title: Hepatic lesions: discrimination of nonsolid, benign lesions from solid, malignant lesions with heavily T2-weighted fast spin-echo MR imaging.
abstract: OBJECTIVE
  To determine whether the combined use of heavily and moderately T2-weighted fast spin-echo magnetic resonance (MR) images improves differentiation of non-solid, benign hepatic lesions from solid malignancies.
  
  
  METHODS
  Three radiologists reviewed moderately (n = 133) and heavily (n = 133) T2-weighted and multiphasic dynamic contrast material-enhanced (n = 93) MR images in 133 patients with proved focal hepatic lesions (95 benign, 38 malignant). The radiologists used a five-point scale to rate their confidence in determination of malignancy.
  
  
  RESULTS
  All three reviewers were statistically significantly better able to differentiate small (diameter less than 3 cm; n = 84) benignancies from small malignancies with the combination of moderately and heavily T2-weighted images (area under the receiver operating characteristic curve, 0.99 for each reader) than with moderately T2-weighted images alone (area, 0.88-0.90; P < .05). Confident diagnoses were rendered in 69 (82%) patients, with 100% accuracy for the combined use of moderately and heavily T2-weighted images. For larger lesions (diameter 3 cm or larger; n = 49), accurate differentiation was possible with moderately T2-weighted images alone. Additional use of multiphasic images did not improve the sensitivity, specificity, or accuracy of image interpretation.
  
  
  CONCLUSIONS
  The combined use of moderately and heavily T2-weighted fast spin-echo MR images improves differentiation of small benign hepatic lesions from small malignant lesions.
authors.affiliation: Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
authors.forename: K
authors.initials: K
authors.lastname: Ito
authors.forename: D G
authors.initials: DG
authors.lastname: Mitchell
authors.forename: E K
authors.initials: EK
authors.lastname: Outwater
authors.forename: J
authors.initials: J
authors.lastname: Szklaruk
authors.forename: A G
authors.initials: AG
authors.lastname: Sadek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media