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• Clinical Article •
The value of histogram-based apparent diffusion coefficient in distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma
TIAN Shuishui  XU Yongsheng  GAO Yuling  LIU Haifeng  LIU Zhao  LEI Junqiang 

Cite this article as: Tian SS, Xu YS, Gao YL, et, al. The value of histogram-based apparent diffusion coefficient in distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma. Chin J Magn Reson Imaging, 2019, 10(7): 514-518. DOI:10.12015/issn.1674-8034.2019.07.007.


[Abstract] Objective: To explore the application of histogram analysis of apparent diffusion coefficient (ADC) maps in differentiation of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).Materials and Methods: One hundred and twenty-five patients (84 patients with 84 HCCs and 41 patients with 41 ICCs) who underwent preoperative routine abdomen MRI sequences, Gd-EOB-DTPA enhanced MRI and DWI were evaluated in this retrospectively study. The entire tumor ADC values derived from histogram anlysis (including ADC_min, ADC_5th, ADC_25th, ADC_75th, ADC_95th, ADC_max, ADC_mean, ADC_median, skewness and kurtosis) were calculated. The comparison of ADC value were performed by the Student's t test or Mann-Whitney U test. ROC analysis was used to assess the diagnostic performance of ADC histogram in distinguishing the two pathological types of primary liver cancer. The chi-square test was used to compare the diagnostic ability of Gd-EOB-DTPA dynamic enhancement scan (group A) with that of ADC histogram parameters (group B) with the maximum diagnostic efficacy.Results: The ADC_75th, ADC_95th, ADC max, ADC_mean and ADC median of intrahepatic cholangiocarcinoma were significant higher than those of hepatocellular carcinoma (P<0.05), ADC_min of hepatocellular carcinoma intrahepatic was higher in comparison to intrahepatic cholangiocarcinoma (P<0.05), There was no significant difference between two groups in ADC_5th, ADC_25th, skewness and kurtosis (P>0.05). ADC_max achieved the largest AUC (0.901) in differentiating HCC and ICC, when cutoff value was 2.65×10-3 mm2/s, the sensitivity and specificity were 82.6% and 86.9%. The specificity of group B was higher than that of group A, and the difference was statistically significant (P<0.05).Conclusions: ADC histogram could be used to differentiate HCC from ICC, and the ADC_max is the most optimal parameter.
[Keywords] carcinoma, hepatocellular；intrahepatic ccholangiocarcinoma；magnetic resonance imaging；diagnosis, differential

TIAN Shuishui Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 73000, China; The First Clinical Medical College of LanZhou University, Lanzhou 73000, China

XU Yongsheng Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 73000, China; The First Clinical Medical College of LanZhou University, Lanzhou 73000, China

GAO Yuling Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 73000, China; The First Clinical Medical College of LanZhou University, Lanzhou 73000, China

LIU Haifeng Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 73000, China; The First Clinical Medical College of LanZhou University, Lanzhou 73000, China

LIU Zhao Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 73000, China

LEI Junqiang* Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 73000, China

*Correspondence to: Lei JQ, E-mail: leijq1990@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article is funded by the Gansu Provincial Natural Science Foundation of China No. 1506RJZA265 Supported by the Fundamental Research Funds for the Central Universities No. lzujbky-2019-cd04
Received  2019-01-02
Accepted  2019-05-24
DOI: 10.12015/issn.1674-8034.2019.07.007
Cite this article as: Tian SS, Xu YS, Gao YL, et, al. The value of histogram-based apparent diffusion coefficient in distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma. Chin J Magn Reson Imaging, 2019, 10(7): 514-518. DOI:10.12015/issn.1674-8034.2019.07.007.

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