Impact of apparent diffusion coefficient on prognosis of early hepatocellular carcinoma: a case control study

BMC Surg. 2023 Jan 11;23(1):6. doi: 10.1186/s12893-022-01892-6.

Abstract

Background: We investigated the usefulness of apparent diffusion coefficients (ADC) from diffusion-weighted images (DWI) obtained using magnetic resonance imaging (MRI) for prognosis of early hepatocellular carcinoma (HCC): Barcelona Clinic Liver Cancer (BCLC) stage 0 and A.

Methods: We enrolled 102 patients who had undergone surgical resection for early HCC: BCLC stage 0 and A, and calculated their minimum ADC using DWI-MRI. We divided patients into ADCHigh (n = 72) and ADCLow (n = 30) groups, and compared clinicopathological factors between the two groups.

Results: The ADCLow group showed higher protein induced by vitamin K absence-II (PIVKA-II) levels (p = 0.02) compared with the ADCHigh group. In overall survival, the ADCLow group showed significantly worse prognosis than the ADCHigh group (p < 0.01). Univariate analysis identified multiple tumors, infiltrative growth, high PIVKA-II, and low ADC value as prognostic factors. Multivariate analysis identified infiltrative growth and low ADC value as an independent prognostic factor.

Conclusion: ADC values can be used to estimate the prognosis of early HCC.

Keywords: Apparent diffusion coefficient; Hepatocellular carcinoma; Magnetic resonance imaging; Prognostic prediction.

MeSH terms

  • Carcinoma, Hepatocellular* / diagnostic imaging
  • Carcinoma, Hepatocellular* / surgery
  • Case-Control Studies
  • Humans
  • Liver Neoplasms* / diagnostic imaging
  • Prognosis
  • Retrospective Studies