The role of ADC measurement in differential diagnosis of focal hepatic lesions

Onur, Mehmet Ruhi; Çiçekçi, Mehtap; Kayali, Alperen; Poyraz, Ahmet Kursad; Kocakoç, Ercan

doi:10.1016/j.ejrad.2011.01.116

Cited by 49 publications

(40 citation statements)

References 17 publications

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“…In spite of significant differences in the D* values between HCC and FNH, its efficacy was inferior to ADC total and D, as is generally accepted. The values in our study for ADC total (2,27), D (26,44), and f (24, 45) were in line with or similar to those results reported previously. Our D* values were out of range of other studies, especially for FNH (24,27).…”

Section: Discussionsupporting

confidence: 82%

“…The apparent diffusion coefficient (ADC), calculated from two b values, is a quantitative analysis of diffusion that has received significant attention in clinical practice (2,3). However, the ADC calculated from a mono-exponential fit has been shown to be larger than the true diffusion in voxels, which means traditional DWI and ADC might have been overestimated for lesion analysis in daily practice.…”

mentioning

confidence: 99%

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Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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A mong primary malignant hepatic tumors, hepatocellular carcinoma (HCC) is the most common disease and is highly associated with chronic hepatitis B and cirrhosis. Focal nodular hyperplasia (FNH) is the second most common benign focal liver lesion (1), and although it displays gentle biological behavior generally, it can cause abdominal pain or right upper quadrant discomfort occasionally. In terms of the extent of vascular supply during contrast enhancement, HCC and FNH both show a hyperarterialization pattern. HCC is characterized by rapid washout in portal and delayed phase compared with adjacent liver tissue, while FNH displays isointensity or mild hyperintensity in the venous phase because of its slower washout. Liver-specific contrast agents, such as gadoxetic acid, can provide unique information to diagnose these conditions more precisely; however, such agents increase the cost and time-consumption of diagnosis. Occasionally, HCC and FNH show confounding or atypical appearances on imaging, especially for high-or middle-grade differentiated HCC, leading to confusion, misdiagnosis ( Fig. 1), and even unnecessary interventions. Since the treatment of these two lesions is completely different, avoiding unnecessary invasive treatment or tests, such as biopsy, surgery, or interventional therapy, is vital for the prognosis and quality of life of the patient. Therefore, it is crucial to diagnose these conditions noninvasively and accurately before surgery.Diffusion-weighted imaging (DWI) is a functional technology to detect diffusion of water molecules and permits to capture more detailed disease information. For lesion detection, the signal intensity on diffusion-weighted image depends on several factors, particularly cell density. A B D O M I N A L I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to explore whether intravoxel incoherent motion (IVIM)-related parameters of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) demonstrate differences that could be used to differentiate and improve diagnostic efficiency. METHODSA total of 27 patients, including 22 with HCC and 5 with FNH, underwent liver 3.0 T magnetic resonance imaging for routine sequences. They were concurrently examined by IVIM diffusion-weighted imaging (DWI) scanning with 11 different b values (0-800 s/mm 2 ). IVIM-derived parameters, such as pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f ), and apparent diffusion coefficient (ADC total ), were quantified automatically by post-processing software and compared between HCC and FNH groups. A receiver operating characteristic (ROC) curve was then created to predict their diagnostic value. RESULTS

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Section: Discussionsupporting

confidence: 82%

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confidence: 99%

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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“…The apparent diffusion coefficient (ADC) can be calculated from images obtained with different strengths of diffusion‐sensitizing gradients (b values) and provides a quantifiable measure of tissue diffusion and perfusion. However, even with this ADC approach differentiating between malignant and benign liver lesions is still inaccurate . This inconclusiveness is partly attributable to using region‐of‐interest (ROI)‐based techniques to obtain MRI metrics …”

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confidence: 99%

Utility of volumetric contrast‐enhanced and diffusion‐weighted MRI in differentiating between common primary hypervascular liver tumors

Zarghampour

Fouladi

Pandey

et al. 2018

Magnetic Resonance Imaging

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“…To date, studies assessing quantitative diffusion metrics have usually assessed the mean apparent diffusion coefficient (mADC) value of liver lesions in an attempt to distinguish benign from malignant etiologies. However, such studies have demonstrated significant overlap in mADC values between hemangiomata and liver metastases [1,7,8], limiting the ability to consistently differentiate the lesions. Similarly, using qualitative assessment of high-b-value diffusion images, readers can still mistake hemangiomata for metastases, as both lesions can maintain high signal [4,5,9].…”

Section: Introductionmentioning

confidence: 97%

Improved differentiation between hepatic hemangioma and metastases on diffusion-weighted MRI by measurement of standard deviation of apparent diffusion coefficient

2015

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The role of ADC measurement in differential diagnosis of focal hepatic lesions

Cited by 49 publications

References 17 publications

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Utility of volumetric contrast‐enhanced and diffusion‐weighted MRI in differentiating between common primary hypervascular liver tumors

Improved differentiation between hepatic hemangioma and metastases on diffusion-weighted MRI by measurement of standard deviation of apparent diffusion coefficient

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