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Applied Research of Diffusion Weighted Imaging in Recurrent Hepatocellular Carcinoma

Author: LiuYuFeng
Tutor: XuMaoSheng
School: Zhejiang University of Traditional Chinese Medicine
Course: Medical Imaging and Nuclear Medicine
Keywords: Hepatocellular carcinoma magnetic resonance imaging diffusion-weighted imaging
CLC: R735.7
Type: Master's thesis
Year: 2011
Downloads: 13
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Abstract


Hepatocellular carcinoma is one of the most common cancer in the world, its high mortality, high incidence, recurrence rate is high. Early detection and early diagnosis of hepatocellular carcinoma lesions and clarifying the number and location of its lesions are essential for formulating reasonable treatment options.Objective To evaluate the value of breathhold diffusion-weighted imaging (DWI) and Gd-DTPA enhanced MRI alone and combined in detection of various size of recurrent hepatocellular carcinoma (HCC) recurrences.Methods patients who were confirmed as HCC by pathology and surgery or TACE Treatment of patients with informed consent and were followed up with 3.0T MRI (T1-weighted imaging,T2-weighted imaging,Gd-DTPA enhanced imaging and diffusion weighted Imaging) every two months. During two-year follow-up, forty-five patients suspected of recurrent HCC (RHCC) were confirmed by surgery, biopsy, follow-up and lipiodol CT. A total of 154 RHCC lesions were confirmed. All images were divided into Gd-DTPA MRI group (T1WI, T2WI and Gd-DTPA enhanced MRI images),DWI group (T1WI, T2WI and DWI images) and Gd-DTPA+DWI group (T1WI,T2WI,DWI). Receiver operating characteristic (ROC) curve were used to assess the accuracy of three methods (Gd-DTPA group, DWI group and the group of Gd-DTPA + DWI). it were calculated that sensitivity and specificity of three reviewers analyzed three methods detect three different sizes of lesions (≥2cm,1-2cm and≤1cm lesions), and analyzed whether the differences between two of its had statistical significance.Results For detecting tiny RHCC(≤lcm), the sensitivity of Gd-DTPA group was 29.9%、37.3% and 29.9% for three readers respectively; that of DWI group was 77.6%、76.1% and 76.1%; and it of Gd-DTPA+DWI group was 85.1%、83.6% and 85.1% in the Gd-DTPA+DWI group; The sensitivity of DWI group and Gd-DTPA+DWI group were higher than that of Gd-DTPA group (P<0.05). There were not signant difference in three groups for detecting RHCC(≥2cm or 1-2cm). ROC analysis showed higher Az value of DWI group (0.94) and Gd-DTPA+DWI group (0.96)compared with that of conventional MRI group (0.84) in combination (P<0.001).Conclusion DWI combined with conventional MRI is helpful to improve the detection of HCC recurrences, especially for tiny RHCCs. DWI check out minimal recurrent hepatocellular carcinoma (≤lcm) check out sensitive rate is significantly higher than Gd-DTPA enhanced MRI.

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