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Prognostic prediction of apparent diffusion coefficient obtained by diffusion-weighted MRI in mass-forming
Shinichiro Yamada1, Yuji Morine1, Satoru Imura1
1Department of Surgery, Tokushima University, Tokushima City, Japan.
Background:
We evaluated apparent diffusion coefficient (ADC) of diffusion-weighted image MRI as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma (IHCC).
Methods:
We enrolled 26 patients who had undergone hepatic resections for mass-forming-type IHCC in this study, and calculated their mean ADC, using diffusion-weighted image MRI (b: 0, 20, 800 seconds/mm2 ; 1.5 T MRI). Patients were divided into the ADCHigh and the ADCLow groups at the median ADC value (n = 13 for both). We also immunohistochemically evaluated hypoxia-inducible factor (HIF)-1α in tumor tissue.
Results:
Median age in the ADCLow was older (P = .03), and showed significant higher rate of scirrhous tumor (P = .02). The 5-year overall survival rate in the ADCLow group was significantly worse than in the ADCHigh group (P = .04). In multivariate analysis, hilar tumor, portal vein invasion and low ADC were independent prognostic factors (P < .05). The ADCLow group also had a higher rate of high HIF-1α expression than the ADCHigh group (P < .05). Representative case of ADCLow group showed rich stroma and high HIF-1α expression.
Conclusions:
The ADC values in MRIs can predict IHCC prognosis, and correlated with stromal density and HIF-1α expression.
Insights
Apparent diffusion coefficient (ADC) measured by MRI can predict prognosis for mass-forming intrahepatic cholangiocarcinoma (IHCC). Lower ADC values indicate poorer survival and correlate with increased stromal density and hypoxia-inducible factor-1α expression.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Intrahepatic cholangiocarcinoma (IHCC) is a challenging liver cancer.
- Identifying prognostic factors for IHCC is crucial for patient management.
Purpose of the Study:
- To evaluate the apparent diffusion coefficient (ADC) from diffusion-weighted image MRI as a prognostic factor for mass-forming IHCC.
Main Methods:
- 26 patients with mass-forming IHCC undergoing hepatic resection were studied.
- Mean ADC values were calculated using 1.5T MRI (b: 0, 20, 800 s/mm²).
- Patients were grouped into ADCHigh and ADCLow based on the median ADC value. Hypoxia-inducible factor (HIF)-1α expression was assessed via immunohistochemistry.
Main Results:
- The ADCLow group was older and showed a higher rate of scirrhous tumors (P=.02).
- Five-year overall survival was significantly worse in the ADCLow group (P=.04).
- Low ADC, hilar tumor location, and portal vein invasion were independent prognostic factors (P<.05).
- The ADCLow group exhibited higher HIF-1α expression (P<.05).
Conclusions:
- ADC values derived from MRI are predictive of IHCC prognosis.
- Lower ADC values correlate with increased stromal density and higher HIF-1α expression in IHCC.
