title: Diffusion-weighted imaging of hepatocellular carcinoma for predicting early recurrence and survival after hepatectomy.
abstract: OBJECTIVE
  The effectiveness of imaging (including apparent diffusion coefficient [ADC] of diffusion-weighted magnetic resonance imaging [DWI]) and laboratory variables for predicting early tumor recurrence and overall survival after surgery in hepatocellular carcinoma (HCC) patients are analyzed.
  
  
  METHODS
  The present study included 116 consecutive patients with HCC who underwent partial hepatectomy. Patients were classified into two groups: patients with and without early recurrence (<1 year). Preoperative imaging variables (tumor number, size, shape, capsule, ADC, and venous invasion) and laboratory variables were evaluated to predict early recurrence using univariate and multivariate analyses. Overall survival was calculated using the Kaplan-Meier method.
  
  
  RESULTS
  Twenty patients (17 %) developed early recurrence after surgery. Multivariate logistic regression analysis showed that tumor ADC (p = 0.0002), aspartate aminotransferase (p = 0.0121), and serum prothrombin time activity percentage (p = 0.0082) were statistically significant for predicting early recurrence. The optimal ADC cutoff value for predicting early recurrence obtained from receiver operating characteristic analysis was ≤0.898 × 10(-3) mm(2)/s. In patients with ADC ≤0.898 × 10(-3) mm(2)/s, the 3- and 5-year survival rates (77 and 56 %, respectively) were significantly decreased compared with those in patients with ADC >0.898 × 10(-3) mm(2)/s (97 and 97 %, respectively; p = 0.0015).
  
  
  CONCLUSIONS
  Low tumor ADC value by DWI was a risk factor for early postoperative HCC recurrence and was associated with lower patient survival rates.
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
authors.forename: Ali
authors.initials: A
authors.lastname: Muhi
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan. ichikawa@yamanashi.ac.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ichikawa
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Sano
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
authors.forename: Zareen
authors.initials: Z
authors.lastname: Fatima
authors.affiliation: First Department of Surgery, University of Yamanashi, Yamanashi, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: First Department of Surgery, University of Yamanashi, Yamanashi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.affiliation: First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Enomoto
authors.affiliation: Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
keywords: Apparent diffusion coefficient; Liver; Magnetic resonance imaging