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Diffusion-weighted imaging of hepatocellular carcinoma for predicting early recurrence and survival after hepatectomy
Hepatology International, 06/29/2012
Muhi A et al. – Low tumor apparent diffusion coefficient [ADC] value by DWI was a risk factor for early postoperative hepatocellular carcinoma (HCC) recurrence and was associated with lower patient survival rates.
Methods- The present study included 116 consecutive patients with HCC who underwent partial hepatectomy.
- Patients were classified into two groups: patients with and without early recurrence (<1 year).
- Preoperative imaging variables (tumor number, size, shape, capsule, ADC, and venous invasion) and laboratory variables were evaluated to predict early recurrence using univariate and multivariate analyses.
- Overall survival was calculated using the Kaplan–Meier method.
- Twenty patients (17 %) developed early recurrence after surgery.
- Multivariate logistic regression analysis showed that tumor ADC (p = 0.0002), aspartate aminotransferase (p = 0.0121), and serum prothrombin time activity percentage (p = 0.0082) were statistically significant for predicting early recurrence.
- The optimal ADC cutoff value for predicting early recurrence obtained from receiver operating characteristic analysis was ≤0.898 × 10–3 mm2/s. In patients with ADC ≤0.898 × 10-3 mm2/s, the 3– and 5–year survival rates (77 and 56 %, respectively) were significantly decreased compared with those in patients with ADC >0.898 × 10–3 mm2/s (97 and 97 %, respectively; p = 0.0015).