Diagnostic Performance Of SWI And IVIM In The Grading Of Hepatocellular Carcinoma

Part one Diagnostic performance of susceptibility-weighted imaging in the grading of hepatocellular carcinomaObjective: To explore the value of susceptibility-weighted Imaging(SWI)in the graded diagnosis of hepatocellular carcinoma(HCC)before surgery.Materials and Methods: Prospectively collected 131 patients with liver occupying lesions and no history of treatment.All patients were examined with conventional 3.0 T MR scan for conventional upper abdomen scan and SWI sequence scan before surgery.There were 57 patients(66 cancerous lesions)Postoperative pathology confirmed hepatocellular carcinoma.Two pathologists classified 66 cancer lesions into high and low grades according to the Edmondson-Steiner classification standard.Two imaging doctors analyzed the internal tumors of the HCC lesion without knowing the pathological classification results.Magnetically sensitive signals(ITSS),scored based on the number of small veins and bleeding lesions,and calculated the number of ITSS per unit area.Spearman correlation analysis was performed on the ITSS score and the number of ITSS per unit area with the pathological grade of hepatocellular carcinoma.These two evaluations The diagnostic value of the method was analyzed by receiver operating characteristic(ROC)curve.Results: Of the 57 patients and 66 lesions included in this study,35 were in the low-level HCC group and 31 were in the high-level HCC group.In the ITSS morphology score,the number of low-grade components of hepatocellular carcinoma(1.43±1.09)was lower than that of the high-grade group(2.10±1.01),and the difference was statistically significant(P=0.014).In the number of ITSS per unit area,the number of low-level groups(0.16±0.22)was higher than that of high-level groups(0.14±0.14),and there was no statistical difference(P=0.34).In the Spearman correlation coefficient results with the pathological grade of hepatocellular carcinoma,the result of the ITSS morphology score was 0.30(P=0.01),which was statistically different.The result of the number of ITSS per unit area was 0.12(P=0.35),The two are not statistically significant.Conclusion: SWI's ITSS has some value in differentiating HCC pathological grades before surgery,but it needs to be further studied with more data.Part two Correlation Between MRI IVIM Histogram Analysis and Prediction of HCC Pathological Grading and Ki-67 expressionObjective: To evaluate the value of histogram parameters of whole tumor IVIM in distinguishing tumor grades and predicting the proliferation potential of HCC.Materials and Methods: Prospectively collected 131 first-patient patients with clinical hepatic mass lesions and no history of treatment.All patients underwent 3T MR examination for routine upper abdomen scan and IVIM functional imaging.Postoperative pathological diagnosis of 52 patients was hepatocellular carcinoma.Subsequently,Edmondson-Steiner classification and immunohistochemistry were performed to obtain the classification results and Ki67 expression rate.The two imaging doctors manually mapped the ROI co-vering the entire tumor without knowing the pathological classification and immunohistochemical results.The internal software matlab was used to calculate the histogram.Graph parameters,Spearman correlation test was used to evaluate the correlation between histogram indexes and pathological indexes.Results: this study finally included 52 patients with liver cancer,according to the Edmondson-Steiner(-s)E classification standard,the low level group(I,II)25 cases,the high level group of 27 cases(?,level IV).Ki-67 was divided into 35 cases with high Ki67(+)expression and 17 cases with low Ki67(-)expression.IVIM draw histogram parameters,including D figure of the mean,median,10,25,40,70 th,75th and 90 th percent,f figure of the mean,median,25,40,70 th,75th and 90 th percentage and histopathological grade significantly and negatively correlated,f figure of skewness,kurtosis and Dp figure of standard deviation and histopathological grade were positively correlated.In addition,the mean,variance,25 th and 40 th percentiles of graph D,mean,median,40 th,70th and 75 th percentiles of graph f were negatively correlated with the expression of Ki67.When the 75 th percentile of figure D was 0.001,the optimal threshold for the classification of HCC pathological grade was 80.0% and 96.3%,respectively.When the 70 th percentile of figure f is equal to 0.260,it divides into the optimal threshold of Ki67 expression,and its sensitivity and specificity are 82.4% and 68.6%,respectively.Conclusion: Through a non-invasive MRI scan and extracting histogram parameters from the IVIM image,a large number of significant correlations between HCC and pathological grading and Ki67 were obtained,which indicates that by extracting multiple histogram parameters of IVIM,it helps to distinguish before surgery HCC pathological classification and prediction of the proliferation potential of HCC provide guidance information for clinical treatment programs.