Intravoxel incoherent motion (IVIM) in diffusion-weighted imaging (DWI) for Hepatocellular carcinoma: correlation with histologic grade

Abstract

PurposeTo assess the correlation between DWI diffusion parameters obtained using Intravoxel Incoherent Motion Method (IVIM) and histological grade of Hepatocellular carcinoma (HCC).ResultsAccording 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 2.11×10-3 mm2/sec, an fp of 47.33% and an Dt of 0.94×10-3 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 MethodsA 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.ConclusionsADC 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.

Utility of intravoxel incoherent motion MRI derived parameters for prediction of aggressiveness in urothelial bladder carcinoma

“…We also observed that ADC value indicated better diagnostic value than D or f value alone on evaluating aggressive behavior of bladder cancer. The same conclusions were reported previously in other tumors …”

“…The same conclusions were reported previously in other tumors. [20][21][22] Recently, Wang et al 14 observed the IVIM-derived parameters D value showed higher AUC than ADC value (0.894 versus 0.786), for discriminating MIBC that is equivalent to high-aggressive bladder cancer, but no significant difference was observed in f value, which was somewhat different from our results. In our study, the ADC value showed higher AUC than D value (0.895 versus 0.862), and f value showed second-highest AUC (0.873) for discriminating highaggressive bladder cancer.…”

Esophageal carcinoma: Intravoxel incoherent motion diffusion‐weighted MRI parameters and histopathological correlations

“…One previous study demonstrated that the ADC and ADC slow were higher in low‐grade gliomas than high‐grade gliomas, as the tumor cellularity was associated with the tumor grade; high cellularity often correlated with high‐grade gliomas. Our results are consistent with findings from previous studies in tumors elsewhere in the body . Furthermore, the numerical values of ADC were greater than ADC slow in each group; this was because the ADC slow was derived from the biexponential model and can eliminate the interference of perfusion and maintain the true diffusion.…”

“…Our results are consistent with findings from previous studies in tumors elsewhere in the body. 32,33 Furthermore, the numerical values of ADC were greater than ADC slow in each group; this was because the ADC slow was derived from the biexponential model and can eliminate the interference of perfusion and maintain the true diffusion. Furthermore, the AUC value of the ADC slow obtained by two radiologists were higher than ADC in distinguishing PD from WM differentiating esophageal carcinoma and a stronger correlation was also found in ADC slow .…”

Diagnostic accuracy of quantitative diffusion parameters in the pathological grading of hepatocellular carcinoma: A meta‐analysis

“…A number of studies verified that the mean ADC value had a strong relationship with the pathological grades of HCC, and the diagnostic accuracy of the ADC value was moderate to high. In recent years, the intravoxel incoherent motion diffusion‐weighted imaging (IVIM) techniques showed potential for having a further improved diagnostic performance for the pathological grading of HCC . IVIM was able to separate the true water molecular diffusion from microcapillary perfusion.…”