AUTHOR=Li Chenhui , Wen Yan , Xie Jinhuan , Chen Qianjuan , Dang Yiwu , Zhang Huiting , Guo Hu , Long Liling 

TITLE=Preoperative prediction of VETC in hepatocellular carcinoma using non-Gaussian diffusion-weighted imaging at high b values: a pilot study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1167209

DOI=10.3389/fonc.2023.1167209

ISSN=2234-943X

ABSTRACT=Background: Vessels encapsulating tumor clusters (VETC) have been considered an important cause of hepatocellular carcinoma (HCC) metastasis.
Purpose: To compare the potential of various diffusion parameters derived from the monoexponential model and four non-Gaussian models (DKI, SEM, FROC, and CTRW) in preoperatively predicting the VETC of HCC.
Methods: 86 HCC patients (40 VETC-positive and 46 VETC-negative) were prospectively enrolled. Diffusion-weighted images were acquired using six b-values (range from 0 to 3000 s/mm2). Various diffusion parameters derived from diffusion kurtosis (DK), stretched-exponential (SE), fractional-order calculus (FROC), and continuous-time random walk (CTRW) models, together with the conventional apparent diffusion coefficient (ADC) derived from the monoexponential model were calculated. All parameters were compared between VETC-positive and VETC-negative groups using an independent sample t-test or Mann-Whitney U test, and then the parameters with significant differences between the two groups were combined to establish a predictive model by binary logistic regression. Receiver operating characteristic (ROC) analyses were used to assess diagnostic performance.
Results: Among all studied diffusion parameters, only DKI_K and CTRW_α significantly differed between groups (P=0.002 and 0.004, respectively). For predicting the presence of VETC in HCC patients, the combination of DKI_K and CTRW_α had the larger area under the ROC curve (AUC) than the two parameters individually (AUC=0.747 vs. 0.678 and 0.672, respectively).
Conclusions: DKI_K and CTRW_α outperformed traditional ADC for predicting the VETC of HCC.
Keywords: Hepatocellular carcinoma, Vessels encapsulating tumor clusters , Magnetic resonance imaging, Diffusion-weighted images, Non-Gaussian models,  Prediction