Prediction of histological grade of hepatocellular carcinoma using quantitative diffusion-weighted MRI: a retrospective multivendor study

Ogihara, Yusuke; Kitazume, Yoshio; Iwasa, Yoshihiro; Taura, Shinichi; Himeno, Yoshiro; Kimura, Tsunehito; Sawano, Seishi; Terada, Shigehiko; Tanabe, Minoru; Saida, Yukihisa; Tateishi, Ukihide

doi:10.1259/bjr.20170728

Cited by 13 publications

(14 citation statements)

References 32 publications

(51 reference statements)

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“…Ogihara et al confirmed the utility of diffusion-weighted imaging as an AF for HCC across a number of different vendors and b-values. 26 Another study by Shankar et al, noted a trend of decreasing ADC values in patients with HCC, correlated with increasing grade of the tumor. 27 This prospective study included patients with single observations identified on screening ultrasounds, which were subsequently characterized with contrastenhanced MRI (CE-MRI).…”

Section: Changes To Af In Li-rads V2017mentioning

confidence: 95%

“…Biliary excretion occurs via the multidrug resistance-associated proteins MRP2 at the canalicular membrane. 26 In early as well as progressed HCC, OATP1B1/B3 expression is often either absent or reduced compared to background liver parenchyma, whereas MRP2 expression is often increased. 30 As a result, HCCs tend to be hypointense compared to the liver in the delayed/hepatobiliary phase.…”

Section: Contrast Agents Available For Use In Mri For Diagnosis Of Hccmentioning

confidence: 99%

Section: Contrast Agents Available For Use In Mri For Diagnosis Of Hccmentioning

confidence: 99%

“…26 Iodized oil, based on poppy seed oil, can be used as a radio-opaque intra-arterially administered contrast agent. Although accumulation of iodized oil on CT evaluation shortly after TACE portends a technically satisfactory result, it can be difficult to identify areas of residual hyperenhancement.…”

Section: Li-rads V2017 Treatment Responsementioning

confidence: 99%

“…Infrequently, HCCs have a high expression of OATP and low expression of MRP2 or have high expression of OATP and MRP2; these lesions can appear isointense or even hyperintense to the surrounding liver parenchyma. 26,34 Several studies have shown that MRI performed with hepatobiliary contrast agents provides higher sensitivity compared to dynamic contrast-enhanced CT for the detection of HCC, as well as liver metastases. [34][35][36] According to Suh et al, 37 a hypointense nodule in the hepatobiliary phase of gadoxetate-enhanced MRI that is nonhypervascular in the arterial phase should be regarded as intermediate risk, whereas one that is hypervascular in the arterial phase should be considered high risk (Fig.…”

Section: Contrast Agents Available For Use In Mri For Diagnosis Of Hccmentioning

confidence: 99%

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LI‐RADS 2017: An update

Kielar

Chernyak

Bashir

et al. 2018

Magnetic Resonance Imaging

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Section: Changes To Af In Li-rads V2017mentioning

confidence: 95%

Section: Contrast Agents Available For Use In Mri For Diagnosis Of Hccmentioning

confidence: 99%

Section: Contrast Agents Available For Use In Mri For Diagnosis Of Hccmentioning

confidence: 99%

Section: Li-rads V2017 Treatment Responsementioning

confidence: 99%

Section: Contrast Agents Available For Use In Mri For Diagnosis Of Hccmentioning

confidence: 99%

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LI‐RADS 2017: An update

Kielar

Chernyak

Bashir

et al. 2018

Magnetic Resonance Imaging

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Noninvasive Evaluation of the Pathologic Grade of Hepatocellular Carcinoma Using MCF-3DCNN: A Pilot Study

