Abstract
The aim of our study is to characterize the venous vasculatures of hepatocellular carcinoma (HCC) using a multi-breath-hold two-dimensional (2D) susceptibility weighted imaging (SWI) in comparison with conventional Magnetic Resonance Imaging (MRI) sequences. Twenty-nine patients with pathologically confirmed HCC underwent MR examination at a 3.0 T scanner. The number of venous vascularity in or around the lesion was counted and the image quality was subjectively evaluated by two experienced radiologists independently based on four image sets: 1) SWI, 2) T1-weighted sequence, 3) T2-weighted sequence, and 4) T1-weighted dynamic contrast-enhanced (DCE) sequence. Of the 29 patients, a total of 33 liver lesions were detected by both SWI and conventional MR sequences. In the evaluation of the conspicuity of venous vascularity, a mean of 10.7 tumor venous vessels per mass was detected by the SWI and 3.9 tumor vasculatures were detected by T1-weighted DCE (P<0.0001), while none was detected by T1-, T2-weighted sequences. The Pearson correlation coefficients between the lesion sizes and the number of tumor vasculatures detected by T1-weighted DCE was 0.708 (P<0.001), and 0.883 by SWI (P<0.001). Our data suggest that SWI appears to be a more sensitive tool compared to T1-weighted DCE sequence to characterize venous vasculature in liver lesions.
Highlights
Hepatocellular carcinoma (HCC) is one of the five most common malignancies and the third leading cause of cancerrelated deaths worldwide, with an increasing incidence due to hepatitis B and C viral infection [1]
The former totally overlooks the main issue that vasculature measurements done on biopsies or single slices from a lesion may be skewed by tumor heterogeneity and interior regions of necrosis, and the latter disregards tumor necrosis due to treatment, which is the objective of all effective loco-regional therapies widely used for HCC
Susceptibility Weighted Imaging (SWI) is shown to be beneficial in quantification of tumor hemorrhage, and correlate hemorrhage with tumor staging in abdominal organs of human body, such as liver [11,19]
Summary
Hepatocellular carcinoma (HCC) is one of the five most common malignancies and the third leading cause of cancerrelated deaths worldwide, with an increasing incidence due to hepatitis B and C viral infection [1]. The changes in tumor micro-vessel density (MVD) or the measurement of the greatest dimension of all target lesions were adopted as the criterion to assess the treatment response of a tumor [3,4]. The former totally overlooks the main issue that vasculature measurements done on biopsies or single slices from a lesion may be skewed by tumor heterogeneity and interior regions of necrosis, and the latter disregards tumor necrosis due to treatment, which is the objective of all effective loco-regional therapies widely used for HCC. In vivo monitoring the abnormality of venous vasculatures may be of high clinical significance for deciding which treatment options in HCC to use, for example, selecting a surgical program and embolotherapy
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call