrences after hepatectomy.

MRI Features for Predicting Microvascular Invasion of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

“…All 36 studies were cohort studies, with 33 retrospective studies [2, 7-9, 11-16, 18, 20-23, 27-44] and 3 prospective studies [45-47]. The proportions of LC were variable, with 18 studies having >50% of patients with LC [8, 13-15, 18, 23, 28, 32-34, 36, 37, 41-43, 45-47], and 18 studies having <50% of patients with LC [2, 7, 9, 11, 12, 16, 20-22, 27, 29-31, 35, 38-40, 44]. Thirteen studies had all HCC size of <5 cm [2, 9, 12, 18, 21, 28, 31-34, 39, 41, 43], 23 studies used HBA contrast-enhanced MRI [2, 7-9, 11-14, 16, 20, 21, 27-31, 33, 37-41, 44], and 24 studies used DWI [8, 11, 16, 18, 20, 22, 23, 27, 28, 30-37, 39, 40, 42, 44-47].…”

“…Regarding multifocality, 4 studies used satellite nodules [8, 16, 23, 45] and 3 studies used ≥2 lesions [22, 30, 35] as a definition of multifocality. Regarding diffusion restriction, 4 studies were clear about the use of ADC [16, 23, 32, 39], whereas 3 were unclear [28, 34, 40].…”

“…In the reference standard domain, 1 study had a high risk of bias because it interpreted the reference standard result with the index test result [28]. Twenty-two studies had an unclear risk of bias due to the ambiguity on whether the reference standard result was interpreted without knowledge of the index test result [2, 7-9, 12, 16, 20, 21, 23, 30, 31, 33, 37-43] or about how to define pathological MVI [7, 16, 22, 23, 27, 30, 32, 33, 40]. In the index test domain, 5 studies were unclear on whether the index test result was interpreted without knowledge of the reference standard [9, 15, 29, 38, 45], and 7 studies lacked the prespecified definition of analyzed MRI features [8, 15, 22, 40, 42, 45, 46].…”

“…However, our meta-analysis identified the 4 additional features including larger tumor size (>5 cm), rim arterial enhancement, multifocality, and hypointensity on T1WI. The number of subjects and analyzed MRI features in previous individual studies was generally insufficient, with 91.7% (33/36) of studies including <200 patients [7-9, 11-16, 18, 20-23, 27-30, 32-40, 42-47] and 94.4% (34/36) analyzing <10 imaging features [2, 7-9, 11-15, 18, 20-23, 27-29, 31-47]. Furthermore, the analyzed MRI features varied across the previous studies, with the selection criteria used for the MRI features being unclear, and the individual studies might therefore have been limited in their ability to determine significant MRI features for predicting MVI.…”

Hepatocellular carcinoma grading and recurrence prediction using T1 mapping on gadolinium‑ethoxybenzyl diethylenetriamine pentaacetic acid‑enhanced magnetic resonance imaging

“…In addition, Zhou et al (4) reported that the Edmondson-Steiner grade of HCC was an independent risk factor for recurrence after resection. Mori et al (31) also demonstrated that poorly differentiated HCC was more likely to have intrahepatic metastasis and recurrence compared with well-/moderately differentiated HCC. The results from the present study revealed that the HCC patients with lower T 1(L-H)/H (%) values had lower cumulative recurrence rates compared with those patients with higher T 1(L-H)/H (%) values at the 20-min HBP.…”