Apparent diffusion coefficient of hepatocellular carcinoma on diffusion- weighted imaging: Histopathologic tumor grade versus arterial vascularity during dynamic magnetic resonance imaging

作者：Park In Kyung; Yu Jeong Sik^*; Cho Eun Suk; Kim Joo Hee; Chung Jae Joon

来源：PLos One, 2018, 13(5): e0197070.

DOI：10.1371/journal.pone.0197070

Objectives
Apparent diffusion coefficient (ADC) has been suggested to reflect the tumor grades of hepatocellular carcinomas (HCCs); i.e., it can be used as a biomarker to predict the patients' prognosis. To verify its feasibility as a biomarker, the present study sought to determine how the ADC values of HCC are affected by a tumor's histopathologic grade and arterial vascularity.
Materials and methods
From 131 consecutive patients, 141 surgically resected HCCs (16 well-differentiated [wd-HCCs], 83 moderately-differentiated [md-HCCs], and 42 poorly-differentiated HCCs [pd-HCCs]) were subjected to a comparison of the tumors' arterial vascularity (non-, slightly-, or markedly-hypervascular) determined on dynamic magnetic resonance imaging (MRI) and the ADC was measured retrospectively.
Results
The pd-HCCs (1.05 +/- 0.16 x 10(-3) mm(2)/s) had a significantly lower ADC than md-HCCs (1.16 +/- 0.21 x 10(-3) mm(2)/s; p = 0.010), but there was no significant difference compared to wdHCCs (1.11 +/- 0.18 x 10(-3) mm(2)/s; p = 0.968). The mean ADC was significantly higher in markedly hypervascular lesions (1.20 +/- 0.20 x 10(-3) mm(2)/s) than in nonhypervascular lesions (0.95 +/- 0.14 x 10(-3) mm(2)/s; p<0.001) or slightly hypervascular lesions (1.04 +/- 0.15 x 10(-3) mm(2)/ s; p<0.001). The ADC values and arterial vascularity were significantly correlated in wd-HCCs (p = 0.005) and md-HCCs (p<0.001). The mean ADC of pd-HCCs was significantly lower than those of other lesions, even in the markedly hypervascular lesion subgroup (p = 0.020).
Conclusion
Although pd-HCC constantly shows low ADCs regardless of arterial vascularities, ADCs cannot stably stratify histopathologic tumor grades due to the variable features of wd-HCCs; and the ADC should be used with caution as a tumor biomarker of HCC.

• 出版日期2018-5-11