Title:The Combination of Gd-EOB-DTPA Enhanced T1 Mapping with Apparent
Diffusion Coefficient could Improve the Diagnostic Efficacy of Hepatocellular
Carcinoma Grading
Volume: 20
Author(s): Hui He, Xiaotian Li, Jing Liu, Qiuyun Tong, Min Ling, Zisan Zeng and Zhipeng Zhou*
Affiliation:
- Department of Radiology, The Affiliated Hospital of Guilin Medical University, Guilin 54100, China
Keywords:
Gd-EOB-DTPA, T1 mapping, Apparent diffusion coefficient, Hepatocellular carcinoma, Magnetic resonance imaging, Patients.
Abstract:
Background:
Accurately predicting the hepatocellular carcinoma (HCC) grade may facilitate the rational selection of treatment strategies. The diagnostic
efficacy of the combination of Gadolinium ethoxybenzy diethylenetriamine pentaacetic (Gd-EOB-DTPA) enhancement T1 mapping and apparent
diffusion coefficient (ADC) values in predicting HCC grade needs further validation.
Objectives:
This study aimed to assess the capacity of Gd-EOB-DTPA-enhanced T1 mapping and ADC values, both individually and in combination, to
discriminate between different grades of HCC.
Materials and Methods:
From July 2017 to February 2020, 96 patients (male, 83; mean age, 53.67 years; age range, 29-71 years) clinically diagnosed with HCC were
included in the present study. All patients underwent Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI, including T1 mapping
sequence) before surgery or biopsy. All the patients were categorized into 3 groups according to the pathological results (including 24 cases of
well-differentiated HCCs, 59 cases of moderately differentiated HCCs, 13 cases of and poorly differentiated HCCs). The mean Gd-EOB-DTPA
enhanced T1 values (ΔT1=[(T1pre-T1post)/T1pre]×100%) and ADC values between different grading groups of HCC were calculated and
compared. The area under the characteristics curve (AUC), the diagnostic threshold, sensitivity, and specificity of ΔT1 and ADC for differential
diagnosis were analyzed.
Results:
Mean ΔT1 was 58% for well-differentiated HCCs, 50% for moderately-differentiated HCCs, and 43% for poorly-differentiated HCCs. ΔT1 showed
statistical differences between the groups (P<0.001). The mean ADC values of the 3 groups were 1.11×10−3 mm2/s, 0.91×10−3 mm2/s, and
0.80×10−3mm2/s, respectively. ADC showed statistical differences between the groups (P<0.001). In discriminating well- differentiated group
from the moderately differentiated group, the AUC of ΔT1 was 0.751 (95% CI: 0.642, 0.859), the AUC of ADC was 0.782 (95% CI: 0.671, 0.894),
the AUC of combined model was 0.811 (95% CI: 0.709, 0.914). In discriminating the poorly differentiated group from the moderately
differentiated group, the AUC of ΔT1 was 0.768 (95% CI: 0.634, 0.902), the AUC of ADC was 0.754 (95% CI: 0.603, 0.904), and the AUC of the
combined model was 0.841 (95% CI: 0.729, 0.953).
Conclusion:
Gd-EOB-DTPA enhanced T1 mapping, and ADC values have complementary effects on the sensitivity and specificity for identifying different
HCC grades. A combined model of Gd-EOB-DTPA-enhanced MRI T1 mapping and ADC values could improve diagnostic performance for
predicting HCC grades.
