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• Clinical Article •
The value of texture analysis based on diffusion tensor imaging in distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma
WANG Man  LIU Ailian  ZHAO Ying  LIN Tao  WANG Nan  SONG Qingwei  GUO Yan  LI Xin  WU Tingfan 

Cite this article as: Wang M, Liu AL, Zhao Y, et al. The value of texture analysis based on diffusion tensor imaging in distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma[J]. Chin J Magn Reson Imaging, 2021, 12(8): 15-21. DOI:10.12015/issn.1674-8034.2021.08.004.


[Abstract] Objective To explore the value of texture analysis based on diffusion tensor imaging (DTI) in distinguishing hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Materials andMethods The data of patients who underwent 1.5 T MRI examination of upper abdomen in the first Affiliated Hospital of Dalian Medical University and pathologically confirmed HCC (52 cases) or ICC (28 cases) were studied retrospectively. The DTI images were reconstructed to generate apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps. ROIs covering the entire tumor were drawn on each slice of ADC and FA signal intensity maps by two observers (with 2 years and 8 years of imaging diagnosis experience). The texture parameters of the tumor were extracted by AK software. The intra-class correlation coefficient (ICC) was used to test the consistency of the data. The independent samples t test or Mann-Whitney U test was used to compare the differences of the parameters. ROC curves were plotted to analyze diagnostic efficiency. Using Logistic regression analysis to establish the predictive model. The Delong test was used to compare the difference in efficacy between combined diagnosis and single parameter.Results The data consistency of two observers was good (intraclass correlation coeficient ＞0.75). Maxintensity, mean value, variance, standard deviation and entropy of ADC signal intensity graph in HCC group were smaller than those in ICC group. Energy, kurtosis and correlation were larger than those in ICC group (P＜0.05). Maxintensity, variance, standard deviation, and LRE of the FA signal intensity map in the HCC group were smaller than those of the ICC group; the correlation and SRE were larger than the ICC group (P＜0.05). There was no statistical difference in other parameters (P＞0.05). The diagnostic efficiency of ADC-correlation was the best, AUC, sensitivity and specificity scores were 0.856, 75.0%, 82.1%.The best diagnosis can be obtained when the three parameters of ADC-energy, FA-maximum, and FA-short-run advantage are combined or the four parameters of ADC-energy, ADC-correlation, FA-maximum, and FA-short-run advantage are combined. The AUC was 0.877, the sensitivity and the specificity scores were 78.6%, 84.6%. Delong test showed statistical differences between combined diagnosis and multiple parameters (P＜0.05).Conclusions DTI-based texture analysis can provide multiple parameters for differential diagnosis of HCC and ICC.
[Keywords] hepatocellular carcinoma；intrahepatic cholangiocarcinoma；diffusion tensor imaging；texture analysis；magnetic resonance imaging

WANG Man1   LIU Ailian1*   ZHAO Ying1   LIN Tao1   WANG Nan1   SONG Qingwei1   GUO Yan2   LI Xin2   WU Tingfan2  

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

2 GE Healthcare, Shanghai 200000, China

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

Conflicts of interest   None.

ACKNOWLEDGMENTS This work was part of National Natural Science Foundation of China (No.61971091).
Received  2021-04-09
Accepted  2021-06-11
DOI: 10.12015/issn.1674-8034.2021.08.004
Cite this article as: Wang M, Liu AL, Zhao Y, et al. The value of texture analysis based on diffusion tensor imaging in distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma[J]. Chin J Magn Reson Imaging, 2021, 12(8): 15-21. DOI:10.12015/issn.1674-8034.2021.08.004.

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