Role of 3-T diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant hepatic lesions

Abstract

Aim: To evaluate the ability of DWIs to distinguish between benign and malignant focal hepatic lesions (FHLs) using 3 T MR. Material and methods: A total of 73 FHLs in 48 patients were evaluated. There were 28 benign lesions including 13 hemangiomas (17.8%), 8 hepatic cysts (10.9%), 4 regenerating hepatic nodules (5.4%), 2 adenomas (2.7%) and 1 focal fatty infiltration (1.3%). The others 45 lesions were malignant including 28 hepatocellular carcinomas (38.3%), 15 metastases (20.5%) and 2 cholangiocarcinomas (2.7%). The study used two b values (0 and 800 s/mm2) and the ADC values were calculated. Results: The mean ADC value for simple liver cysts was 2.58 ± 0.35 × 10−3 mm2/s, for solid benign lesions was 1.63 ± 0.41 × 10−3 mm2/s and for malignant lesions was 1.21 ± 0.38 × 10−3 mm2/s with statistical difference (p < 0.0001). We found that the best ADC cutoff value was 1.49 × 10−3 mm2/s with accuracy of 83.6% in differentiation between the all benign and malignant FHLs. While with exclusion of the cystic hepatic lesions, the best ADC cutoff value was reduced to be 1.35 × 10−3 mm2/s with accuracy of 78.5%. Conclusions: DWI can be used to differentiate between the benign and malignant FHLs.

Keywords

• Diffusion weighted imaging
• 3 T
• Hepatic focal lesions
• Magnetic resonance imaging