Hepatocellular carcinoma: IVIM diffusion quantification for prediction of tumor necrosis compared to enhancement ratios.
Hepatocellular carcinoma: IVIM diffusion quantification for prediction of tumor necrosis compared to enhancement ratios.
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DOI：
10.1016/j.ejro.2015.11.002
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发表时间：
2016
影响因子：
2
通讯作者：
Taouli B
中科院分区：
文献类型：
--
作者：
Kakite S;Dyvorne HA;Lee KM;Jajamovich GH;Knight-Greenfield A;Taouli B
将肝实质和肝细胞癌（HCC）的体素内非相干运动（IVIM）扩散参数与肝脏/肿瘤增强和坏死程度相关联;并评估扩散参数与增强比（ER）预测肿瘤完全坏死的诊断性能。在这项IRB批准的符合HIPAA的研究中，我们纳入了46例HCC患者，除了3.0 T的常规序列外，他们还接受了IVIM弥散加权（DW）MRI。测量肿瘤和肝实质的真扩散系数（D）、假扩散系数（D*）、灌注分数（PF）和表观扩散系数（ADC）。采用增强扫描法计算肿瘤ER，对比后减影法评估肿瘤坏死程度。IVIM参数和ER在HCC和背景肝脏之间以及在坏死和存活肿瘤成分之间进行比较。进行ROC分析以预测肿瘤完全坏死。评估了79例HCC（平均大小2.5 cm）。D、PF和ADC在HCC中显著高于肝脏（p < 0.0001）。D/PF与ER呈弱显着负/正相关，D/PF/ADC与肿瘤坏死呈显着相关（D，r 0.452，p < 0.001）。在扩散参数中，D具有预测肿瘤完全坏死的最高曲线下面积（AUC 0.811）。ER在预测肿瘤完全坏死方面优于扩散参数（AUC > 0.95，p < 0.002）。D在预测肿瘤完全坏死方面具有合理的诊断性能，但低于造影剂增强成像。
To correlate intra voxel incoherent motion (IVIM) diffusion parameters of liver parenchyma and hepatocellular carcinoma (HCC) with degree of liver/tumor enhancement and necrosis; and to assess the diagnostic performance of diffusion parameters vs. enhancement ratios (ER) for prediction of complete tumor necrosis. In this IRB approved HIPAA compliant study, we included 46 patients with HCC who underwent IVIM diffusion-weighted (DW) MRI in addition to routine sequences at 3.0 T. True diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (PF) and apparent diffusion coefficient (ADC) were quantified in tumors and liver parenchyma. Tumor ER were calculated using contrast-enhanced imaging, and degree of tumor necrosis was assessed using post-contrast image subtraction. IVIM parameters and ER were compared between HCC and background liver and between necrotic and viable tumor components. ROC analysis for prediction of complete tumor necrosis was performed. 79 HCCs were assessed (mean size 2.5 cm). D, PF and ADC were significantly higher in HCC vs. liver (p < 0.0001). There were weak significant negative/positive correlations between D/PF and ER, and significant correlations between D/PF/ADC and tumor necrosis (for D, r 0.452, p < 0.001). Among diffusion parameters, D had the highest area under the curve (AUC 0.811) for predicting complete tumor necrosis. ER outperformed diffusion parameters for prediction of complete tumor necrosis (AUC > 0.95, p < 0.002). D has a reasonable diagnostic performance for predicting complete tumor necrosis, however lower than that of contrast-enhanced imaging.