Neuroendocrine liver metastases: Value of apparent diffusion coefficient and enhancement ratios for characterization of histopathologic grade
| Autor: | Bachir Taouli, Guido H. Jajamovich, Cecilia Besa, Yong Cui, Stephen C. Ward, Michelle K. Kim |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Histopathologic Grade medicine.diagnostic_test business.industry Magnetic resonance imaging Neuroendocrine tumors medicine.disease 030218 nuclear medicine & medical imaging body regions 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine Tumor Grading Effective diffusion coefficient Radiology Nuclear Medicine and imaging Radiology Prospective cohort study business Arterial phase Diffusion MRI |
| Zdroj: | Journal of Magnetic Resonance Imaging. 44:1432-1441 |
| ISSN: | 1053-1807 |
| DOI: | 10.1002/jmri.25320 |
| Popis: | PURPOSE To assess the value of apparent diffusion coefficient (ADC) measured with diffusion-weighted imaging (DWI) and enhancement ratios (ER) measured with contrast-enhanced T1-weighted imaging (CE-T1WI) for the characterization of histopathologic tumor grade of neuroendocrine tumor liver metastases (NETLM). MATERIALS AND METHODS Twenty-two patients with pathology-proven NETLM and pretreatment 1.5 Tesla (T) and 3T MRI including DWI were included in this Institutional Review Board-approved retrospective study. ADC histogram parameters, including mean, minimum (min), skewness, and kurtosis as well as ER, were computed for all lesions. Tumor grading was based on the World Health Organization 2010 classification. Kruskal-Wallis and Mann-Whitney test were used to assess for differences in ADC and ER between different tumor grades. MRI parameters were correlated with pathologic findings using Spearman correlation test. Receiver operating characteristic analysis was performed to determine optimum thresholds for predicting tumor grade. RESULTS Forty-eight NETLM (mean size 3.5 cm) were analyzed with the following grade distribution: G1 (n = 25), G2 (n = 16), and G3 (n = 7). ADC-mean (×10-3 mm2 /s) of G3 tumors (0.87 ± 0.43) was significantly lower than that of G1 (1.47 ± 0.63) and G2 (1.27 ± 0.63; P = 0.042). A weak significant negative correlation was observed between ADC and tumor grade (ADC-mean: r = -0.33, P = 0.02; ADC-min: r = -0.37, P = 0.01) and Ki-67 (ADC-mean: r = -0.31, P = 0.03; ADC-min: r = -0.39, P = 0.007). AUROC, sensitivity and specificity of ADC-mean/ADC-min/ER (measured at the early arterial phase) for differentiation of G3 versus G1-G2 were 0.80/0.76/0.67, 100%/50%/70%, and 68.4%/84.2%/66.6%, respectively. CONCLUSION ADC is a promising marker for characterization of histopathologic grade of NETLM. These results should be confirmed in a prospective study. J. Magn. Reson. Imaging 2016;44:1432-1441. |
| Databáze: | OpenAIRE |
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