Can IVIM help predict HCC recurrence after hepatectomy?

Yao Zhang, Sichi Kuang, Qungang Shan, Dailin Rong, Zhongping Zhang, Hao Yang, Jun Wu, Jingbiao Chen, Bingjun He, Ying Deng, Neil Roberts, Jun Shen, Sudhakar K Venkatesh, Jin Wang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To determine the diagnostic performance of intravoxel incoherent motion (IVIM) parameters to predict tumor recurrence after hepatectomy in patients with hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC). Materials and methods: One hundred and fifty-seven patients (mean age 52.54 ± 11.32 years, 87% male) with surgically and pathologically confirmed HCC were included. Regions of interests were drawn including the tumors by two independent radiologists. ADC and IVIM-derived parameters (true diffusion coefficient [D]; pseudodiffusion coefficient [D*]; pseudodiffusion fraction [f]) were obtained preoperatively. The Cox proportional hazards model was used to analyze the predictors associated with tumor recurrence after hepatectomy. Results: Forty-seven of 157 (29.9%) patients experienced tumor recurrence. The multivariate Cox proportional hazards model revealed that a D value < 0.985 × 10−3 mm2/s (hazard ratio (HR), 0.190; p = 0.023) was a risk factor for tumor recurrence. Additional risk factors included younger age (HR, 0.328; p = 0.034) and higher serum alpha-fetoprotein (AFP) level (HR, 2.079; p = 0.013). Further, receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of the obtained Cox regression model improved from 0.68 for the combination of AFP and age alone to 0.724 for the combination of D value, AFP, and age. Conclusion: The D value derived from the IVIM model is a potential biomarker for the preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence. Key Points: • The recurrence rate of HCC after hepatectomy was higher in patients with ADC, D, and f values that were lower than the optimal cutoff values. • The optimal cutoff values of ADC, D, D*, and f for predicting recurrence in HBV associated HCC were 0.858 × 10−3 mm2/s, 0.985 × 10−3 mm2/s, 12.5 × 10−3 mm2/s, and 23.4%, respectively. • The D value derived from IVIM diffusion-weighted imaging may be a useful biomarker for preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence.

Original languageEnglish (US)
JournalEuropean radiology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Hepatectomy
Hepatocellular Carcinoma
Recurrence
alpha-Fetoproteins
Proportional Hazards Models
Neoplasms
Hepatitis B virus
Biomarkers
ROC Curve
Area Under Curve

Keywords

  • Diffusion
  • Hepatitis B virus (HBV)
  • Hepatocellular carcinoma (HCC)
  • Magnetic resonance imaging (MRI)
  • Recurrence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Zhang, Y., Kuang, S., Shan, Q., Rong, D., Zhang, Z., Yang, H., ... Wang, J. (Accepted/In press). Can IVIM help predict HCC recurrence after hepatectomy? European radiology. https://doi.org/10.1007/s00330-019-06180-1

Can IVIM help predict HCC recurrence after hepatectomy? / Zhang, Yao; Kuang, Sichi; Shan, Qungang; Rong, Dailin; Zhang, Zhongping; Yang, Hao; Wu, Jun; Chen, Jingbiao; He, Bingjun; Deng, Ying; Roberts, Neil; Shen, Jun; Venkatesh, Sudhakar K; Wang, Jin.

In: European radiology, 01.01.2019.

Research output: Contribution to journalArticle

Zhang, Y, Kuang, S, Shan, Q, Rong, D, Zhang, Z, Yang, H, Wu, J, Chen, J, He, B, Deng, Y, Roberts, N, Shen, J, Venkatesh, SK & Wang, J 2019, 'Can IVIM help predict HCC recurrence after hepatectomy?', European radiology. https://doi.org/10.1007/s00330-019-06180-1
Zhang, Yao ; Kuang, Sichi ; Shan, Qungang ; Rong, Dailin ; Zhang, Zhongping ; Yang, Hao ; Wu, Jun ; Chen, Jingbiao ; He, Bingjun ; Deng, Ying ; Roberts, Neil ; Shen, Jun ; Venkatesh, Sudhakar K ; Wang, Jin. / Can IVIM help predict HCC recurrence after hepatectomy?. In: European radiology. 2019.
@article{36f3e230c9804da8bfbea9f0b5c8d0bb,
title = "Can IVIM help predict HCC recurrence after hepatectomy?",
abstract = "Purpose: To determine the diagnostic performance of intravoxel incoherent motion (IVIM) parameters to predict tumor recurrence after hepatectomy in patients with hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC). Materials and methods: One hundred and fifty-seven patients (mean age 52.54 ± 11.32 years, 87{\%} male) with surgically and pathologically confirmed HCC were included. Regions of interests were drawn including the tumors by two independent radiologists. ADC and IVIM-derived parameters (true diffusion coefficient [D]; pseudodiffusion coefficient [D*]; pseudodiffusion fraction [f]) were obtained preoperatively. The Cox proportional hazards model was used to analyze the predictors associated with tumor recurrence after hepatectomy. Results: Forty-seven of 157 (29.9{\%}) patients experienced tumor recurrence. The multivariate Cox proportional hazards model revealed that a D value < 0.985 × 10−3 mm2/s (hazard ratio (HR), 0.190; p = 0.023) was a risk factor for tumor recurrence. Additional risk factors included younger age (HR, 0.328; p = 0.034) and higher serum alpha-fetoprotein (AFP) level (HR, 2.079; p = 0.013). Further, receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of the obtained Cox regression model improved from 0.68 for the combination of AFP and age alone to 0.724 for the combination of D value, AFP, and age. Conclusion: The D value derived from the IVIM model is a potential biomarker for the preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence. Key Points: • The recurrence rate of HCC after hepatectomy was higher in patients with ADC, D, and f values that were lower than the optimal cutoff values. • The optimal cutoff values of ADC, D, D*, and f for predicting recurrence in HBV associated HCC were 0.858 × 10−3 mm2/s, 0.985 × 10−3 mm2/s, 12.5 × 10−3 mm2/s, and 23.4{\%}, respectively. • The D value derived from IVIM diffusion-weighted imaging may be a useful biomarker for preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence.",
keywords = "Diffusion, Hepatitis B virus (HBV), Hepatocellular carcinoma (HCC), Magnetic resonance imaging (MRI), Recurrence",
author = "Yao Zhang and Sichi Kuang and Qungang Shan and Dailin Rong and Zhongping Zhang and Hao Yang and Jun Wu and Jingbiao Chen and Bingjun He and Ying Deng and Neil Roberts and Jun Shen and Venkatesh, {Sudhakar K} and Jin Wang",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00330-019-06180-1",
language = "English (US)",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Can IVIM help predict HCC recurrence after hepatectomy?

