Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study

Seung Up Kim, Young Chul Kim, Ji Soo Choi, Kyung Sik Kim, Gi Hong Choi, Jin Sub Choi, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Eun Hee Choi, Young Nyun Park, Chae Yoon Chon, Kwang Hyub Han, Myeong Jin Kim

Research output: Contribution to journalArticle

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Abstract

Liver fibrosis determines the functional liver reserve. Several studies have reported that the apparent diffusion coefficient (ADC) values of diffusion-weighted magnetic resonance imaging (DW-MRI) can assess liver fibrosis. We investigated whether DW-MRI predicts postoperative hepatic insufficiency and liver fibrosis in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Twenty-six patients with HBV-related HCC who received preoperative DW-MRI on a 3-T MRI system were enrolled between July and December 2008. ADC values were measured twice by two observers. Three "b values" were used: 50, 400 and 800 s/mm2. Postoperative hepatic insufficiency was defined as persistent hyperbilirubinemia (total bilirubin level >5 mg/dl for more than 5 days after surgery) or postoperative death without other causes. The mean age (21 men and 5 women) was 51.4 years. Three patients experienced postoperative hepatic insufficiency. liver stiffness measurement predicted postoperative hepatic insufficiency, advanced fibrosis (F3-4), and cirrhosis significantly [area under the receiving operator characteristic curve (AUROC)=0.942, 0.771 and 0.818, respectively, with P=.047, 0.048 and 0.006, respectively]; ADC values of DW-MRI, however, did not (AUROC=0.797, 0.648 and 0.491, respectively, with P=.100, 0.313 and 0.938, respectively). Reliability of ADC values between right and left hepatic lobes (ρ=0.868 and ρ=0.910 in the first and second measures of Observer A; ρ=0.865 and ρ=0.831 in the first and second measures of Observer B) was high and the intra- and interobserver reliability (ρ=0.958 in observer A and ρ=0.977 in observer B; ρ=0.929 in the first measure and ρ=0.978 in the second measure between the two observers) were high. All reliability was significant (P<.001). Our results suggest that DW-MRI on a 3-T MRI system is not suitable for predicting postoperative hepatic insufficiency, advanced liver fibrosis, and cirrhosis in patients with HBV-related HCC, despite significantly high reliability.

Original languageEnglish
Pages (from-to)802-811
Number of pages10
JournalMagnetic Resonance Imaging
Volume28
Issue number6
DOIs
Publication statusPublished - 2010 Jul 1

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Hepatic Insufficiency
Diffusion Magnetic Resonance Imaging
Viruses
Hepatitis B virus
Liver Cirrhosis
Magnetic resonance imaging
Hepatocellular Carcinoma
Liver
Magnetic resonance
Imaging techniques
Fibrosis
Hyperbilirubinemia
Ambulatory Surgical Procedures
Bilirubin
Surgery
Stiffness

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging

Cite this

Kim, Seung Up ; Kim, Young Chul ; Choi, Ji Soo ; Kim, Kyung Sik ; Choi, Gi Hong ; Choi, Jin Sub ; Park, Jun Yong ; Kim, Do Young ; Ahn, Sang Hoon ; Choi, Eun Hee ; Park, Young Nyun ; Chon, Chae Yoon ; Han, Kwang Hyub ; Kim, Myeong Jin. / Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study. In: Magnetic Resonance Imaging. 2010 ; Vol. 28, No. 6. pp. 802-811.
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author = "Kim, {Seung Up} and Kim, {Young Chul} and Choi, {Ji Soo} and Kim, {Kyung Sik} and Choi, {Gi Hong} and Choi, {Jin Sub} and Park, {Jun Yong} and Kim, {Do Young} and Ahn, {Sang Hoon} and Choi, {Eun Hee} and Park, {Young Nyun} and Chon, {Chae Yoon} and Han, {Kwang Hyub} and Kim, {Myeong Jin}",
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Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study. / Kim, Seung Up; Kim, Young Chul; Choi, Ji Soo; Kim, Kyung Sik; Choi, Gi Hong; Choi, Jin Sub; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Choi, Eun Hee; Park, Young Nyun; Chon, Chae Yoon; Han, Kwang Hyub; Kim, Myeong Jin.

In: Magnetic Resonance Imaging, Vol. 28, No. 6, 01.07.2010, p. 802-811.

