The role of MR diffusion in differentiation of malignant and benign hepatic focal lesions |
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Authors: | Mahmoud Abdel Latif Galal El HawaryAdel El Badrawy Hatem El Alfy |
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Affiliation: | Mansoura University Hospital (MUH), Egypt |
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Abstract: | AimTo determine if focal liver masses could be differentiated as benign or malignant by DWI and ADC maps.Methods and materialsSixty focal liver lesions were scanned using 1.5 T MRI. DWI was performed with b 0, b 500 and b 1000 gradients with ADC measurements. Comparison of mean ADC values between each benign and malignant lesion was done. Reference standard of diagnosis was obtained by correlating DWI with histopathologic findings and imaging follow-up. The accuracies of DWI and ADC values were assessed with the Student’s t test, and cut-off values were determined with receiver operating characteristic curve analysis.ResultsWhen ADC value of 1.0 × 10−3 mm2/s was used as a threshold value for differentiation of malignant tumors from benign lesions, sensitivity was 90.3%, specificity 78.57% and accuracy 86.7%. The best result was obtained with the use of ADC cut off value (at b 500) of 1.5 × 10−3 mm2/s and ADC cut off value (at b 1000) of 1.0 × 10−3 mm2/s, with 90.3% sensitivity, 92.86% specificity, 91.1% accuracy, 96.6% positive predictive value and 81.3% negative predictive value.ConclusionDWI and ADC map is a useful tool in differential diagnosis of malignant from benign liver lesions. |
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Keywords: | DWI, diffusion weighted imaging ADC, apparent diffusion coefficient T, tesla MRI, magnetic resonance imaging ROC, receiver operating characteristic curve FNH, focal nodular hyperplasia HCC, hepato-cellular carcinoma CT, computed tomography DWMRI, diffusion-weighted magnetic resonance imaging DWI, diffusion-weighted imaging n, number FLL, focal liver lesions FSPGR, fast-spoiled gradient echo SSFSE, single shot fast spin echo S, second TR, repetition time TE, echo time FOV, field of view cm, centimeter ASSET, array spatial sensitivity encoding technique mm, millimeter ROI, region of interest SD, standard deviation SI, signal intensity DW-EPIs, diffusion-weighted-echo planar imagings SNR, signal to noise ratio mm/s, millimeter/second |
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