Role of diffusion-weighted magnetic resonance imaging inthe differential diagnosis of focal hepatic lesions

Abstract

AIM:To evaluate the utility of diffusion-weighted imaging (DWI) in screening and differential diagnosis of benign and malignant focal hepatic lesions. METHODS:Magnetic resonance imaging (MRI) examinations were performed using the Signa Excite Xl Twin Speed 1.5T system (GE Healthcare, Milwaukee, WI, USA). Seventy patients who had undergone MRI of the liver [29 hepatocellular carcinomas (HCC), four cholangiocarcinomas, 34 metastatic liver cancers, 10 hemangiomas, and eight cysts] between April 2004 and August 2008 were retrospectively evaluated. Visualization of lesions, relative contrast ratio (RCR), and apparent diffusion coefficient (ADC) were compared between benign and malignant lesions on DWI. Superparamagnetic iron oxide (SPIO) was administered to 59 patients, and RCR was compared pre-and postadministration. RESULTS:DWI showed higher contrast between malignant lesions (especially in multiple small metastatic cancers) and surrounding liver parenchyma than did contrast-enhanced computed tomography. ADCs (mean ± SD × 10 -3 mm 2 /s) were significantly lower (P < 0.05) in malignant lesions (HCC: 1.31 ± 0.28 and liver metastasis: 1.11 ± 0.22) and were significantly higher in benign lesions (hemangioma: 1.84 ± 0.37 and cyst: 2.61 ± 0.45) than in the surrounding hepatic tissues. RCR between malignant lesions and surrounding hepatic tissues significantly improved after SPIO administration, but RCRs in benign lesions were not improved. CONCLUSION:DWI is a simple and sensitive method for screening focal hepatic lesions and is useful for differential diagnosis.

Diffusion-Weighted MR Imaging of the Benign Hepatic Focal Lesions

“…This is in agreement with previous studies [4] [19]- [22]. There is difference in ADC value of cyst from other study [3] [18] [19] [23]. This variability in ADC values is probably due to imaging parameters, b value combination or different technique either breath-hold or respiratory triggered.…”

Diagnostic Performance of Diffusion Weighted Imaging of Malignant and Benign Pulmonary Nodules and Masses: Comparison with Positron Emission Tomography

“…DWI can be used to distinguish benign from malignant lesions in the lung Ohba et al, 2009;, in the thorax (Tondo et al, 2011), in the prostate (Yamamura et al, 2011), in the breast (Fornasa et al, 2011), and in the liver (Koike et al, 2009;. DWI was reported to be superior to FDG-PET in the detection of primary lesions and the nodal assessment of non-small cell lung cancers (Usuda et al, 2011;Wu et al, 2012).…”

Diagnostic value of diffusion weighted MRI and ADC in differential diagnosis of cavernous hemangioma of the liver

“…Quantitative evaluations were made on images showing the amount of diffusion of water molecules called ADC maps. ADC combines the effects of capillary perfusion and water diffusion in extracellular and extravascular intervals 14 . As with solid lesions and abscess, while the cell density in the lesion increases, the diffusion becomes limited; so, cellular lesions on DWI with high b values (a factor indicating MR gradient strength and duration) (b=400-1000 s/mm2) gain a hyperintense signal property; showing low numeric values on the ADC map.…”