DWI/ADC in Differentiation of Benign from Malignant Focal Liver Lesion

ObjectivesThe aim of this study was to determine the diagnostic value of diffusion-weighted MRI of the liver at 3T to classify liver fibrosis/cirrhosis.Methods62 patients who underwent both histopathological examination and diffusion-weighted imaging of the liver via 3T MRI within a period of 3 months were included in the study. The Ishak score (1-6) was used to determine the degree of fibrosis: No liver fibrosis (NLF; Ishak 0, n = 16), mild liver fibrosis (MLF; Ishak 1-2, n = 23), advanced liver fibrosis (ALF; Ishak 3-5, n = 12), and liver cirrhosis (LC; Ishak 6, n = 11).ResultsThe corresponding ADC values for the individual patient groups were as follows: NLF: 1123 (SD 95.8); MLF: 1032 (SD 77.6); ALF: 962 (SD 68.8); LC: 1015 (SD 60.2) mm2/s. There is a significant difference between NLF and MLF (p = 0.004) and between MLF and ALF (p = 0.022). A significant difference between patients with ALF and LC (p = 0.117) could not be found.ConclusionLiver fibrosis/cirrhosis lowers the ADC values of the liver parenchyma in 3T MRI. However, the degree of fibrosis can only be conditionally determined on the basis of ADC values.

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“…Diffusion-weighted imaging is an MRI method that can also be used for detecting inflammatory/tumoral diseases in the abdomen [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

DWI - histology: a possible means of determining degree of liver fibrosis?

et al. 2018

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“…This inconsistency in ADC cutoff points is probably attributable, among other reasons, to differences between scanners and differences in the parameters used to obtain diffusion-weighted images and ADC maps. [22,29,30] In our subgroup analysis restricted to benign lesions, adenomata and FNH exhibited ADC values of 1.41×10 − 3 mm 2 /s and 1.30×10 − 3 mm 2 /s respectively; both are intermediate values, and are not signi cantly difference between one another or in comparison with the ADC values found in malignant lesions. The application of DWI and ADC mapping in the characterization of certain benign solid liver lesions and the potential of this technique to distinguish benign lesions from malignant ones is still a topic of discussion.…”

Section: Adc and Adc Ratio Valuesmentioning

confidence: 57%

“…Sample size was calculated in the WinPepi software suite, based on previously reported results from the literature [14,[20][21][22][23]. These calculations showed that, to detect a signi cant difference between the ADCs of benign and malignant lesions, at the 5% signi cance level, with a statistical power of 80%, at least 65 lesions would have to be analyzed.…”

Section: Discussionmentioning

confidence: 99%

The Use of the Apparent Diffusion Coefficient (ADC) for Characterization and Differentiation of Focal Hepatic Lesions in Noncirrhotic Patients.

Justo

Watte

Hochhegger

2021

Preprint

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PURPOSE Diffusion-weighted imaging (DWI) is a MRI technique that, although relatively recent, has shown promise for the evaluation of focal hepatic lesions, providing information both on qualitative and quantitative parameters. The present study was designed to analyze the role of DWI, particularly the ADC (apparent diffusion coefficient), in differentiating benign solid liver lesions from malignant ones in a sample of noncirrhotic patients. METHODS We conducted a retrospective analysis of MRI scans performed at a tertiary hospital in Porto Alegre, Rio Grande do Sul, Brazil, from 2015 to 2018. The distribution of lesions into benign vs. malignant groups was determined by imaging criteria and/or histological analysis. ADC were obtained for each lesion.RESULTS Overall, 118 focal liver lesions were evaluated, with 78 benign and 40 malignant. The mean ADC value was 1.420×10−3 mm2/s for benign lesions versus 1.130×10−3 mm2/s for malignant lesions (p<0.001). ROC curve analysis showed an area under the curve of 0.79, optimal cutoff point of 1.19×10−3 mm2/s for discriminating between malignant and benign lesions, sensitivity and specificity of 75% and 73.1%.CONCLUSIONS We demonstrate the appropriateness of ADC for characterization of benign solid lesions of the liver and to distinguish these masses from malignant metastatic lesions.

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“…The importance of ADC values in diagnosis of malignancies of liver, breast, uterus, cervix have been widely studied. [7][8][9][10] Few similar studies have explored the limitations and diagnostic challenges faced while using DWI/ADC to detect pancreatic malignancies. [11,12] In our study, the ADC value in pancreatic malignancies (n=14) ranged from 0.850 x 10 -3 -1.14x10 -3 /s with a mean ADC value of 0.9340×10 −3 mm 2/ /s±0.07 which was found to be pointedly lower than the normal control group of 1.36326 × 10 −3 mm 2 s±0.16 (p<0.0005), (Figure 1c) thus clearly defining the utility of DWI/ ADC in such cases.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Diffusion Weighted Imaging and Apparent Diffusion Coefficient in Characterizing Pancreatitis and Pancreatic Adenocarcinoma

Radhan¹,

Chandrasekharan²,

Ramachandran³

et al. 2019

jemds

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BACKGROUND The main purpose of this article is to establish the usefulness of Diffusion Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) as complementary tools to conventional MRI sequences in characterizing benign (pancreatitis) and malignant (pancreatic adenocarcinoma) pancreatic pathologies in comparison to a control group. METHODS A prospective observational study was done over a period of two years with images obtained using Siemens Magnatom Avanto 1.5T MRI. 130 patients with pancreatic abnormalities were included in this study. An additional control group included 32 patients with normal pancreatic parenchyma. MRI findings including DWI and ADC values were calculated for all patients which was then correlated with clinical, lab and histopathological data. RESULTS Out of the 130 positive cases, 116 (89 %) were benign and 14 (11%) were malignant lesions based on MRI features. Benign lesions include acute pancreatitis (47%), acute on chronic pancreatitis (11%) and chronic pancreatitis (31%). Rest of the cases were pancreatic adenocarcinomas (11%). There was significant reduction of ADC values in patients with acute pancreatitis (mean ADC-1.016 x 10-3), acute on chronic pancreatitis (mean ADC-1.122 x 10-3) and chronic pancreatitis (mean ADC-1.277 x 10-3) as well as pancreatic carcinoma (mean ADC-0.934 x 10-3) in comparison with the control group (mean ADC-1.363 x 10-3). CONCLUSIONS DWI with ADC mapping can play a significant role in the evaluation of pancreatic diseases. It can help in differentiating benign and malignant disease (ADC values of malignancy are significantly lower than benign disease).

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DWI/ADC in Differentiation of Benign from Malignant Focal Liver Lesion

Abstract: Material and methods:The study was of prospective-retrospective character. It was carried out at the AKH in Vienna (Austria), where 100 patients with focal liver lesions were included in the study. All

Cited by 14 publications

References 19 publications

DWI - histology: a possible means of determining degree of liver fibrosis?

DWI - histology: a possible means of determining degree of liver fibrosis?

The Use of the Apparent Diffusion Coefficient (ADC) for Characterization and Differentiation of Focal Hepatic Lesions in Noncirrhotic Patients.

Usefulness of Diffusion Weighted Imaging and Apparent Diffusion Coefficient in Characterizing Pancreatitis and Pancreatic Adenocarcinoma

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