The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular Carcinoma
Yunfei Zhang,1,2,* Ruofan Sheng,1,2,* Chun Yang,2 Yongming Dai,3 Mengsu Zeng1,2 1Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, People’s Republic of China; 2Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-09-01
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| Series: | Journal of Hepatocellular Carcinoma |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-feasibility-of-using-tri-exponential-intra-voxel-incoherent-motion-peer-reviewed-fulltext-article-JHC |
| _version_ | 1797669445270765568 |
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| author | Zhang Y Sheng R Yang C Dai Y Zeng M |
| author_facet | Zhang Y Sheng R Yang C Dai Y Zeng M |
| author_sort | Zhang Y |
| collection | DOAJ |
| description | Yunfei Zhang,1,2,* Ruofan Sheng,1,2,* Chun Yang,2 Yongming Dai,3 Mengsu Zeng1,2 1Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, People’s Republic of China; 2Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 3School of Biomedical Engineering, ShanghaiTech University, Shanghai, 200032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongming Dai, School of Biomedical Engineering, ShanghaiTech University, Shanghai, 200032, People’s Republic of China, Tel +86 13917166155, Email daiyongming5555@163.com Mengsu Zeng, Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People’s Republic of China, Tel +86-021-64041990, Email zengmengsu111@163.comPurpose: To assess the effectiveness of tri-exponential Intra-Voxel Incoherent Motion (tri-IVIM) MRI in preoperatively identifying microvascular invasion (MVI) in hepatocellular carcinoma (HCC).Patients and Methods: In this prospective study, 67 patients with HCC were included. Metrics from bi-exponential IVIM (bi-IVIM) and tri-IVIM were calculated. Subgroup comparisons were analyzed using the independent Student’s t-test or Mann–Whitney U-test. Logistic regression was performed to explore clinical risk factors. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis.Results: MVI-positive HCCs exhibited significantly lower true diffusion coefficient (Dt) from bi-IVIM, as well as fast-diffusion coefficients (Df) and slow-diffusion coefficients (Ds) from tri-IVIM, compared to MVI-negative HCCs (p < 0.05). Tumor size and alpha-fetoprotein (AFP) were identified as risk factors. The combination of tri-IVIM-derived metrics (Ds and Df) yielded higher diagnostic accuracy (AUC = 0.808) compared to bi-IVIM (AUC = 0.741). A predictive model based on a nomogram was constructed using Ds, Df, tumor size, and AFP, resulting in the highest diagnostic accuracy (AUC = 0.859). Decision curve analysis indicated that the constructed model, provided the highest net benefit by accurately stratifying the risk of MVI, followed by tri-IVIM and bi-IVIM.Conclusion: Tri-IVIM can provide information on perfusion and diffusion for evaluating MVI in HCC. Additionally, tri-IVIM outperformed bi-IVIM in identifying MVI-positive HCC. By integrating clinical risk factors and metrics from tri-IVIM, a predictive nomogram exhibited the highest diagnostic accuracy, potentially aiding in the noninvasive and preoperative assessment of MVI.Keywords: tri-exponential intra-voxel incoherent motion, diffusion weighted imaging, hepatocellular carcinoma, microvascular invasion |
| first_indexed | 2024-03-11T20:44:28Z |
| format | Article |
| id | doaj.art-8e13982e1910478bb80b129a726a8087 |
| institution | Directory Open Access Journal |
| issn | 2253-5969 |
| language | English |
| last_indexed | 2024-03-11T20:44:28Z |
| publishDate | 2023-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj.art-8e13982e1910478bb80b129a726a80872023-10-01T18:14:19ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692023-09-01Volume 101659167187063The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular CarcinomaZhang YSheng RYang CDai YZeng MYunfei Zhang,1,2,* Ruofan Sheng,1,2,* Chun Yang,2 Yongming Dai,3 Mengsu Zeng1,2 1Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, People’s Republic of China; 2Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China; 3School of Biomedical Engineering, ShanghaiTech University, Shanghai, 200032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongming Dai, School of Biomedical Engineering, ShanghaiTech University, Shanghai, 200032, People’s Republic of China, Tel +86 13917166155, Email daiyongming5555@163.com Mengsu Zeng, Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People’s Republic of China, Tel +86-021-64041990, Email zengmengsu111@163.comPurpose: To assess the effectiveness of tri-exponential Intra-Voxel Incoherent Motion (tri-IVIM) MRI in preoperatively identifying microvascular invasion (MVI) in hepatocellular carcinoma (HCC).Patients and Methods: In this prospective study, 67 patients with HCC were included. Metrics from bi-exponential IVIM (bi-IVIM) and tri-IVIM were calculated. Subgroup comparisons were analyzed using the independent Student’s t-test or Mann–Whitney U-test. Logistic regression was performed to explore clinical risk factors. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis.Results: MVI-positive HCCs exhibited significantly lower true diffusion coefficient (Dt) from bi-IVIM, as well as fast-diffusion coefficients (Df) and slow-diffusion coefficients (Ds) from tri-IVIM, compared to MVI-negative HCCs (p < 0.05). Tumor size and alpha-fetoprotein (AFP) were identified as risk factors. The combination of tri-IVIM-derived metrics (Ds and Df) yielded higher diagnostic accuracy (AUC = 0.808) compared to bi-IVIM (AUC = 0.741). A predictive model based on a nomogram was constructed using Ds, Df, tumor size, and AFP, resulting in the highest diagnostic accuracy (AUC = 0.859). Decision curve analysis indicated that the constructed model, provided the highest net benefit by accurately stratifying the risk of MVI, followed by tri-IVIM and bi-IVIM.Conclusion: Tri-IVIM can provide information on perfusion and diffusion for evaluating MVI in HCC. Additionally, tri-IVIM outperformed bi-IVIM in identifying MVI-positive HCC. By integrating clinical risk factors and metrics from tri-IVIM, a predictive nomogram exhibited the highest diagnostic accuracy, potentially aiding in the noninvasive and preoperative assessment of MVI.Keywords: tri-exponential intra-voxel incoherent motion, diffusion weighted imaging, hepatocellular carcinoma, microvascular invasionhttps://www.dovepress.com/the-feasibility-of-using-tri-exponential-intra-voxel-incoherent-motion-peer-reviewed-fulltext-article-JHCtri-exponential intra-voxel incoherent motiondiffusion weighted imaginghepatocellular carcinomamicrovascular invasion. |
| spellingShingle | Zhang Y Sheng R Yang C Dai Y Zeng M The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular Carcinoma Journal of Hepatocellular Carcinoma tri-exponential intra-voxel incoherent motion diffusion weighted imaging hepatocellular carcinoma microvascular invasion. |
| title | The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular Carcinoma |
| title_full | The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular Carcinoma |
| title_fullStr | The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular Carcinoma |
| title_full_unstemmed | The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular Carcinoma |
| title_short | The Feasibility of Using Tri-Exponential Intra-Voxel Incoherent Motion DWI for Identifying the Microvascular Invasion in Hepatocellular Carcinoma |
| title_sort | feasibility of using tri exponential intra voxel incoherent motion dwi for identifying the microvascular invasion in hepatocellular carcinoma |
| topic | tri-exponential intra-voxel incoherent motion diffusion weighted imaging hepatocellular carcinoma microvascular invasion. |
| url | https://www.dovepress.com/the-feasibility-of-using-tri-exponential-intra-voxel-incoherent-motion-peer-reviewed-fulltext-article-JHC |
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