The value of diffusion-weighted imaging in characterizing focal liver masses.

RATIONALE AND OBJECTIVES To determine if focal liver masses could be differentiated as benign or malignant on the basis of diffusion-weighted imaging (DWI). METHODS AND MATERIALS A total of 104 patients with focal liver masses were scanned using 1.5 T magnetic resonance imaging (MRI). DWI was performed with b values of 0, 50, and 400 s/mm(2). Of these, 76 patients had lesions larger than 2 cm diameter, radiologic or pathologic characterization of the lesion, and diagnostic quality DWI. The apparent diffusion coefficient (ADC) of the largest liver lesion was measured. The liver masses were diagnosed on histology or had characteristic computed tomography/MRI findings and follow up of more than 6 months. The analyzed lesions were hemangioma (n = 17), cysts (n = 5), hepatocellular cancer (HCC) (n = 41), adenoma (n = 3), focal nodular hyperplasia (FNH) (n = 6), and metastases (n = 4). RESULTS The mean (standard deviation) ADC values (10(-5) mm(2)/second) of hemangiomas, cysts, FNH, and HCC were 156.8 (54.1), 190.2 (43.0), 130.1 (81.9), and 107.6 (32.7). The ADC of cysts and hemangiomas were significantly higher than that of other lesions (P = .0003, t-test). There was no significant difference between ADC values of solid, benign liver lesions (FNH, adenoma) and malignant lesions (HCC, metastases) (P = .62). CONCLUSION Solid liver lesions have a lower ADC than cysts and hemangiomas. However, there is no significant difference in ADC between solid benign and malignant lesions. DWI appears to have only minimal additional value over currently used MRI sequences in characterizing liver masses.

[1]  D. Collins,et al.  Diffusion-weighted MRI in the body: applications and challenges in oncology. , 2007, AJR. American journal of roentgenology.

[2]  Yi-kai Xu,et al.  Quantitative evaluation of diffusion-weighted magnetic resonance imaging of focal hepatic lesions. , 2005, World journal of gastroenterology.

[3]  Pierre-Yves Boëlle,et al.  Diffusion‐weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C , 2007, Hepatology.

[4]  Stephanie R Wilson,et al.  Focal liver masses: enhancement patterns on contrast-enhanced images--concordance of US scans with CT scans and MR images. , 2007, Radiology.

[5]  Zhi-jian Yu,et al.  Evaluation of diffusion weighted imaging of magnetic resonance imaging in small focal hepatic lesions: a quantitative study in 56 cases. , 2005, Hepatobiliary & pancreatic diseases international : HBPD INT.

[6]  Sheng-Nan Lu,et al.  Small hepatic nodules (≤2 cm) in cirrhosis patients: characterization with contrast‐enhanced ultrasonography , 2006, Liver international : official journal of the International Association for the Study of the Liver.

[7]  H. Kawai,et al.  Diffusion-weighted imaging of the liver: technical challenges and prospects for the future. , 2005, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine.

[8]  Jean-Luc Daire,et al.  Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. , 2003, Radiology.

[9]  G. Morana,et al.  Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study. , 2005, Radiology.

[10]  A. Gamst,et al.  Double-contrast MRI for accurate staging of hepatocellular carcinoma in patients with cirrhosis. , 2008, AJR. American journal of roentgenology.

[11]  G. Morana,et al.  Focal nodular hyperplasia: morphologic and functional information from MR imaging with gadobenate dimeglumine. , 2001, Radiology.

[12]  T. Moteki,et al.  Evaluation of hepatic lesions and hepatic parenchyma using diffusion‐weighted reordered turboFLASH magnetic resonance images , 2002, Journal of magnetic resonance imaging : JMRI.

[13]  Bachir Taouli,et al.  Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience. , 2007, AJR. American journal of roentgenology.

[14]  D. Le Bihan,et al.  Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. , 1988, Radiology.

[15]  Double-contrast MRI (DC-MRI) in the study of the cirrhotic liver: utility of administering Gd-DTPA as a complement to examinations in which SPIO liver uptake and distribution alterations (SPIO-LUDA) are present and in the identification and characterisation of focal lesions , 2006, La radiologia medica.

[16]  M Takahashi,et al.  Focal liver masses: characterization with diffusion-weighted echo-planar MR imaging. , 1997, Radiology.

[17]  S. Laurberg,et al.  The value of contrast enhanced ultrasonography in detection of liver metastases from colorectal cancer: a prospective double-blinded study. , 2007, European journal of radiology.