Value of MR histogram analyses for prediction of microvascular invasion of hepatocellular carcinoma

Abstract

The objective is to explore the value of preoperative magnetic resonance (MR) histogram analyses in predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Fifty-one patients with histologically confirmed HCC who underwent diffusion-weighted and contrast-enhanced MR imaging were included. Histogram analyses were performed and mean, variance, skewness, kurtosis, 1th, 10th, 50th, 90th, and 99th percentiles were derived. Quantitative histogram parameters were compared between HCCs with and without MVI. Receiver operating characteristics (ROC) analyses were generated to compare the diagnostic performance of tumor size, histogram analyses of apparent diffusion coefficient (ADC) maps, and MR enhancement.The mean, 1th, 10th, and 50th percentiles of ADC maps, and the mean, variance. 1th, 10th, 50th, 90th, and 99th percentiles of the portal venous phase (PVP) images were significantly different between the groups with and without MVI (P <0.05), with area under the ROC curves (AUCs) of 0.66 to 0.74 for ADC and 0.76 to 0.88 for PVP. The largest AUC of PVP (1th percentile) showed significantly higher accuracy compared with that of arterial phase (AP) or tumor size (P <0.001).MR histogram analyses—in particular for 1th percentile for PVP images—held promise for prediction of MVI of HCC.

Histogram Analysis of Diffusion Kurtosis Magnetic Resonance Imaging for Diagnosis of Hepatic Fibrosis

“…The corresponding areas under the ROC curve (AUCs), sensitivity and specificity for the classification of fibrosis (grade F1 or higher, F2 or higher, and F4) were calculated. For all significant parameters of D, K, and ADC maps, the highest AUCs of each MR parameter were used to compare the diagnostic performance in fibrosis staging ( 12 ), using the DeLong method ( 21 ). All tests were two-sided and p < 0.05 was considered statistically significant.…”

“…However, routine MR signal measurements only provide mean values, which do not account for the underlying spatial distribution. MR histogram analysis is a new approach for quantification of the distribution of signal intensity of voxels using routinely acquired MR data, and refers to a mathematical approach to evaluate variations in gray-level intensity within a region of interest (ROI), which reflects histological heterogeneity ( 11 12 ). MR histogram analysis facilitated the detection and staging of liver fibrosis, confined to the application of gadoxetic acid-enhanced MRI and conventional DWI ( 13 14 15 ).…”

Histogram analyses of diffusion kurtosis indices and apparent diffusion coefficient in assessing liver regeneration after ALPPS and a comparative study with portal vein ligation

“…However, routine MR signal measurements only provide information for mean values. MR histogram analysis is an approach for quantifying the distribution of signal intensity of voxels, accounting for the underlying spatial distribution and intensity variations, which reflects the microstructural heterogeneity …”

“…MR histogram analysis is an approach for quantifying the distribution of signal intensity of voxels, accounting for the underlying spatial distribution and intensity variations, which reflects the microstructural heterogeneity. 16,17 The applications of DKI in liver are scarce and have kept some limited to in vitro studies. 14,18,19 Therefore, the purpose of this study was to investigate the value of DKI histogram analysis in assessing liver regeneration and functional compensation after ALPPS in comparison with PVL, as well as the potential intrinsic microstructure basis.…”

Preoperative computed tomography and serum α-fetoprotein to predict microvascular invasion in hepatocellular carcinoma

“…Recent studies have suggested that computed tomography (CT), [ 8 ] CT perfusion, [ 9 ] PET-CT, [ 10 ] gadoxetic acid-enhanced magnetic resonance imaging (MRI), [ 11 , 12 ] and apparent diffusion coefficient (ADC) measurement [ 13 – 15 ] could be used to predict MVI. However, there have been no studies of capsular invasion on CT (a standard HCC imaging modality) to predict MVI.…”