title: Pathology of hepatocellular carcinoma and its precursors using proton magnetic resonance spectroscopy and a statistical classification strategy.
abstract: OBJECTIVE
  Apply the statistical classification strategy (SCS) to magnetic resonance spectroscopy (MRS) data from liver biopsies and test its potential to discriminate between normal liver, cirrhotic nodules and nodules of hepatocellular carcinoma with a high degree of accuracy.
  
  
  METHODS
  Liver tissue specimens from 54 patients undergoing either partial (hemi) or total hepatectomy were analysed by one-dimensional proton MRS at 8.5 Tesla. Histologically, these specimens were confirmed as normal (n=31), cirrhotic (n=59), and hepatocellular carcinoma (HCC, n=32). Diagnostic correlation was performed between the MR spectra and histopathology. An SCS was applied consisting of pre-processing MR magnitude spectra to identify spectral regions of maximal discriminatory value, and cross-validated linear discriminant analysis.
  
  
  RESULTS
  SCS applied to MRS data distinguished normal liver tissue from HCC with an accuracy of 100%. Normal liver tissue was distinguished from cirrhotic liver with an accuracy of 92% and cirrhotic liver was distinguished from HCC with an accuracy of 98%.
  
  
  CONCLUSIONS
  SCS applied to proton MRS of liver biopsies provides a robust method to distinguish, with a high degree of accuracy, HCC from both cirrhotic and normal liver.
authors.affiliation: Institute for Magnetic Resonance Research and Department of Magnetic Resonance in Medicine, University of Sydney, NSW, Australia.
authors.forename: Robyne
authors.initials: R
authors.lastname: Soper
authors.forename: Uwe
authors.initials: U
authors.lastname: Himmelreich
authors.forename: Dorothy
authors.initials: D
authors.lastname: Painter
authors.forename: Ray L
authors.initials: RL
authors.lastname: Somorjai
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Lean
authors.forename: Brion
authors.initials: B
authors.lastname: Dolenko
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Mountford
authors.forename: Peter
authors.initials: P
authors.lastname: Russell
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000145:classification / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000145:classification / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011230:Precancerous Conditions / Q000145:classification / Q000473:pathology* / Q000601:surgery; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D011522:Protons