J Cancer 2016; 7(6):730-735. doi:10.7150/jca.14197

Research Paper

Apparent Diffusion Coefficient Quantification in Determining the Histological Diagnosis of Malignant Liver Lesions

Konstantinos Drevelegas1, Katerina Nikiforaki2, Manolis Constantinides1, Nickolas Papanikolaou2, Lavrentios Papalavrentios3, Ioanna Stoikou5, Paul Zarogoulidis6✉, Georgia Pitsiou6, Athanasia Pataka6, John Organtzis6, Eleni Papadaki6, Konstantinos Porpodis6, Ioanna Kougioumtzi7, Ioannis Kioumis6, Constantinos Kouskouras4, Evaggelos Akriviadis3, Antonios Drevelegas1

1. Department of Radiology, Interbalkan Medical Centre, Thessaloniki, Greece;
2. Research & Development, N.Papanikolaou & Associates LLC, Crete, Greece;
3. Department of Internal Medicine-Gastroenterology, Interbalkan Medical Centre, Thessaloniki, Greece;
4. Department of Radiology, Ahepa University Hospital, Thessaloniki, Greece;
5. Department of Microbiolgy, George Gennimatas Hospital, Thessaloniki, Greece;
6. Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
7. Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece.

Abstract

Purpose: Diffusion Weighted Imaging is an established diagnostic tool for accurate differential diagnosis between benign and malignant liver lesions. The aim of our study was to evaluate the role of Histogram Analysis of ADC quantification in determining the histological diagnosis as well as the grade of malignant liver tumours. To our knowledge, there is no study evaluating the role of Histogram Analysis of ADC quantification in determining the histological diagnosis as well as the grade of malignant liver tumours.

Methods: During five years, 115 patients with known liver lesions underwent Diffusion Weighted Imaging in 3Tesla MR scanner prior to core needle biopsy. Histogram analyses of ADC in regions of interest were drawn and were correlated with biopsy histological diagnosis and grading.

Results: Histogram analysis of ADC values shows that 5th and 30th percentile parameters have statistically significant potency of discrimination between primary and secondary lesions groups (p values 0.0036 and 0.0125 respectively). Skewness of the histogram can help discriminate between good and poor differentiated (p value 0.17). Discrimination between primary malignancy site in metastases failed for the present number of patients in each subgroup.

Conclusion: Statistical parameters reflecting the shape of the left side of the ADC histogram can be useful for discriminating between primary and secondary lesions and also between well differentiated versus moderate or poor. For the secondary malignancies, they failed to predict the original site of tumour.

Keywords: Diffusion Weighted Imaging, histogram analysis, liver lesions, biopsy.

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How to cite this article:
Drevelegas K, Nikiforaki K, Constantinides M, Papanikolaou N, Papalavrentios L, Stoikou I, Zarogoulidis P, Pitsiou G, Pataka A, Organtzis J, Papadaki E, Porpodis K, Kougioumtzi I, Kioumis I, Kouskouras C, Akriviadis E, Drevelegas A. Apparent Diffusion Coefficient Quantification in Determining the Histological Diagnosis of Malignant Liver Lesions. J Cancer 2016; 7(6):730-735. doi:10.7150/jca.14197. Available from http://www.jcancer.org/v07p0730.htm