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- Title
Can IVIM help predict HCC recurrence after hepatectomy?
- Authors
Zhang, Yao; Kuang, Sichi; Shan, Qungang; Rong, Dailin; Zhang, Zhongping; Yang, Hao; Wu, Jun; Chen, Jingbiao; He, Bingjun; Deng, Ying; Roberts, Neil; Shen, Jun; Venkatesh, Sudhakar K.; Wang, Jin
- Abstract
<bold>Purpose: </bold>To determine the diagnostic performance of intravoxel incoherent motion (IVIM) parameters to predict tumor recurrence after hepatectomy in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).<bold>Materials and Methods: </bold>One hundred and fifty-seven patients (mean age 52.54 ± 11.32 years, 87% male) with surgically and pathologically confirmed HCC were included. Regions of interests were drawn including the tumors by two independent radiologists. ADC and IVIM-derived parameters (true diffusion coefficient [D]; pseudodiffusion coefficient [D*]; pseudodiffusion fraction [f]) were obtained preoperatively. The Cox proportional hazards model was used to analyze the predictors associated with tumor recurrence after hepatectomy.<bold>Results: </bold>Forty-seven of 157 (29.9%) patients experienced tumor recurrence. The multivariate Cox proportional hazards model revealed that a D value < 0.985 × 10-3 mm2/s (hazard ratio (HR), 0.190; p = 0.023) was a risk factor for tumor recurrence. Additional risk factors included younger age (HR, 0.328; p = 0.034) and higher serum alpha-fetoprotein (AFP) level (HR, 2.079; p = 0.013). Further, receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of the obtained Cox regression model improved from 0.68 for the combination of AFP and age alone to 0.724 for the combination of D value, AFP, and age.<bold>Conclusion: </bold>The D value derived from the IVIM model is a potential biomarker for the preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence.<bold>Key Points: </bold>• The recurrence rate of HCC after hepatectomy was higher in patients with ADC, D, and f values that were lower than the optimal cutoff values. • The optimal cutoff values of ADC, D, D*, and f for predicting recurrence in HBV associated HCC were 0.858 × 10-3 mm2/s, 0.985 × 10-3 mm2/s, 12.5 × 10-3 mm2/s, and 23.4%, respectively. • The D value derived from IVIM diffusion-weighted imaging may be a useful biomarker for preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence.
- Subjects
PROPORTIONAL hazards models; HEPATITIS B virus; RECEIVER operating characteristic curves; DIFFUSION magnetic resonance imaging; CANCER relapse; EPIDEMIOLOGICAL research; HEPATECTOMY; HEPATOCELLULAR carcinoma; LIVER tumors; MAGNETIC resonance imaging; MOTION; CHRONIC hepatitis B
- Publication
European Radiology, 2019, Vol 29, Issue 11, p5791
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-019-06180-1