ABSTRACT

To evaluate the diagnostic performance of diffusion-weighted magnetic resonance imaging (DWI) to predict the histopathologic grade of hepatocellular carcinoma (HCC).

The DWI images of 40 patients (20 well differentiated, 13 moderately differentiated, 7 poorly or undifferentiated) diagnosed histopathologically with HCC before treatment were evaluated retrospectively. Apparent diffusion coefficient (ADC) values obtained from DWI were measured for each lesion. The differences in the ADC values of histopathological subgroups were evaluated using the Kruskal-Wallis test, then the Mann Whitney-U test for pairwise comparision. The correlation between parameters was evaluated using the Spearman correlation test. Receiver operating characteristics curve analysis was used to evaluate the diagnostic performance.

The median ADC value of poorly and undifferentiated HCCs (0.600 x 10-3 mm2 / sec) was statistically significantly lower than moderately differentiated (0.730 x 10-3 mm2 / sec) and well differentiated (0.938 x 10-3 mm2 / sec) HCCs (p <0.001). A strong negative-correlation was found between the histopathological grade of HCC and ADC (r = 0.796, p <0.001).

ADC can be useful as a non-invasive diagnostic tool in predicting the histologic subtypes of HCC.