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Title: [Preliminary study of whole-tumor volume analysis of mono-exponential and intravoxel incoherent motion models in the preoperative histologic grading of hepatocellular carcinoma].
Author: Wei Y, Gao FF, Huang ZX, Tang HH, Wang M, Wang Y, Zhang T, Song B.
Journal: Zhonghua Yi Xue Za Zhi; 2018 Aug 21; 98(31):2460-2465. PubMed ID: 30138995.
Abstract:
Objective: To investigate the diagnostic performance of whole-tumor volume analysis of mono-exponential and intravoxel incoherent motion (IVIM)parameters in the preoperative grading of hepatocellular carcinoma (HCC). Methods: A total of 106 patients who undewent parital hepatectomy were prospectively enrolled and underwent with routine MR and IVIM examination.112 HCCs were confirmed by the surgical pathology.The original images of IVIM were imported into the GE AW 4.6 workstation.Two independent radiologist who were blinded to the histopathological results analyzed the data.Freehand ROI was used to cover the whole tumor volume, ADC, ADC(slow), ADC(fast) and f was calculated.Intra-class correlation coefficient (ICC) was used to evaluate the inter-observer agreement, One-way ANOVA and Kruskal-Wallis sign rank test were used to evaluate the difference of these parameters in grading HCC, Spearman correlation analysis was used to determine the correlation between these parameters and histologic grade, receiver operating characteristics (ROC) curves were performed to evaluate the diagnostic performance. Results: ICC value of ADC, ADC(slow), ADC(fast) and f were 0.948, 0.966, 0.901 and 0.940, respectively.Statistical significances were obtained from the ADC(slow)(R1: χ(2)=74.403, P<0.001; R2: F=44.973, P<0.001) and ADC (R1: χ(2)=52.987, P<0.001; R2: F=30.851, P<0.001) in grading HCC.Between the multiple-comparison in grading HCC, the ADC(slow) and ADC (except for E-S 3 and 4, R1: P=0.134; R2: P=0.069) also demonstrated a statistical significant difference (all P<0.05). Area under curve (AUC) value of two radiologists for ADC(slow) were 0.905 and 0.917, for ADC were 0.831 and 0.829, a negative correlation was obtained from the ADC and ADC(slow) (all P<0.05). Conclusion: Mono-exponential and intravoxel incoherent motion (IVIM) model can be used to evaluate the pathological differentiated grade of HCC, ADC and ADC(slow) value entailed the highest diagnostic performance. 目的： 探讨全体素测量单指数模型与体素内不相干运动模型(IVIM)参数对肝癌术前病理分级诊断价值。 方法： 前瞻性纳入2016年10月至2017年6月四川大学华西医院接受肝脏部分切除术患者106例，共计112个经手术病理证实肝癌，均行常规MRI及IVIM成像。将IVIM原始图像传至GE AW 4.6处理站，两名医师独立、盲法进行数据分析。选取肿瘤组织所有层面手动勾勒感兴趣区(ROI)，计算表观扩散系数(ADC)、真实扩散系数(ADC(slow))、灌注相关扩散系数(ADC(fast))和灌注分数(f)。组内相关系数(ICC)用于分析两名医师间一致性，单因素方差分析(正态、方差齐)和Kruskal－Wallis秩合检验(非正态)用于比较不同病理分级间各参数值差异，Spearman相关用于评价各参数与病理分级间相关性，受试者工作特征(ROC)曲线用于评价各参数值鉴别诊断效能。 结果： 两名医师间ADC、ADC(slow)、ADC(fast)和f其ICC分别为0.948、0.966、0.901和0.940；肝癌不同Edmondson－Steiner(E－S)分级间ADC(slow)(R1：χ(2)＝74.403，P<0.001；R2：F＝44.973，P<0.001)与ADC(R1：χ(2)＝52.987，P<0.001；R2：F＝30.851, P<0.001)值差异均有统计学意义(均P<0.05)，不同E－S分级间两两比较ADC(slow)值和ADC(除E－S 3与4，R1：P＝0.134，R2：P＝0.069)差异均有统计学意义(均P<0.05)；两名医师测量ADC(slow)值其ROC曲线下面积分别为0.905、0.917，ADC为0.831、0.829；ADC及ADC(slow)与病理分级呈负相关(均P<0.001)。 结论： 扩散加权成像单指数模型及IVIM模型可用于肝癌病理分级评估，且以ADC及ADC(slow)值诊断效能最佳。.

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