Evaluation of Apparent Diffusion Coefficient Value of Diffusion Weighted Imaging for Hepatocellular Carcinoma in Different Histological Grades

Sohail Akhtar; Muhammad Akhtar; Aurangzeb; Muhammad Afzal

Objective: To determine the mean ADC value of DWI for HCC in different histological grades. Study Design: Descriptive Cross-sectional study Setting and Duration: The study was conducted in Combined Military Hospital (CMH) Lahore from Nov 2015 to May 2016. Methodology: A total of 45 patients fulfilling the inclusion criteria with biopsy proven diagnosis of HCC were enrolled. The patients were divided into well-, moderatelyand poorly differentiated HCC on the basis of histopathology for subsequent analysis. All patients underwent MRI examination. ADC value for each patient of the lesion was measured using a separate dedicated post processing work station by placing a Region of Interest (ROI) on the lesion. Results: The mean age of the patients was 52.08±12.60 years. There were 46.67% (n=21) male and 53.33% (n=24) female patients. There was significantly (p-value < 0.05) raised level of ADC in older age patients of more than 50 years. There was no significant (p-value > 0.05) difference in ADC value (1.00±0.22 vs 0.99±0.31 x 10- 3 mm² /s) between male and female patients. The overall mean ADC value of the patients was 1.0±0.27 x 10-3 mm² /s. A significant (p-value < 0.05) difference was found in ADC values of three grades of HCC, the mean ADC value was 1.18±0.14 x 10-3 mm² /s for well differentiated HCC, 1.13±0.12 x 10-3 mm² /s for moderately differentiated and 0.69±0.20 x 10-3 mm² /s for poorly differentiated grade of HCC, showing increase in ADC value with decrease in grade of HCC. Conclusion: The ADC value based on DW1 may be used for evaluation of histological grade of HCC while this technique is very quick and non-invasive without the requirement of contrast material.