title: Diffusion-weighted imaging (DWI) of hepatocellular carcinomas: a retrospective analysis of the correlation between qualitative and quantitative DWI and tumour grade.
abstract: OBJECTIVE
  To evaluate the application of qualitative and quantitative diffusion-weighted imaging (DWI) in predicting the histological grade of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Two hundred and fifty-four patients with pathologically confirmed HCC who underwent hepatic DWI on a 1.5-T platform (b = 0, 600 s/mm2) were evaluated retrospectively. HCCs were divided into well-, moderately, and poorly differentiated groups. The relationships between naked-eye signal intensity (SI), SI values, apparent diffusion coefficient (ADC) values on DWI, and the histopathological differentiation of HCC were analysed. Receiver operating characteristic (ROC) curves were drawn to determine the optimal operating points (OOPs) of the SI and ADC values to predict the tumour grade.
  
  
  RESULTS
  A weak negative correlation (r=-0.350, p<0.05) was obtained between naked-eye SI and histological grade. There was a significant difference in mean SI values between well- (68.32±31.71) and moderately (102.39±45.55)/poorly (114.55±32.15) differentiated HCC but not between moderately and poorly differentiated HCC. The OOP of the SI value by ROC curve analysis was 66.5 to predict well-differentiated HCC. The mean ADC values of well-, moderately, and poorly differentiated HCC were 1.67±0.13×10-3, 1.31±0.16×10-3, and 1.08±0.11×10-3mm2/s, respectively, with significant differences between any two combinations of groups. The OOPs of ADC to diagnose well- and poorly differentiated HCC were 1.5×10-3and 1.24×10-3mm2/s, respectively.
  
  
  CONCLUSIONS
  Qualitative and quantitative SI and ADC values at DWI may be useful to estimate the histological grade of HCC preoperatively and non-invasively.
authors.affiliation: Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China.
authors.forename: T
authors.initials: T
authors.lastname: Jiang
authors.affiliation: Department of Nuclear Medicine, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China. Electronic address: xujiehua@mail.sysu.edu.cn.
authors.forename: J H
authors.initials: JH
authors.lastname: Xu
authors.affiliation: Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangdong No. 2 Provincial People's Hospital, No. 466, Xin GangZhong Road, HaiZhu district, Guangzhou, GuangDong Province, 510317, PR China.
authors.forename: R
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China.
authors.forename: L R
authors.initials: LR
authors.lastname: Peng
authors.affiliation: Department of Nuclear Medicine, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China.
authors.forename: Z D
authors.initials: ZD
authors.lastname: Zhou
authors.affiliation: Department of Nuclear Medicine, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China.
authors.forename: M
authors.initials: M
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D012189:Retrospective Studies; D055815:Young Adult