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Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study.

Authors
Kim, SU; Kim, YC; Choi, JS; Kim, KS; Choi, GH; Park, JY; Kim, do Y; Ahn, SH; Choi, EH; Park, YN; Chon, CY; Han, KH; Kim, MJ
Citation
Magnetic resonance imaging, 28(6):802-811, 2010
Journal Title
Magnetic resonance imaging
ISSN
0730-725X1873-5894
Abstract
Liver fibrosis determines the functional liver reserve. Several studies have reported that the apparent diffusion coefficient (ADC) values of diffusion-weighted magnetic resonance imaging (DW-MRI) can assess liver fibrosis. We investigated whether DW-MRI predicts postoperative hepatic insufficiency and liver fibrosis in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Twenty-six patients with HBV-related HCC who received preoperative DW-MRI on a 3-T MRI system were enrolled between July and December 2008. ADC values were measured twice by two observers. Three "b values" were used: 50, 400 and 800 s/mm(2). Postoperative hepatic insufficiency was defined as persistent hyperbilirubinemia (total bilirubin level >5 mg/dl for more than 5 days after surgery) or postoperative death without other causes. The mean age (21 men and 5 women) was 51.4 years. Three patients experienced postoperative hepatic insufficiency. liver stiffness measurement predicted postoperative hepatic insufficiency, advanced fibrosis (F3-4), and cirrhosis significantly [area under the receiving operator characteristic curve (AUROC)=0.942, 0.771 and 0.818, respectively, with P=.047, 0.048 and 0.006, respectively]; ADC values of DW-MRI, however, did not (AUROC=0.797, 0.648 and 0.491, respectively, with P=.100, 0.313 and 0.938, respectively). Reliability of ADC values between right and left hepatic lobes (rho=0.868 and rho=0.910 in the first and second measures of Observer A; rho=0.865 and rho=0.831 in the first and second measures of Observer B) was high and the intra- and interobserver reliability (rho=0.958 in observer A and rho=0.977 in observer B; rho=0.929 in the first measure and rho=0.978 in the second measure between the two observers) were high. All reliability was significant (P<.001). Our results suggest that DW-MRI on a 3-T MRI system is not suitable for predicting postoperative hepatic insufficiency, advanced liver fibrosis, and cirrhosis in patients with HBV-related HCC, despite significantly high reliability.
MeSH terms
AdultAgedArea Under CurveCarcinoma, Hepatocellular/complications/*surgery/virologyDiffusion Magnetic Resonance Imaging/*methodsFemaleHepatic Insufficiency/*diagnosisHepatitis B/*complicationsHumansHyperbilirubinemia/complications/diagnosisLiver/pathology/surgeryLiver Cirrhosis/complications/diagnosisLiver Neoplasms/complications/*surgery/virologyMaleMiddle AgedObserver VariationPilot ProjectsPostoperative Complications/*diagnosisPredictive Value of TestsPreoperative Care/*methodsProspective StudiesROC CurveReproducibility of ResultsSurvival Analysis
DOI
10.1016/j.mri.2010.03.018
PMID
20395100
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
AJOU Authors
김, 영철
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