Özet:

The aim is to investigate the relationship of the differentiation degree in the hepatosellular carcinoma (HSK) with the quantitative data obtained from the histogram analysis of the apparent diffusion coefficient (ADC) and the findings of contrasted magnetic resonance imaging (MRG). Tools and Methods: In the period between December 2014 and December 2017, the upper abdominal MR images of the 18 years old and older facts were reviewed backward. 41 tumors diagnosed with hepatocellular carcinoma were divided into 3 groups, in bad, medium and good differences according to the results of histopathology. For each differentiation group, the demographic characteristics of the facts, MRG findings and ADC measurements were recorded. Results: Bad [n: 14 (%34)], medium [n: 15 (%37)] and good [n: 12 (%29)] differences in HSKs the minimum, average and maximum ADC values were calculated as 0.59 (0.47-0.64); 0.75 (0.72-0.86); 1.00 (0.88-1,24)x10-3 mm2/s, 0.67 (0.56-0.79); 0.97 (0.75-1,00); 1.17 (1,05-1,31)x10-3 mm2/s, 0.96 (0.82-0.97); 1.12 (1,01-1,24); 1.40 (1,29-1,62)x10-3 mm2/s. There has been statistically significant differences between bad-medium, bad-good, middle-good groups for minimum ADC, middle-good, bad-good groups for average ADC, and only bad-medium groups for maximum ADC (p<0,001). It has been observed that numerous single, well-limited and correct boundary HSKs may be beneficial in the prediction of having good differences. Other contrasted MRG findings have been found to have a large scale of confusion between differentiation groups. The result: especially the minimum ADC appears to be successful in predicting the differentiation degree of HSK. ADC, easy to reach, cheap, non-invasive and quantitative data can take its place in routine practice in the future as a bio-specific agent that is easy to interpret. Keywords: hepatocellular carcinoma; Magnetic Resonance Imaging; Diffusion Weight Imaging (DAG); Apparent Diffusion Coefficient (ADC) ABSTRACT Objective: The aim of this study was to investigate the relationship between grade of differentiation in hepatocellular carcinoma (HCC) with the quantitative data obtained by the histogram analysis of apparent diffusion coefficient (ADC) and contrast-enhanced magnetic resonance imaging (MRI) findings. Material and Methods: The upper abdomen MR images of patients 18 years of age and older who were examined between December 2014 and December 2017 were retrospectively analyzed. According to histopathology results, 41 tumours diagnosed as hepatocellular carcinoma were divided into 3 groups as poorly, moderately- and well-differentiated. Demographic characteristics, MRI findings and ADC measurements of the cases were recorded for each differentiation group. Results: In poorly-differentiated [(n: 14 (34%)], moderately-differentiated [n: 15 (37%)] and well-differentiated [(n:12 (29%)] HCCs, minimum, average and maximum ADC values were respectively calculated as 0.59 (0.47-0.64); 0.75 (0.72-0.86); 1,00 (0.88-1.24) x10-3 mm2/s for poor groups; 0.67 (0.56-0.79); 0.97 (0.75- 1.00); 1.17 (1.05-1.31)x10-3 mm2/s for moderate groups; 0.96 (0.82-0.97); 1.12 (1.01-1.24); 1.40 (1.29-1.62) x10-3 mm2/s for well-differentiated groups. A statistically significant difference was found between poor-moderate, poor-well, moderate-well groups for minimum ADC, between moderate-well, poor-well groups for average ADC, and only poor-moderate groups for maximum ADC (p <0.001). It has been observed that single, well-circumscribed and smooth-edged HCCs may be useful in predicting that they are well-differentiated. For other contrast MRI findings, a substantial overlap was found between differentiation groups. Conclusion: The minimum ADC, in particular, seems to be successful in estimating the degree of differentiation of HCC. ADC can take its place in routine practice in the future as a biomarker which is easily accessible, inexpensive, non-invasive and easy to interpret with quantitative data. Keywords: Hepatocellular Carcinoma; Magnetic Resonance Imaging; Diffusion Weighted Imaging (DWI); Apparent Diffusion Coefficient (ADC)

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