Evaluation of intravoxel incoherent motion-diffusion weighted imaging in predicting early recurrence of hepatocellular carcinoma after curative hepatectomy

Objective To investigate the value of preoperative intravoxel incoherent motion-diffusion weighted imaging (IVIM-DWI) in predicting early recurrence of hepatocellular carcinoma (HCC) after curative hepatectomy. Methods The clinical data of 51 HCC patients who underwent curative hepatectomy at Beijing Tsinghua Changgung Hospital, Tsinghua University from December 2014 to March 2017 were retrospectively analyzed. The study included 45 males and 6 females, aged 56.4±10.1. The patients were divided into the early-recurrence group (21 patients) and the non-recurrence group (30 patients) according to whether there was HCC recurrence within 1 year after curative hepatectomy. The parameters of the lesions were measured and calculated: the apparent diffusion coefficient (ADC) value, true diffusion coefficient (D) value, perfusion-related diffusion coefficient (D*) value and perfusion fraction (f) value. Receiver operating characteristic curves (ROC) were used to evaluate the prediction efficiency of the parameters. Results The ADC and D values of the early-recurrence group were significantly lower than the non-recurrence group. The differences were statistically significant (P<0.05). In predicting early recurrence of HCC after curative hepatectomy, the ADC values showed the area under ROC was 0.713 (95% CI: 0.572~0.855), the sensitivity was 0.857 and specificity was 0.567 when the optimal threshold value was 1.24×10-3mm2/s. The D values in predicting early recurrence demonstrated the area under ROC was 0.740 (95% CI: 0.602~0.877), the sensitivity was 0.905 and specificity was 0.600 when the optimal threshold value was 1.03×10-3mm2/s. Conclusions The ADC and D values of IVIM-DWI could provide evidence in predicting early recurrence of HCC after curative hepatectomy. The D values had a higher prediction efficiency. Key words: Carcinoma, hepatocellular; Hepatectomy; Recurrence; Diffusion weighted imaging