title: Assessment of histological differentiation in gastric cancers using whole-volume histogram analysis of apparent diffusion coefficient maps.
abstract: To investigate the efficacy of histogram analysis of the entire tumor volume in apparent diffusion coefficient (ADC) maps for differentiating between histological grades in gastric cancer.
  
  
  
  Seventy-eight patients with gastric cancer were enrolled in a retrospective 3.0T magnetic resonance imaging (MRI) study. ADC maps were obtained at two different b values (0 and 1000 sec/mm2) for each patient. Tumors were delineated on each slice of the ADC maps, and a histogram for the entire tumor volume was subsequently generated. A series of histogram parameters (eg, skew and kurtosis) were calculated and correlated with the histological grade of the surgical specimen. The diagnostic performance of each parameter for distinguishing poorly from moderately well-differentiated gastric cancers was assessed by using the area under the receiver operating characteristic curve (AUC).
  
  
  
  There were significant differences in the 5th, 10th, 25th, and 50thpercentiles, skew, and kurtosis between poorly and well-differentiated gastric cancers (P < 0.05). There were correlations between the degrees of differentiation and histogram parameters, including the 10thpercentile, skew, kurtosis, and max frequency; the correlation coefficients were 0.273, -0.361, -0.339, and -0.370, respectively. Among all the histogram parameters, the max frequency had the largest AUC value, which was 0.675.
  
  
  
  Histogram analysis of the ADC maps on the basis of the entire tumor volume can be useful in differentiating between histological grades for gastric cancer.
  
  
  
  4 J. Magn. Reson. Imaging 2017;45:440-449.
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Yujuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Wenxian
authors.initials: W
authors.lastname: Guan
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
authors.forename: Changfeng
authors.initials: C
authors.lastname: Ji
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Guo
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Zheng
authors.affiliation: School of Electronic Science and Engineering, Nanjing University, Nanjing, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Guan
authors.affiliation: School of Electronic Science and Engineering, Nanjing University, Nanjing, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Ge
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Zhengyang
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Yang
authors.affiliation: Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
authors.forename: Tian
authors.initials: T
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D047368:Tumor Burden
keywords: cell differentiation; diffusion magnetic resonance imaging; histogram; magnetic resonance imaging; stomach neoplasm