Differentiation between cavernous hemangiomas and untreated malignant neoplasms of the liver with free-breathing diffusion-weighted MR imaging: Comparison with T2-weighted fast spin-echo MR imaging |
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Authors: | Philippe Soyer,Lucie CornoMourad Boudiaf,Mounir AoutMarc Sirol,Vinciane Placé Florent Duchat,Youcef GuerracheYann Fargeaudou,Eric VicautMarc Pocard,Lounis Hamzi |
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Affiliation: | a Department of Abdominal Imaging, Hôpital Lariboisière-AP-HP and Université Diderot-Paris 7, 2, rue Ambroise Paré, 75475, Paris Cedex 10, France b Unité 965 INSERM/Paris7, Hôpital Lariboisière-AP-HP and Université Diderot-Paris 7, 2, rue Ambroise Paré, 75475, Paris Cedex 10, France c Clinical Research Unit, Hôpital Lariboisière-AP-HP and Université Diderot-Paris 7, 2, rue Ambroise Paré, 75475, Paris Cedex 10, France d Department of Digestive Diseases, Hôpital Lariboisière-AP-HP and Université Diderot-Paris 7, 2, rue Ambroise Paré, 75475, Paris Cedex 10, France |
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Abstract: | ObjectiveTo test interobserver variability of ADC measurements and compare the diagnostic performances of free-breathing diffusion-weighted (FBDW) with that of T2-weighted FSE (T2WFSE) MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms.Materials and methodsThirty-five patients with cavernous hemangiomas and 35 with untreated hepatic malignant neoplasms had FBDW and T2WFSE MR imaging. Hepatic lesions were characterized with ADC measurement and visual evaluation. Interobserver agreement for ADC measurement was calculated. Association between ADC value and lesion type was assessed using univariate analysis. Sensitivity, specificity and accuracy of ADC values and visual evaluation of MR images for the diagnosis of untreated malignant hepatic neoplasm were compared.ResultsADC measurements showed excellent interobserver correlation (intraclass correlation coefficient = 0.980). Malignant neoplasms had lower ADC values than hemangiomas for the two observers (1.11 × 10−3 mm2/s ± .21 × 10−3vs. 1.77 × 10−3 mm2/s ± .29 × 10−3 for observer 1 and 1.11 × 10−3 mm2/s ± .19 × 10−3vs. 1.79 × 10−3 mm2/s ± .32 × 10−3 for observer 2) and univariate analysis found significant correlations between lesion type and ADC values. Depending on ADC threshold value, accuracy for the diagnosis of malignant neoplasm varied from 82.9% to 94.3%. Using visual evaluation, FBDW showed better specificity and accuracy than T2WFSE MR images for the diagnosis of malignant neoplasm (97.1% vs. 77.1% and 94.3% vs. 62.9%, respectively).ConclusionFBDW imaging provides reproducible quantitative information and surpasses the value of T2WFSE MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms. |
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Keywords: | Cavernous hemangioma Diffusion magnetic resonance imaging Liver neoplasms Lesion characterization Malignant hepatic tumors MR imaging |
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