Research output: Contribution to journalArticle

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T1 - Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study

AU - Kim, Seung Up

AU - Kim, Young Chul

AU - Choi, Ji Soo

AU - Kim, Kyung Sik

AU - Choi, Gi Hong

AU - Choi, Jin Sub

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Choi, Eun Hee

AU - Park, Young Nyun

AU - Chon, Chae Yoon

AU - Han, Kwang Hyub

AU - Kim, Myeong Jin

PY - 2010/7/1

Y1 - 2010/7/1

N2 - Liver fibrosis determines the functional liver reserve. Several studies have reported that the apparent diffusion coefficient (ADC) values of diffusion-weighted magnetic resonance imaging (DW-MRI) can assess liver fibrosis. We investigated whether DW-MRI predicts postoperative hepatic insufficiency and liver fibrosis in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Twenty-six patients with HBV-related HCC who received preoperative DW-MRI on a 3-T MRI system were enrolled between July and December 2008. ADC values were measured twice by two observers. Three "b values" were used: 50, 400 and 800 s/mm2. Postoperative hepatic insufficiency was defined as persistent hyperbilirubinemia (total bilirubin level >5 mg/dl for more than 5 days after surgery) or postoperative death without other causes. The mean age (21 men and 5 women) was 51.4 years. Three patients experienced postoperative hepatic insufficiency. liver stiffness measurement predicted postoperative hepatic insufficiency, advanced fibrosis (F3-4), and cirrhosis significantly [area under the receiving operator characteristic curve (AUROC)=0.942, 0.771 and 0.818, respectively, with P=.047, 0.048 and 0.006, respectively]; ADC values of DW-MRI, however, did not (AUROC=0.797, 0.648 and 0.491, respectively, with P=.100, 0.313 and 0.938, respectively). Reliability of ADC values between right and left hepatic lobes (ρ=0.868 and ρ=0.910 in the first and second measures of Observer A; ρ=0.865 and ρ=0.831 in the first and second measures of Observer B) was high and the intra- and interobserver reliability (ρ=0.958 in observer A and ρ=0.977 in observer B; ρ=0.929 in the first measure and ρ=0.978 in the second measure between the two observers) were high. All reliability was significant (P<.001). Our results suggest that DW-MRI on a 3-T MRI system is not suitable for predicting postoperative hepatic insufficiency, advanced liver fibrosis, and cirrhosis in patients with HBV-related HCC, despite significantly high reliability.

AB - Liver fibrosis determines the functional liver reserve. Several studies have reported that the apparent diffusion coefficient (ADC) values of diffusion-weighted magnetic resonance imaging (DW-MRI) can assess liver fibrosis. We investigated whether DW-MRI predicts postoperative hepatic insufficiency and liver fibrosis in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Twenty-six patients with HBV-related HCC who received preoperative DW-MRI on a 3-T MRI system were enrolled between July and December 2008. ADC values were measured twice by two observers. Three "b values" were used: 50, 400 and 800 s/mm2. Postoperative hepatic insufficiency was defined as persistent hyperbilirubinemia (total bilirubin level >5 mg/dl for more than 5 days after surgery) or postoperative death without other causes. The mean age (21 men and 5 women) was 51.4 years. Three patients experienced postoperative hepatic insufficiency. liver stiffness measurement predicted postoperative hepatic insufficiency, advanced fibrosis (F3-4), and cirrhosis significantly [area under the receiving operator characteristic curve (AUROC)=0.942, 0.771 and 0.818, respectively, with P=.047, 0.048 and 0.006, respectively]; ADC values of DW-MRI, however, did not (AUROC=0.797, 0.648 and 0.491, respectively, with P=.100, 0.313 and 0.938, respectively). Reliability of ADC values between right and left hepatic lobes (ρ=0.868 and ρ=0.910 in the first and second measures of Observer A; ρ=0.865 and ρ=0.831 in the first and second measures of Observer B) was high and the intra- and interobserver reliability (ρ=0.958 in observer A and ρ=0.977 in observer B; ρ=0.929 in the first measure and ρ=0.978 in the second measure between the two observers) were high. All reliability was significant (P<.001). Our results suggest that DW-MRI on a 3-T MRI system is not suitable for predicting postoperative hepatic insufficiency, advanced liver fibrosis, and cirrhosis in patients with HBV-related HCC, despite significantly high reliability.

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