The preliminary study of MR Amide proton transfer-weighted for distinguishing hepatocellular carcinoma from intrahepatic mass-forming cholangiocarcinoma
The preliminary study of MR Amide proton transfer-weighted for distinguishing hepatocellular carcinoma from intrahepatic mass-forming cholangiocarcinoma
Objective:To evaluate the effectiveness of amide proton transfer-weighted imaging(APTw)and diffusion-weighted imaging(DWI)in distinguishing between hepatocellular carcinoma(HCC)and mass intrahepatic cholangiocarcinoma(IMCC).Methods:A total of 150 patients with focal liver lesions were prospectively enrolled in this study for upper abdomen MRI scans,which included APTw and DWI sequences.Patients diagnosed with HCC and IMCC,confirmed by pathology,were in-cluded in the study.The APTw and ADC values of the lesions were independently measured by two radiologists on the APTw and ADC images.The differences in APTw and ADC values between HCC and IMCC were analyzed using an independent sample t-test.Pearson correlation analysis was utilized to evaluate the relationship between APTw values and ADC values.Moreover,the diagnostic perform-ances of APTw and ADC in differentiating HCC and IMCC were analyzed using a receiver operating characteristic(ROC)curve.Results:A total of 76 patients were enrolled in this study,including 53 HCC patients and 23 IMCC patients.The APTw value of the HCC group was found to be higher than that of the IMCC group[(1.37±0.99)％vs.(-0.31±0.79)％,P＜0.001],while the ADC value of the HCC group was lower(0.87±0.14)×10-3mm2/s compared to the IMCC group[(1.02±0.20)× 10-3mm2/s,P＜0.001].Additionally,there was a negative correlation found between APTw value and ADC value(R=0.44,P＜0.001).The area under the receiver operating characteristic curve(AUC)of APTw was higher than that of ADC in differentiating HCC from IMCC(0.90 vs.0.72,P＜0.001).Moreover,the optimal cut-off value of APTw for differentiating IMCC from HCC was 0.04％,with a sensitivity of 92％and specificity of 78％.Conclusion:The quantitative imaging of APTw surpassed DWI in the differential diagnosis of HCC and IMCC,thereby providing valuable supplementary diag-nostic information.The quantitative imaging of APTw has been shown to be more effective than DWI in the differential diagnosis of HCC and IMCC.Thus,APTw imaging provides essential supplementary diagnostic information in the diagnosis of these two liver cancers.
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