Hypointense hepatocellular carcinomas on apparent diffusion coefficient mapping: Pathological features and metastatic...

Area of Science:

• Hepatobiliary imaging
• Oncology
• Radiology

Background:

• Hepatocellular carcinoma (HCC) is a primary liver malignancy.
• Diffusion-weighted magnetic resonance imaging (DW-MRI) is a key diagnostic tool.
• Apparent diffusion coefficient (ADC) mapping provides insights into tissue microstructure.

Purpose of the Study:

• To evaluate pathological features of HCC with hypointense signal on ADC maps.
• To determine the association between ADC map signal intensity and metastatic recurrence post-hepatectomy.

Main Methods:

• 52 patients with HCC underwent DW-MRI before hepatectomy.
• HCC signal intensity on ADC maps was compared to surrounding liver.
• Tumors were categorized as hypointense or non-hypointense on ADC maps.

Main Results:

• Hypointense HCC showed significantly higher rates of poor histological differentiation and microscopic portal invasion.
• 3-year metastatic recurrence rates were 56% for hypointense HCC vs. 13% for non-hypointense HCC.
• ADC map hypointensity was the sole independent predictor of metastatic recurrence.

Conclusions:

• Hypointense HCC on ADC maps are pathologically distinct, exhibiting aggressive features.
• ADC map signal intensity is a valuable prognostic marker for HCC recurrence.
• This imaging characteristic aids in predicting patient outcomes after liver surgery.