Jia

Xiao

Wang

et al. 2019

BioMed Research International

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Purpose. To evaluate the diagnostic performance of deep learning with a multichannel fusion three-dimensional convolutional neural network (MCF-3DCNN) in the differentiation of the pathologic grades of hepatocellular carcinoma (HCC) based on dynamic contrast-enhanced magnetic resonance images (DCE-MR images). Methods and Materials. Fifty-one histologically proven HCCs from 42 consecutive patients from January 2015 to September 2017 were included in this retrospective study. Pathologic examinations revealed nine well-differentiated (WD), 35 moderately differentiated (MD), and seven poorly differentiated (PD) HCCs. DCE-MR images with five phases were collected using a 3.0 Tesla MR scanner. The 4D-tensor representation was employed to organize the collected data in one temporal and three spatial dimensions by referring to the phases and 3D scanning slices of the DCE-MR images. A deep learning diagnosis model with MCF-3DCNN was proposed, and the structure of MCF-3DCNN was determined to approximate clinical diagnosis experience by taking into account the significance of the spatial and temporal information from DCE-MR images. Then, MCF-3DCNN was trained based on well-labeled samples of HCC lesions from real patient cases by experienced radiologists. The accuracy when differentiating the pathologic grades of HCC was calculated, and the performance of MCF-3DCNN in lesion diagnosis was assessed. Additionally, the areas under the receiver operating characteristic curves (AUC) for distinguishing WD, MD, and PD HCCs were calculated. Results. MCF-3DCNN achieved an average accuracy of 0.7396±0.0104 with regard to totally differentiating the pathologic grade of HCC. MCF-3DCNN also achieved the highest diagnostic performance for discriminating WD HCCs from others, with an average AUC, accuracy, sensitivity, and specificity of 0.96, 91.00%, 96.88%, and 89.62%, respectively. Conclusions. This study indicates that MCF-3DCNN can be a promising technology for evaluating the pathologic grade of HCC based on DCE-MR images.

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Diffusion-Weighted Imaging Reflects Tumor Grading and Microvascular Invasion in Hepatocellular Carcinoma

et al. 2021

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Background: To date, there are inconsistent data about relationships between diffusion-weighted imaging (DWI) and tumor grading/microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Our purpose was to systematize the reported results regarding the role of DWI in prediction of tumor grading/MVI in HCC. Method: MEDLINE library, Scopus, and Embase data bases were screened up to December 2019. Overall, 29 studies with 2,715 tumors were included into the analysis. There were 20 studies regarding DWI and tumor grading, 8 studies about DWI and MVI, and 1 study investigated DWI, tumor grading, and MVI in HCC. Results: In 21 studies (1,799 tumors), mean apparent diffusion coefficient (ADC) values (ADCmean) were used for distinguishing HCCs. ADCmean of G1–3 lesions overlapped significantly. In 4 studies (461 lesions), minimum ADC (ADCmin) was used. ADCmin values in G1/2 lesions were over 0.80 × 10−3 mm2/s and in G3 tumors below 0.80 × 10−3 mm2/s. In 4 studies (241 tumors), true diffusion (D) was reported. A significant overlapping of D values between G1, G2, and G3 groups was found. ADCmean and MVI were analyzed in 9 studies (1,059 HCCs). ADCmean values of MIV+/MVI− lesions overlapped significantly. ADCmin was used in 4 studies (672 lesions). ADCmin values of MVI+ tumors were in the area under 1.00 × 10−3 mm2/s. In 3 studies (227 tumors), D was used. Also, D values of MVI+ lesions were predominantly in the area under 1.00 × 10−3 mm2/s. Conclusion: ADCmin reflects tumor grading, and ADCmin and D predict MVI in HCC. Therefore, these DWI parameters should be estimated for every HCC lesion for pretreatment tumor stratification. ADCmean cannot predict tumor grading/MVI in HCC.

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Prediction of histological grade of hepatocellular carcinoma using quantitative diffusion-weighted MRI: a retrospective multivendor study

Abstract: All DW parameters could discriminate HCC grade. Non-ADC parameters might be more useful than the ADC for predicting poorly-differentiated HCCs. Advances in knowledge: The utility of quantitative DW parameters for predicting HCC grade was demonstrated by using multivendor MR units.

Cited by 13 publications

References 32 publications

LI‐RADS 2017: An update

LI‐RADS 2017: An update

Noninvasive Evaluation of the Pathologic Grade of Hepatocellular Carcinoma Using MCF-3DCNN: A Pilot Study

Diffusion-Weighted Imaging Reflects Tumor Grading and Microvascular Invasion in Hepatocellular Carcinoma

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