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Diffusion-weighted MRI provides additional value to conventional dynamic contrast-enhanced MRI for detection of hepatocellular carcinoma

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Abstract

The purpose of this study was to evaluate the accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating HCC from benign cirrhotic lesions compared with conventional dynamic contrast-enhanced MRI. Fifty-five patients with cirrhosis underwent conventional and DW-MRI at 1.5 Tesla. Signal intensity ratios (SIratio) of solid liver lesions to adjacent hepatic parenchyma were measured for b0, b100, b600 and b1000, and the apparent diffusion coefficients (ADC) were calculated. In 27 patients, imaging results were compared to histopathology, and in 28 patients, to imaging follow-up. Based on predetermined thresholds, sensitivity and specificity of DW-MRI and conventional MRI were compared. SIratio was significantly different between malignant and benign lesions at all b-values (P < 0.0001). No significant difference in ADC was seen (P = 0.47). For detection of malignant lesions, DW-MRI with b600-SIratio yielded a sensitivity of 95.2% compared to 80.6% for conventional MRI (P = 0.023) and a specificity of 82.7% compared to 65.4% (P = 0.064). The improved accuracy was most beneficial for differentiating malignant lesions smaller than 2 cm. DW-MRI with b600-SIratio improved the detection of small HCC and the differentiation of pseudotumoral lesions compared with conventional MRI.

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Acknowledgements

This work was partly financially supported by the research grant ‘Prof. Em. A. L. Baert, Siemens Medical Solutions’.

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Authors and Affiliations

  1. Department of Radiology, University Hospitals Leuven, B-3000, Leuven, Belgium

    Vincent Vandecaveye, Frederik De Keyzer, Katya Op de Beeck, Ilse Roebben, Didier Bielen & Steven Dymarkowski

  2. Department of Hepatology, University Hospitals Leuven, Leuven, Belgium

    Chris Verslype & Frederik Nevens

  3. Department of Pathology, University Hospitals Leuven, Leuven, Belgium

    Mina Komuta & Tania Roskams

  4. Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium

    Baki Topal

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  1. Vincent Vandecaveye
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Correspondence to Vincent Vandecaveye.

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Vandecaveye, V., De Keyzer, F., Verslype, C. et al. Diffusion-weighted MRI provides additional value to conventional dynamic contrast-enhanced MRI for detection of hepatocellular carcinoma. Eur Radiol 19, 2456–2466 (2009). https://doi.org/10.1007/s00330-009-1431-5

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