Meyer Hans-Jonas, Potratz Johann, Jechorek Dörthe, Schramm Kai Ina, Borggrefe Jan, Surov Alexey
Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany.
Department of Pathology, Otto von Guericke University, Magdeburg, Magdeburg, Germany.
Transl Cancer Res. 2025 Mar 30;14(3):1764-1771. doi: 10.21037/tcr-24-1516. Epub 2025 Mar 20.
Imaging modalities can reflect the underlying histopathology of tumors. However, the precise interactions between histopathological microstructure and the resulting imaging phenotype remain elusive. Predicting histopathological features, including the extracellular matrix, in a non-invasive manner could improve clinical care of liver tumors. The present study used cross-sectional guided biopsy specimens to utilize accurate spatial biopsy localization to correlate magnetic resonance imaging (MRI) derived the apparent diffusion coefficient (ADC) values with collagen IV expression in various liver cancers.
A total of 127 patients (n=68 female; 45.6%) with a mean age of 65.3±12.3 years were included in the analysis. Inclusion criteria were an available cross-sectional biopsy, available biopsy specimens and a pre-interventional MRI with diffusion-weighed imaging (DWI) sequence. The tumors included 45 patients (35.4%) with hepatocellular carcinoma (HCC), 26 patients (20.5%) with cholangiocellular carcinoma and 56 patients (44.1%) with liver metastases of various primary tumors. Prebioptic liver MRI with diffusion-weighted imaging was used to correlate ADC values with collagen IV expression obtained from liver biopsy. The ADC values were measured in a co-registered way with cross-sectional biopsy imaging to ensure the spatial concordance between imaging and histopathology. The stained area and signal intensity of the immunohistochemical staining were examined.
The mean average stained area of collagen IV was 32.6%±27.4% and the mean staining intensity was 2.03±1.01. HCC showed statistically less stained area compared to the other tumor types (analysis of variance P<0.0001). In the overall patient sample, there was no correlation between ADCmean and average stained area (r=0.05, P=0.55) and staining intensity (r=-0.04, P=0.60). In a subgroup analysis of HCC patients, there was a significant correlation between ADCmin and the staining intensity (r=-0.33, P=0.02).
ADC values are not associated with collagen IV expression in liver tumors. The complex extracellular matrix is not reflected by the DWI signal, which can be discussed as mainly be influenced by the cellularity of the tumors. Further research is needed to investigate the complex interactions between histopathology and the resulting imaging phenotype of MRI for clinical care.
成像方式能够反映肿瘤潜在的组织病理学特征。然而，组织病理学微观结构与由此产生的成像表型之间的确切相互作用仍不清楚。以非侵入性方式预测包括细胞外基质在内的组织病理学特征可改善肝肿瘤的临床治疗。本研究使用横断面引导活检标本，利用精确的空间活检定位，将磁共振成像（MRI）得出的表观扩散系数（ADC）值与各种肝癌中的IV型胶原表达相关联。
共有127例患者（n = 68例女性；45.6%）纳入分析，平均年龄为65.3±12.3岁。纳入标准为有可用的横断面活检、可用的活检标本以及术前带有扩散加权成像（DWI）序列的MRI。肿瘤包括45例（35.4%）肝细胞癌（HCC）患者、26例（20.5%）胆管细胞癌患者和56例（44.1%）各种原发性肿瘤肝转移患者。术前带有扩散加权成像的肝脏MRI用于将ADC值与从肝脏活检获得的IV型胶原表达相关联。ADC值以与横断面活检成像共同配准的方式测量，以确保成像与组织病理学之间的空间一致性。检查免疫组织化学染色的染色面积和信号强度。
IV型胶原的平均染色面积为32.6%±27.4%，平均染色强度为2.03±1.01。与其他肿瘤类型相比，HCC的染色面积在统计学上更少（方差分析P<0.0001）。在总体患者样本中，ADCmean与平均染色面积（r = 0.05，P = 0.55）和染色强度（r = -0.04，P = 0.60）之间无相关性。在HCC患者的亚组分析中，ADCmin与染色强度之间存在显著相关性（r = -0.33，P = 0.02）。
肝肿瘤中的ADC值与IV型胶原表达无关。复杂的细胞外基质未被DWI信号反映，这可被认为主要受肿瘤细胞密度影响。需要进一步研究以探讨组织病理学与MRI由此产生的成像表型之间的复杂相互作用，用于临床治疗。
