Contribution of Diffusion-Weighted Magnetic Resonance Imaging in the Characterization of Hepatocellular Carcinomas and Dysplastic Nodules in Cirrhotic Liver

Xu, Pengju; Yan, Fuhua; Wang, Jianhua; Shan, Yan; Ji, Yuan; Chen, Caizhong

doi:10.1097/rct.0b013e3181da3671

Cited by 98 publications

(76 citation statements)

References 34 publications

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“…Therefore, the exact value of restriction in diffusion can be assessed by ADC measurements of the lesions 20 . ADC and ADC ratio values of HCCs were significantly lower than DN in our study but lower than previously published reports 3,19 . We found an ADC value of ≤ 1.316x10 -3 mm²/s and an ADC ratio of ≤ 0.94 as the best cut-off points.…”

Section: Discussioncontrasting

confidence: 55%

“…In recent studies on DWI to evaluate hyperintensity of HCCs compared to the surrounding hepatic parenchyma, different b values were used. Piana et al found a sensitivity value of 72% or 82% depending on the reader and Xu et al 19 found a value of 67.5% with a b factor of 500 s/mm², while Vandecaveye found a value of 95.2% with a b factor of 600 s/mm² on DWI 3,12 . A consensus conference on DWI in cancer imaging stated that higher b values are needed in high vascular tissues 20,21 .…”

Section: Discussionmentioning

confidence: 99%

“…Thus, movement of water molecules is progressively restricted and results in a high signal intensity on DWI 7,17,18 . The sensitivity of hyperintensity on DWI for HCC varied between 67.5% and 95.2% according to recent studies 3,5,12,19 . In agreement with previously published reports, we obtained a sensitivity of 88.4 percent.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Utility of diffusion-weighted magnetic resonance imaging in diagnosing hepatocellular carcinoma in cirrhotic liver

Aslan¹,

Inan²,

Karagöz³

et al. 2016

MMJ

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Utility of diffusion-weighted magnetic resonance imaging in diagnosing hepatocellular carcinoma in cirrhotic liver

Aslan¹,

Inan²,

Karagöz³

et al. 2016

MMJ

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“…Taouli et al first showed that ADC values can be used to differentiate between benign and malignant lesions in liver. 20,21 After this, few studies 23,24 were done to differentiate between benign and malignant hepatic lesions and also to differentiate between various grades of HCC. Nasu et al, 19 Piana et al, 15 and Saito et al 25 showed that there exists no relationship between ADC values and histopathological grades of HCC, whereas Heo et al 26 and Nishie et al 27 said that the ADC values of HCC had an inverse correlation with the degree of differentiation.…”

Section: Role Of Diffusion Weighted Imaging For Hepatocellular Carcinmentioning

confidence: 99%

Role of Diffusion Weighted Imaging (DWI) for Hepatocellular Carcinoma (HCC) Detection and its Grading on 3T MRI: A Prospective Study

Shankar

Kalra

Bhatia

et al. 2016

Journal of Clinical and Experimental Hepatology

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Background: Limited studies have evaluated the role of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) for histologically grading the hepatocellular carcinoma (HCC). Objective: To compare the efficacy of DWI with dynamic contrast enhanced magnetic resonance (DCEMR) in detection of HCC in cirrhosis, and to evaluate whether DWI can be used instead of DCEMR. Methods: 20 patients of either sex with cirrhosis and suspected of having HCC on screening USG were included in this prospective study approved by the Institutional Ethics Committee. All patients underwent DCEMR of the abdomen on 3T scanner and fine needle aspiration of the lesions. MR protocol included T1WI, T2WI, DWI, and dynamic CEMR. The results of diffusion weighted imaging were compared with DCEMR to find the efficacy of DWI vis-à-vis CEMR. Results: DWI had a sensitivity and specificity of 100%, for diagnosis of lesions in cases having single lesion on CEMR, and sensitivity of 75% and specificity of 100% for diagnosis of lesions in cases having multiple lesions. There was a decreasing trend of ADC values with increasing grade of the tumor; however, the decreasing trend was not statistically significant. A cut-off ADC value of 0.8705 resulted in a sensitivity of 75% and specificity of 50% for differentiating between welldifferentiated and other grades of HCC. Conclusion: DWI can be used as an alternative for the detection and characterization of HCC, especially in patients with impaired renal function or contrast allergies precluding the use of contrast. In addition, DWI with ADC measurement may be helpful for non-invasive and preoperative prediction of the degree of differentiation of HCC. ( J CLIN EXP HEPATOL 2016;6:303-310)

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“…As a consequence of hepatocyte uptake, normal liver areas exhibit T1 shortening, whereas focal liver lesions without hepatocytes do not. Gd-EOB-DTPA has been shown to be useful in the detection of focal malignant liver lesions, including hepatocellular carcinoma and metastasis (16,17). In the present patient, hepatic EAML showed homogeneous and significantly lower signal intensity at the hepatobiliary phase at 30 min post-Gd-EOB-DTPA injection compared with the normal liver parenchyma.…”

Section: Discussionmentioning

confidence: 62%

Gd-EOB-DTPA-enhanced and diffusion-weighted magnetic resonance findings in hepatic epithelioid angiomyolipoma: A case report

et al. 2015

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Abstract. The present study reports a case of histologically proven hepatic epithelioid angiomyolipoma that was evaluated with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging and diffusion-weighted imaging. A 23-year-old female was admitted to the Northern Jiangsu People's Hospital (Yangzhou, Jiangsu, China) due to a 5.6-cm mass in the liver, and a right partial hepatectomy was performed. Magnetic resonance imaging (MRI) revealed a hypointense mass on T1-weighted imaging, and a hyperintense mass on T2-weighted and diffusion-weighted imaging, with a higher apparent diffusion coefficient value compared with normal liver parenchyma. On the dynamic Gd-EOB-DTPA-enhanced MRI scan, the lesion manifested as hypervascular with multiple filiform vessels and a pseudocapsule image, and in the hepatobiliary phase the lesion demonstrated a lack of contrast retention, thus appearing hypointense compared with the background liver. Pre-operatively, EMAL was diagnosed on the basis of these findings in the tumor. The optimum treatment is complete surgical excision and subsequent follow-up. The patient was healthy and free from recurrence at 6 months and 1 year post-surgery. Therefore, knowledge of EAML specific features on dynamic Gd-EOB-DTPA-enhanced and DWI scans may improve the diagnostic accuracy of hypervascular hepatic tumors and may facilitate treatment selection.

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Contribution of Diffusion-Weighted Magnetic Resonance Imaging in the Characterization of Hepatocellular Carcinomas and Dysplastic Nodules in Cirrhotic Liver

Abstract: Diffusion-weighted MRI can provide additional information to differentiate HCC from DN. Combined with CE-MRI, DWI allows improved characterization of HCC versus DN in cirrhotic liver.

Cited by 98 publications

References 34 publications

Utility of diffusion-weighted magnetic resonance imaging in diagnosing hepatocellular carcinoma in cirrhotic liver

Utility of diffusion-weighted magnetic resonance imaging in diagnosing hepatocellular carcinoma in cirrhotic liver

Role of Diffusion Weighted Imaging (DWI) for Hepatocellular Carcinoma (HCC) Detection and its Grading on 3T MRI: A Prospective Study

Gd-EOB-DTPA-enhanced and diffusion-weighted magnetic resonance findings in hepatic epithelioid angiomyolipoma: A case report

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