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Tesi etd-02212019-131022


Thesis type
Tesi di laurea magistrale LM6
Author
BANDINI, CLAUDIO
URN
etd-02212019-131022
Title
Is Diffusion Weighted MR Imaging a tool to grade Hepatocellular-carcinoma lesions?
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
Commissione
relatore Prof. Caramella, Davide
relatore Prof.ssa Cioni, Dania
Parole chiave
  • Magnetic Resonance Imaging
  • Diffusion weighted Imaging
  • Hepatocellularcarcinoma
  • orthotopic liver transplantation.
Data inizio appello
12/03/2019;
Consultabilità
parziale
Data di rilascio
12/03/2022
Riassunto analitico
The diagnosis of hepatocellular carcinoma (HCC) is based on imaging examinations in combination with clinical and laboratory findings.
Despite technological advances, imaging cirrhotic patients remains a challenging issue because non-malignant hepatocellular lesions, such as dysplastic nodules, mimic a small HCC.
Purpose: to analyze DWI in Magnetic Resonance findings of HCC nodules in livers before transplantation and histologically analyzed.
Methods: 48 patients underwent DWI MR examinations (1.5T system), that included 20-min delayed hepatobiliary (HB) phase imaging, before undergoing orthotopic liver transplantation (OLT); mean time MR-OLT: 45 days.
A total of 155 hepatic nodules were identified, analyzed and graded at histopathological examination. One radiologist performed a qualitative analysis of signal intensities of identified nodules on vascular dynamic phases (30–35 s after injection–arterial phase; 180–190 s after injection late phase), HB phases and in DWI sequences. Correlation between nodules MR patterns and histological classification were analyzed by means of dedicated statistical software.
Results: Among 155 nodules 74 were HCC, of which 11 nodules were early HCC ( 8 nodules were 1-2 cm and 3 nodules were > 2 cm), 28 nodules were GI-GII, 14 nodules clearly GII and 21 nodules were more biologically aggressive (GIII-GIV).
Interestingly, 34 of 36 (94,4%) GII, GIII and GIV lesions results positive at DWI analysis with restricted pattern.
Remaining 33 of 38 (86,9%) nodules (GI and GI-GII) result negative at DWI analysis and 5 GI-GII nodules were detected.
Conclusions: The results of this study highlighted that DWI sequence can be considered a valid tool that significantly improve the diagnostic accuracy and specificity for chronic liver disease-associated HCC.
Interestingly, according with the previews results, DWI can be viewed also as a potential non invasive tool for grading HCC lesions and researching tumor’s biological behavior, especially when histologic analysis is not available.
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