High‐b‐value diffusion‐weighted MR imaging of hepatocellular lesions: Estimation of grade of malignancy of hepatocellular carcinoma

Muhi, Ali; Ichikawa, Tomoaki; Motosugi, Utaroh; Sano, Katsuhiro; Matsuda, Masanori; Kitamura, Takatoshi; Nakazawa, Tadao; Araki, Tsutomu

doi:10.1002/jmri.21931

Cited by 156 publications

(124 citation statements)

References 18 publications

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“…Details on the main published studies regarding ADC measurement and correlations with the pathological grade of HCCs are reported in Table 1. Overall, literature data show that HCC dedifferentiation tends to be associated with a decrease of the ADC value, despite differences between studies [23][24][25][26][27][28][29] . Apart from the direct correlation with the pathological grade, Nakanishi et al [29] found that ADC quantification might have a clinical prognostic value, being significantly lower in patients with early recurrence after surgery than in those without early recurrence.…”

Section: Primary Liver Tumorsmentioning

confidence: 90%

“…Arterial blood supply tends to increase during hepatocarcinogenesis. Perfusion imaging techniques [24] 99 0, 500 1.29 (WD); 1.22 (MD); 1.21 (PD) Saito et al [25] 32 100, 800 1.25 (WD); 1.12 (MD); 1.13 (PD) Muhi et al [26] 73 500, 800 0.91 (WD); 0.71 (MD); 0.68 (PD) Nishie et al [27] 80 0, 500, 1000 1.21 (WD); 1.14 (MD); 0.76 (PD) Heo et al [28] 27 0, 1000 1.20 (WD); 1.10 (MD); 0.90 (PD) Nakanishi et al [29] 44 0, 50, 1000 might provide more structural limitations than fibrosis alone. Legrand et al [44] reported that mean ADC values did not significantly differ between tumors having < 50% and those having > 50% of fibrotic stroma, or between tumors containing dense fibrosis and those containing loose fibrosis.…”

Section: Pancreatic Tumorsmentioning

confidence: 99%

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Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Robertis¹,

Martini²,

Demozzi³

et al. 2015

WJG

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Diffusion-weighted imaging (DWI), dynamic contrastenhanced magnetic resonance imaging (DCE-MRI) and perfusion computed tomography (CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT examinations. Nevertheless, the term "functional imaging" is commonly used to describe molecular imaging techniques, as positron emission tomography (PET) CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive "one-step" morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging, therefore these techniques could be used also for posttreatment assessment, even at an early stage. or altered cellular membranes will present diffusion restriction, which is depicted as signal hyperintensity areas on high b-value DW images and hypointensity on the apparent diffusion coefficient (ADC) maps; ADC measurement can also quantify water molecules' diffusion. As dedifferentiation or therapies may induce microscopic changes in neoplastic tissues that could modify water molecules' diffusion, DWI can distinguish between different degrees of malignancy and can be also proposed for post-treatment monitoring. Moreover, DWI can be performed in a single session with DCE-MRI, thus providing a comprehensive "one-step" morphological and functional evaluation of hepatobilio-pancreatic tumors.Perfusion imaging techniques evaluate changes in signal intensity (DCE-MRI) or density (pCT) after contrast medium injection, being therefore able to assess microvascularization through the evaluation of the dynamics of contrast medium distribution from vessels to the neoplastic tissue. Perfusion parameters are therefore theoretically good candidates for the evaluation of microscopic vascular differences between lesions with different pathological grade and for the assessment of treatment response, especially after chemoembolization or during treatments with antiangiogenic drugs.This editorial analyzes up-to-date literature data regarding the application of functional imaging techniques, apart from molecular imaging, to hepatic and pancreatic tumors, with particular emphasis on correlations to pathological features, prognostic stratification and therapeutic response assessment. FUNCTIONAL IMAGING TECHNIQUES: TECHNICAL BASESIn 1965 Stejskal and Tanne...

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Section: Primary Liver Tumorsmentioning

confidence: 90%

Section: Pancreatic Tumorsmentioning

confidence: 99%

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Robertis¹,

Martini²,

Demozzi³

et al. 2015

WJG

View full text Add to dashboard Cite

show abstract

“…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 . In the current study, we used a b factor of 800 s/mm² on DWI.…”

Section: Discussionmentioning

confidence: 99%

“…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 .…”

Section: Discussionmentioning

confidence: 99%

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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“…HCCs have higher ADC values than that of more aggressive grades [147,148]. Others have shown the ADCs in early HCC is slightly lower than those in moderated HCC [149].…”

Section: Diffusion Weighted Imagingmentioning

confidence: 96%

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

Alghamdi¹

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Non-alcoholic fatty liver disease (NAFLD), a disorder associated with abnormal lipid accumulation within hepatocytes, is considered benign disorder in nature. However, in some cases it may progress to inflammation, nonalcoholic steatohepatitis (NASH), then cirrhosis, precancerous nodules and finally to hepatocellular carcinoma (HCC). NAFLD and NASH are both reversible with appropriate clinical intervention and lifestyle changes. In developed countries, the non-alcoholic fatty liver disease (NAFLD) is becoming one of the most common causes of precancerous and HCC lesions [1]. Unfortunately, most nodular lesions are detected too late with a poor prognosis. The discovery of markers that can predict which livers may progress to HCC would allow early intervention and potentially halting progress to HCC. This would be of great benefit at any stage up to precancerous lesions, however the earlier the better.Development of end stage liver malignancy would be decreased, resulting in decreased mortality from this disease.Histology is considered the reference standard for the assessment of fatty disease and nodular lesion in liver. However, there are significant drawbacks including invasiveness, small sample size and observer-dependence which limits its usefulness in evaluating liver disease.Magnetic resonance imaging is a non-invasive modality that can provide information on anatomical and physiological changes in the liver (e.g. fatty liver disease and HCC). MRI images are primarily assessed visually by expert radiologists looking for anatomical and contrast changes in the images compared to normal tissue. This qualitative method requires inspection of all datasets for abnormalities. Visual interpretation is subjective, labour intensive, and depends on the experience of the radiologist. This can introduce inter-observer variation and is suitable only when the pathology leads to sufficient contrast changes in the images acquired.MRI also allows the calculation of quantitative parameters like T1, T2 and diffusion values. These parameters are dependent on physical, chemical and microstructural properties of the tissue. When standard protocols are used, the calculation of these parameters should be independent of the observer. This has the potential for more precise characterization of changes that occur over time. Clinically, here has been limited utilization of these methods, as they generally require longer acquisition times and significant post processing of the images. Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text.

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High‐b‐value diffusion‐weighted MR imaging of hepatocellular lesions: Estimation of grade of malignancy of hepatocellular carcinoma

Cited by 156 publications

References 18 publications

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

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

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

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