Abstract:

 Objective To determine the value of 3.0T MR arterial spin labeling(ASL) in the diagnosis of early-stage primary liver cancer. Methods A total of 22 newly diagnosed early stage primary liver cancer patients proven by liver biopsy and 20 healthy volunteers were enrolled and underwent MR examination, including 3D pseudo-continuous ASL(pCASL) series. The mean, maximum and minimum blood flow(BF) of liver derived in pCASL of early stage primary liver cancer and healthy controls were measured and compared. Receiver operation characteristic(ROC) curve was used to analyze the diagnostic cutoff and efficiency. Results The mean, maximum and minimum BF in early stage primary liver cancer tissue were,respectively,(108.69±27.32) mL/(100g·min), (138.59±61.61) mL/(100g·min),and(70.18±12.01) mL/(100g·min) , which were significantly higher than in the healthy controls[(78.85±34.89) mL/(100g·min), (99.32±50.01) mL/(100g·min), and (48.63±11.77) mL/(100g·min)](P<0.05). The area under the ROC curve of mean, maximum and minimum BF value was 0.736, 0.686 and 0.900, respectively. Setting the minimum BF value 53.64 mL/(100g·min) as the cutoff threshold to differentiate early stage primary liver cancer tissue and healthy controls, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 95.5%, 70.0%, 95.5%, 70.0% and 83.3%, respectively. Conclusions 3.0T MR 3D-ASL may reflect the difference of perfusion of liver derived between early stage primary liver cancer and healthy controls, which is significant for the early diagnosis of primary liver cancer.

Key words:  Liver neoplasms, Liver tissue, Blood perfusion, Magnetic resonance imaging, Arterial spin labeling, Diagnosis