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Evaluating histologic differentiation of hepatitis B virus-related hepatocellular carcinoma using intravoxel incoherent motion and AFP levels alone and in combination

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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate histologic differentiation of hepatitis B virus (HBV)-related hepatocellular carcinomas (HCCs) using apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM)-derived metrics and to compare findings with alpha-fetoprotein (AFP) levels alone and in combination.

Materials and method

One hundred and six chronic HBV-related HCC patients who underwent IVIM diffusion-weighted magnetic resonance imaging with eleven b values were enrolled. Mean ADC, diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were determined for all detected lesions. The metrics and AFP levels of different histologically differentiated groups were compared. Spearman’s rank correlation was used to assess the statistical dependence among the histologically differentiated HCCs. Receiver operating characteristic (ROC) analysis was performed to evaluate diagnostic performance of these metrics and AFP levels alone and in combination.

Results

ADC, D, and f values and AFP levels were significantly different among well-, moderately, and poorly differentiated HCCs. The four metrics were significantly correlated with histologic differentiation. The area under the ROC curve (AUC-ROC) of ADC, D, f, and AFP for diagnosing well-differentiated HCCs was 0.903, 0.84, 0.782, and 0.806, respectively, and the AUC-ROC of above metrics for diagnosing poorly differentiated HCCs was 0.787, 0.726, 0.624, and 0.633, respectively. The combination of ADC and AFP provided an AUC-ROC of 0.945 for well-differentiated HCC. However, this did not provide better performance for diagnosing poorly differentiated HCC.

Conclusion

ADC, IVIM metrics, and AFP levels may be useful for evaluating histologic differentiation of HBV-related HCCs, and the combination of ADC and AFP provides better diagnostic performance for well-differentiated HCC.

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Authors and Affiliations

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

    Qungang Shan, Jingbiao Chen, Tianhui Zhang, Ronghua Yan, Jun Wu, Zhuang Kang, Bingjun He & Jin Wang

  2. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Yunhong Shu

  3. GE Healthcare MR Research China, Beijing, China

    Zhongping Zhang

Authors
  1. Qungang Shan
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  2. Jingbiao Chen
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  3. Tianhui Zhang
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  4. Ronghua Yan
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  5. Jun Wu
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  6. Yunhong Shu
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  7. Zhuang Kang
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  8. Bingjun He
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  9. Zhongping Zhang
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  10. Jin Wang
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Corresponding author

Correspondence to Jin Wang.

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Funding

Supported by the National Natural Science Foundation of China (81271562) and Science and Technology Program of Guangzhou, China (201704020016).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

The Institutional Review Board approved the study and did not require additional informed consent for reviewing the patients’ medical records and image.

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Shan, Q., Chen, J., Zhang, T. et al. Evaluating histologic differentiation of hepatitis B virus-related hepatocellular carcinoma using intravoxel incoherent motion and AFP levels alone and in combination. Abdom Radiol 42, 2079–2088 (2017). https://doi.org/10.1007/s00261-017-1107-6

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  • DOI: https://doi.org/10.1007/s00261-017-1107-6

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