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Evaluation of hepatic focal lesions using diffusion‐weighted MR imaging: Comparison of apparent diffusion coefficient and intravoxel incoherent motion‐derived parameters
Author(s) -
Yoon Jeong Hee,
Lee Jeong Min,
Yu Mi Hye,
Kiefer Berthold,
Han Joon Koo,
Choi Byung Ihn
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24158
Subject(s) - intravoxel incoherent motion , medicine , effective diffusion coefficient , diffusion mri , nuclear medicine , magnetic resonance imaging , differential diagnosis , radiology , pathology
Purpose To determine whether parameters obtained from intravoxel incoherent motion (IVIM)‐diffusion‐weighted imaging (DWI) using multiple b‐values can improve characterization of common focal liver lesions (FLLs), compared with the apparent diffusion coefficient ( ADC total ). Materials and Methods Our Institutional Review Board approved this retrospective study and informed consent was waived. In all, 142 patients with 169 FLLs underwent liver magnetic resonance imaging (MRI) including IVIM‐DWI with multiple b factors at 3.0T. ADC total and IVIM‐DWI‐derived parameters including true diffusion ( D t ), pseudodiffusion ( D p ), and perfusion fraction ( f ) were calculated for each lesion and compared using dedicated software. Results D t and ADC total were significantly lower in malignancies (0.95 ± 0.21, 1.14 ± 0.24, (×10 −3 mm 2 /sec)) than in benign FLLs (1.61 ± 0.34, 1.72 ± 0.37, (×10 −3 mm 2 /sec)). In the differential diagnosis of malignancies from benign lesions, D t (Az value: 0.971) showed better diagnostic performance than ADC total (Az: 0.933) ( P < 0.0005). D t (Az: 0.961) also showed better diagnostic performance than ADC total (Az: 0.919) in differentiating hypervascular malignancies from benign hypervascular FLLs ( P < 0.0005). In addition, D p and f were significantly higher in hypervascular FLLs (35.74 ± 20.08 (×10 −3 mm 2 /sec), 28.14 ± 11.82 (%)) than hypovascular FLLs (21.87 ± 13.8 (×10 −3 mm 2 /sec), 12.2 ± 5.92 (%)) ( P < 0.0001). Conclusion D t provided better diagnostic performance than ADC total in differentiating benign from malignant lesions. D p and f were significant parameters for diagnosing hypervascular FLLs. J. Magn. Reson. Imaging 2014;39:276–285 . © 2013 Wiley Periodicals, Inc .