title: Apparent diffusion coefficient value of gastric cancer by diffusion-weighted imaging: correlations with the histological differentiation and Lauren classification.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the correlations between histological differentiation and Lauren classification of gastric cancer and the apparent diffusion coefficient (ADC) value of diffusion weighted imaging (DWI).
  
  
  METHODS
  Sixty-nine patients with gastric cancer lesions underwent preoperative magnetic resonance imaging (MRI) (3.0T) and surgical resection. DWI was obtained with a single-shot, echo-planar imaging sequence in the axial plane (b values: 0 and 1000s/mm(2)). Mean and minimum ADC values were obtained for each gastric cancer and normal gastric walls by two radiologists, who were blinded to the histological findings. Histological type, degree of differentiation and Lauren classification of each resected specimen were determined by one pathologist. Mean and minimum ADC values of gastric cancers with different histological types, degrees of differentiation and Lauren classifications were compared. Correlations between ADC values and histological differentiation and Lauren classification were analyzed.
  
  
  RESULTS
  The mean and minimum ADC values of gastric cancers, as a whole and separately, were significantly lower than those of normal gastric walls (all p values <0.001). There were significant differences in the mean and minimum ADC values among gastric cancers with different histological types, degrees of differentiation and Lauren classifications (p<0.05). Mean and minimum ADC values correlated significantly (all p<0.001) with histological differentiation (r=0.564, 0.578) and Lauren classification (r=-0.493, -0.481).
  
  
  CONCLUSIONS
  The ADC values may be helpful as a noninvasive tool for evaluating the histological features of gastric cancer, such as histological type, degree of differentiation and Lauren classification.
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: songliu532909756@gmail.com.
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: wenxianguan123@126.com.
authors.forename: Wenxian
authors.initials: W
authors.lastname: Guan
authors.affiliation: Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: wanghao20140525@126.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: panliang2014@126.com.
authors.forename: Liang
authors.initials: L
authors.lastname: Pan
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: zhupingzhou@126.com.
authors.forename: Zhuping
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: haipingyu2012@126.com.
authors.forename: Haiping
authors.initials: H
authors.lastname: Yu
authors.affiliation: Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA. Electronic address: tianliu2014@126.com.
authors.forename: Tian
authors.initials: T
authors.lastname: Liu
authors.affiliation: Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA. Electronic address: xiaofengyang2014@126.com.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: hjxueren@126.com.
authors.forename: Jian
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, PR China. Electronic address: zyzhou@nju.edu.cn.
authors.forename: Zhengyang
authors.initials: Z
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
keywords: Cell differentiation; Diffusion magnetic resonance imaging; Magnetic resonance imaging; Stomach neoplasm