Amide proton transfer-weighted MRI for predicting histological grade of hepatocellular carcinoma: comparison with diffusion-weighted imaging
Amide proton transfer-weighted MRI for predicting histological grade of hepatocellular carcinoma: comparison with diffusion-weighted imaging
复制标题
酰胺质子转移加权 MRI 预测肝细胞癌组织学分级：与弥散加权成像的比较
DOI：
10.21037/qims.2019.08.07
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发表时间：
2019-10-01
影响因子：
2.8
通讯作者：
Chen, Min
中科院分区：
文献类型：
--
作者：
Lin, Yue;Luo, Xiaojie;Chen, Min
背景：肝细胞癌（HCC）是肝脏最常见的原发性恶性肿瘤，HCC术前分级具有重要的临床意义。酰胺质子转移加权（APTw）成像作为分子影像领域的一种新型造影机制，为HCC的分级提供了新的诊断思路。方法：2017年5月至2018年4月期间，连续入组32例经病理证实的HCC患者，其中高级别HCC 19例，低级别HCC 13例。 DWI 和 APTw 扫描在 3T MRI 扫描仪上进行。两名观察者参考轴向T 2 加权成像独立绘制感兴趣区域，获得APTw和表观扩散系数（ADC）值。使用组内相关系数（ICC）评估观察者间和观察者内的一致性。采用独立样本t检验比较高级别和低级别HCC肿瘤实质的APTw和ADC值。受试者工作特征曲线用于分析高级别和低级别 HCC 肿瘤的诊断效果。采用Spearman相关分析评估Arliv和ADC值与HCC组织学分级的关系。结果：高级别和低级别HCC的APTw或ADC值之间存在显着性差异（P=0.034和0.010）。 APTw 和 DWI 在区分高级别和低级别 HCC 方面均具有良好的诊断性能，曲线下面积分别为 0.814 和 0.745。 Arkv 值与组织学分级（r=0.534；P=0.002）以及 ADC 值与组织学分级（r=-0.417；P=0.018）之间存在中度相关性。结论：APTw 成像是一种有用的成像生物标志物，可补充 DWI，以实现更准确、更全面的 HCC 表征。
Background: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, preoperative grading of HCC is of great clinical significance. Amide proton transfer-weighted (APTw) imaging, as a novel contrast mechanism in the field of molecular imaging, provided new diagnostic ideas for the grading of HCC.Methods: Between May 2017 and April 2018, 32 consecutive patients with pathologically confirmed HCC were enrolled, including 19 high-grade HCCs and 13 low-grade HCCs. DWI and APTw scanning was performed on a 3T MRI scanner. Two observers drew regions of interest independently by referring to the axial T 2 -weighted imaging, and APTw and apparent diffusion coefficient (ADC) values were obtained. Inter- and intra-observer agreements were assessed with the intraclass correlation coefficients (ICCs). The independent sample t test was used to compare the APTw and ADC values between the high- and low-grade HCC tumor parenchyma. The receiver operating characteristic curve was used to analyze the diagnostic efficacy of high- from low-grade HCC tumors. Spearman correlation analysis was used to assess the relationship between Arliv and ADC values and HCC histological grades.Results: There were significant differences between the APTw or ADC values for the high- and low-grade HCCs (P=0.034 and 0.010). Both APTw and DWI had good diagnostic performance in differentiating the high- from the low-grade HCCs, with areas under the curves of 0.814 and 0.745, respectively. Moderate correlations existed between Arkv values and histological grades (r=0.534; P=0.002), as well as ADC values and histological grades (r=-0.417; P=0.018).Conclusions: The APTw imaging is a useful imaging biomarker that complements DWI for the more accurate and comprehensive HCC characterization.