ADC and eADC values predict microvascular invasion of hepatocellular carcinoma in MRI examinaton

Abstract

Objective To evaluate preoperative apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) in diffusion weighted imaging (DWI) on microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods We retrospectively reviewed 43 HCC patients with DWI data confirmed by surgery and pathology. ADC and eADC values were measured both in neoplasm and hepatic tissue, the ratio of tumor to liver (T/L) on ADC and eADC was calculated. The correlation between MVI and ADC value, T/L of ADC value, eADC value and T/L of eADC value was analysed, the best cut-off value of variables was analysed by ROC curve, multi factor analysis was carried out by Logistic regression model. Results The ADC value, T/L of ADC, eADC value and T/L of eADC were (1.458±0.444)×10-3mm2/s, 0.787±0.186, 0.289±0.144 and 1.383(1.179, 1.655), respectively. Among them, the positive MVI group were(1.232±0.480)×10-3mm2/s, 0.683±0.229, 0.323±0.123 and 1.630(1.387, 2.066), respectively. The negative MVI group were(1.545±0.404)×10-3mm2/s, 0.844±0.149, 0.277±0.152 and 1.303(1.176, 1.545), respectively. There was significant difference in ADC value, T/L of ADC value and T/L of eADC value (t=2.164, 2.654, z=-2.058, all P<0.05), the area under the ROC curve were (1.085×10-3) mm2/s, 0.685 and 1.475 using MVI as a diagnostic standard. Multivariate analysis showed that T/L of ADC value was an independent factor affecting MVI of HCC (OR=0.002, 95%CI: 1.380E-5-0.311, P<0.05). Conclusions The ADC value in HCC patients with positive MVI is lower than in HCC patients with negative MVI, T/L of eADC value is higher than in HCC patients with negative MVI, and T/L of ADC value is an independent factor predicticing MVI of HCC. Key words: Carcinoma, hepatocellular; Microvessels; Diffusion magnetic resonance imaging