Value of whole-tumor histogram analysis of diffusion tensor imaging in differentiating intrahepatic mass-forming cholangiocarcinoma and solitary hypovascular hepatic metastases
ZHAO Ying1, LIU Ai-lian1, CHEN Li-hua1, GUO Yan2, LI Ye1, SONG Qing-wei1, NIU Miao1, YANG Wei-ping1
1. Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian Liaoning 16011, China;
2. GE Healthcare, Shanghai 200000, China
Abstract:Objective: To investigate the value of whole-tumor histogram analysis of apparent diffusion coefficient(ADC) and fractional anisotropy(FA) signal intensity derived from diffusion tensor imaging(DTI) in differentiating intrahepatic mass-forming cholangiocarcinoma(IMCC) and solitary hypovascular hepatic metastases(SHHM). Methods: The data of liver MR scanning in our hospital were retrospectively collected, 24 cases of IMCC were pathologically confirmed, and 29 cases of SHHM were confirmed by pathology or follow-up imaging. ADC and FA maps were derived using Functool software on GE AW4.6 workstation, where ADC and FA values were measured. ADC and FA maps were transferred to Omni-Kinetics software(GE Healthcare), and ROIs covering the entire tumor were drawn on each slice of ADC and FA signal intensity maps. Histogram related parameters based on ADC and FA signal intensity, including min intensity, max intensity, mean value, the 10th, 25th, 50th, 75th and 90th percentiles, standard deviation, mean deviation, relative deviation, skewness, and kurtosis, were generated automatically after 3D ROIs covering the whole tumor were delineated by the readers. Comparison of the above parameters between the two groups was tested. Receiver operating characteristic(ROC) curves were plotted to analyze diagnostic efficiency. Results: The ADC and FA values between IMCC and SHHM groups were not statistically different(P>0.05). There was a significant difference in relative deviation of ADC signal intensity between the IMCC(13.76(5.44, 26.87)×102 and SHHM (2.41(1.12, 5.10)×102 groups(P<0.05). Moreover, a significant difference was observed in mean deviation and relative deviation of FA signal intensity between the IMCC(78.84(70.22, 115.37) and 22.09(9.29, 59.62)×102) group and SHHM (67.99(60.92, 89.39) and 3.16(1.19, 11.32)×102) group(P<0.05). The mean value and 10th percentile of FA signal intensity of IMCC group were statistically lower than those of SHHM group(P<0.05). The remaining parameters were not statistically different between two groups. The area under ROC curve of relative deviation of ADC and FA signal intensity were 0.828 and 0.848, respectively. The sensitivity/specifcity of ADC and FA were 79.2%(82.8%) and 87.5%(69.0%), respectively. Conclusion: Routine ADC and FA values of DTI are not efficient for identifying IMCC and SHHM. However, whole-tumor histogram analysis method based on ADC and FA signal intensity can provide multiple quantitative parameters for differentiating IMCC and SHHM.
赵 莹1,刘爱连1,陈丽华1,郭 妍2,李 烨1,宋清伟1,牛 淼1,杨伟萍1. DTI全肿瘤直方图鉴别肿块型肝内胆管细胞癌与单发少血供肝转移瘤的价值[J]. 中国临床医学影像杂志, 2020, 31(4): 261-266.
ZHAO Ying1, LIU Ai-lian1, CHEN Li-hua1, GUO Yan2, LI Ye1, SONG Qing-wei1, NIU Miao1, YANG Wei-ping1. Value of whole-tumor histogram analysis of diffusion tensor imaging in differentiating intrahepatic mass-forming cholangiocarcinoma and solitary hypovascular hepatic metastases. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(4): 261-266.
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