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A comparative study of monoexponential versus biexponential models of diffusion-weighted imaging in differentiating histologic grades of hepatitis B virus-related hepatocellular carcinoma

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the diagnostic value of apparent diffusion coefficient (ADC) and intravoxel incoherent motion metrics in discriminating histologic grades of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV) infection.

Methods

117 chronic HBV patients with 120 pathologically confirmed HCCs after surgical resection or liver transplantation were enrolled in this retrospective study. Diffusion-weighted imaging was performed using eleven b values (0–1500 s/mm2) and two b values (0, 800 s/mm2) successively on a 3.0 T system. ADC0, 800, ADCtotal, diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were calculated. The parameters of three histologically differentiated subtypes were investigated using Kruskal–Wallis test, Spearman rank correlation, and receiver-operating characteristic analysis. Interobserver agreement was assessed using the intraclass correlation coefficient.

Results

There was excellent agreement for ADCtotal/D/f, good agreement for ADC0,800, and moderate agreement for D*. ADCtotal, ADC0, 800,D, and f were significantly different for well, moderately, and poorly differentiated HCCs (P < 0.001), and they were all inversely correlated with histologic grades: r = − 0.633, − 0.394, − 0.435, and − 0.358, respectively (P < 0.001). ADCtotal demonstrated higher performance than ADC0,800 in diagnosing both well and poorly differentiated HCCs (P < 0.001 and P = 0.04, respectively). ADCtotal showed higher performance than D and f in diagnosing well differentiated HCCs (P < 0.001) and similar performance in diagnosing poorly differentiated HCCs (P = 0.06 and 0.13, respectively).

Conclusions

ADCtotal showed better diagnostic performance than ADC0,800, D, and f to discriminate histologic grades of HCC.

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Funding

The scientific guarantor of this publication is Jin Wang. The authors of this manuscript declare no relationships with any companies, products or services of which may be related to the subject matter of the article. This study has received funding from Science and Technology Program of Guangzhou, China (No. 201704020016) and the National Natural Science Foundation of China (81271562).

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Author notes

  1. Qungang Shan and Sichi Kuang have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Rd., Guangzhou, 510630, Guangdong, People’s Republic of China

    Qungang Shan, Sichi Kuang, Yao Zhang, Bingjun He, Jun Wu & Jin Wang

  2. Department of Radiology, MeiZhou People’s Hospital, Meizhou Affiliated Hospital of Sun Yat-Sen University, Huangtang Road, Meizhou, 514031, Guangdong, People’s Republic of China

    Tianhui Zhang

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  1. Qungang Shan
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Shan, Q., Kuang, S., Zhang, Y. et al. A comparative study of monoexponential versus biexponential models of diffusion-weighted imaging in differentiating histologic grades of hepatitis B virus-related hepatocellular carcinoma. Abdom Radiol 45, 90–100 (2020). https://doi.org/10.1007/s00261-019-02253-3

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