AU - Zhang, Yao

AU - Kuang, Sichi

AU - Shan, Qungang

AU - Rong, Dailin

AU - Zhang, Zhongping

AU - Yang, Hao

AU - Wu, Jun

AU - Chen, Jingbiao

AU - He, Bingjun

AU - Deng, Ying

AU - Roberts, Neil

AU - Shen, Jun

AU - Venkatesh, Sudhakar K

AU - Wang, Jin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To determine the diagnostic performance of intravoxel incoherent motion (IVIM) parameters to predict tumor recurrence after hepatectomy in patients with hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC). Materials and methods: One hundred and fifty-seven patients (mean age 52.54 ± 11.32 years, 87% male) with surgically and pathologically confirmed HCC were included. Regions of interests were drawn including the tumors by two independent radiologists. ADC and IVIM-derived parameters (true diffusion coefficient [D]; pseudodiffusion coefficient [D*]; pseudodiffusion fraction [f]) were obtained preoperatively. The Cox proportional hazards model was used to analyze the predictors associated with tumor recurrence after hepatectomy. Results: Forty-seven of 157 (29.9%) patients experienced tumor recurrence. The multivariate Cox proportional hazards model revealed that a D value < 0.985 × 10−3 mm2/s (hazard ratio (HR), 0.190; p = 0.023) was a risk factor for tumor recurrence. Additional risk factors included younger age (HR, 0.328; p = 0.034) and higher serum alpha-fetoprotein (AFP) level (HR, 2.079; p = 0.013). Further, receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of the obtained Cox regression model improved from 0.68 for the combination of AFP and age alone to 0.724 for the combination of D value, AFP, and age. Conclusion: The D value derived from the IVIM model is a potential biomarker for the preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence. Key Points: • The recurrence rate of HCC after hepatectomy was higher in patients with ADC, D, and f values that were lower than the optimal cutoff values. • The optimal cutoff values of ADC, D, D*, and f for predicting recurrence in HBV associated HCC were 0.858 × 10−3 mm2/s, 0.985 × 10−3 mm2/s, 12.5 × 10−3 mm2/s, and 23.4%, respectively. • The D value derived from IVIM diffusion-weighted imaging may be a useful biomarker for preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence.

AB - Purpose: To determine the diagnostic performance of intravoxel incoherent motion (IVIM) parameters to predict tumor recurrence after hepatectomy in patients with hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC). Materials and methods: One hundred and fifty-seven patients (mean age 52.54 ± 11.32 years, 87% male) with surgically and pathologically confirmed HCC were included. Regions of interests were drawn including the tumors by two independent radiologists. ADC and IVIM-derived parameters (true diffusion coefficient [D]; pseudodiffusion coefficient [D*]; pseudodiffusion fraction [f]) were obtained preoperatively. The Cox proportional hazards model was used to analyze the predictors associated with tumor recurrence after hepatectomy. Results: Forty-seven of 157 (29.9%) patients experienced tumor recurrence. The multivariate Cox proportional hazards model revealed that a D value < 0.985 × 10−3 mm2/s (hazard ratio (HR), 0.190; p = 0.023) was a risk factor for tumor recurrence. Additional risk factors included younger age (HR, 0.328; p = 0.034) and higher serum alpha-fetoprotein (AFP) level (HR, 2.079; p = 0.013). Further, receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of the obtained Cox regression model improved from 0.68 for the combination of AFP and age alone to 0.724 for the combination of D value, AFP, and age. Conclusion: The D value derived from the IVIM model is a potential biomarker for the preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence. Key Points: • The recurrence rate of HCC after hepatectomy was higher in patients with ADC, D, and f values that were lower than the optimal cutoff values. • The optimal cutoff values of ADC, D, D*, and f for predicting recurrence in HBV associated HCC were 0.858 × 10−3 mm2/s, 0.985 × 10−3 mm2/s, 12.5 × 10−3 mm2/s, and 23.4%, respectively. • The D value derived from IVIM diffusion-weighted imaging may be a useful biomarker for preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence.

KW - Diffusion

KW - Hepatitis B virus (HBV)

KW - Hepatocellular carcinoma (HCC)

KW - Magnetic resonance imaging (MRI)

KW - Recurrence

UR - http://www.scopus.com/inward/record.url?scp=85071636799&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071636799&partnerID=8YFLogxK

U2 - 10.1007/s00330-019-06180-1

DO - 10.1007/s00330-019-06180-1

M3 - Article

C2 - 30972544

AN - SCOPUS:85071636799

JO - European Radiology

JF - European Radiology

SN - 0938-7994

ER -