The value of three-dimensional volumetric ROI histogram analysis based on intravoxel incoherent motion imaging in preoperative assessment of pathological differentiation degree of hepatocellular carcinoma

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• Clinical Article •

ZHANG Zhe LIU Ailian ZHAO Ying GUO Yan

Cite this article as: Zhang Z, Liu AL, Zhao Y, et al. The value of three-dimensional volumetric ROI histogram analysis based on intravoxel incoherent motion imaging in preoperative assessment of pathological differentiation degree of hepatocellular carcinoma. Chin J Magn Reson Imaging, 2020, 11(9): 758-764, 770. DOI:10.12015/issn.1674-8034.2020.09.008.

Abstract

[Abstract] Objective: To explore the value of three-dimensional volumetric ROI histogram of intravoxel incoherent motion (IVIM) in preoperatively evaluating pathological differentiation of hepatocellular carcinoma (HCC).Materials and Methods: We retrospectively analyzed 51 HCC patients (52 HCC lesions) confirmed by pathology, who preoperatively underwent liver acquistion with volume acceleration (LAVA) dynamic enhancement, DWI and IVIM scanning of MR. The HCC lesions were categorized as poorly differentiated group (15 lesions) and non-poorly differentiated group (37 lesions) according to the pathological results. The DWI images were post-processed to obtain the apparent diffusion coefficient (ADC) images and the IVIM images were post-processed to obtain D (Dmono), D^* (D^*mono) and f (fmono) images on GE AW4.6 workstation. Conventional ROI analysis: using Functool software on GE AW 4.6 workstation, we drew three ROIs of the same area from the solid components of the largest layer of HCC on ADC, D, D^* and f images respectively. The average value of signal intensity of three ROIs was calculated and recorded as cROI (conventional ROI). Three-dimensional volumetric ROI histogram analysis: using Omni-Kinetics software, we drew the ROI along the edge of each layer of lesion on the ADC, D, D^* and f images, and then these ROIs were respectively merged into a volumetric ROI. The parameters of the volumetric ROI histogram were calculated, including min, max, mean, std, range, skewness, kurtosis and percentile quantile. ICC test was used to evaluate the consistency of two observers' measurements. Independent sample student's t tests or Mann-Whitney U test was used to compare the differences between the two groups of HCC. Combination diagnosis was made based on statistically significant histogram parameters. The ROC curves were made, followed by the diagnostic performance analysis and comparison between any two AUC values by using Delong test.Results: (1) The two observers' measurements were consistent (ICC> 0.75). (2) The ADCrange and Dstd/range of poorly differentiated HCC were significantly higher than that of non-poorly differentiated HCC (P<0.05). (3) Dmin/ mean/5th/10th/25th/50th, D^*min, fmin and DcROI of poorly differentiated HCC were lower than that of non-poorly differentiated HCC. (4) After combining the volumetric ROI histogram parameters D5th, D10th, D50th and Drange, the AUC value increased, and the difference was statistically significant (P<0.05).Conclusions: The three-dimensional volumetric ROI histogram based on IVIM was helpful for preoperatively evaluating pathological differentiation of HCC. After combining histogram parameters, the diagnostic efficiency was improved.

[Keywords] intravoxel incoherent motion；carcinoma, hepatocellular；magnetic resonance imaging

Contributor Information

ZHANG Zhe Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

LIU Ailian^* Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

ZHAO Ying Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

GUO Yan GE Healthcare (Shanghai), Shanghai 200000, China

*Correspondence to: Liu AL, E-mail: liuailian@dmu.edu.cn

Conflicts of interest None.

Publication Information

ACKNOWLEDGMENTS This article is supported by the National Natural Science Found of China No. 61971091

Received 2020-03-30

Accepted 2020-07-20

DOI: 10.12015/issn.1674-8034.2020.09.008

Text

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