Comparison of diffusion-weighted with T2-weighted Imaging for detection of small hepatocellular carcinoma in cirrhosis: preliminary quantitative study at 3-T.
OBJECTIVE
To compare diffusion-weighted (DW) with standard T2-weighted imaging for quantitative evaluation of small hepatocellular carcinoma (HCC) in cirrhosis.


METHODS
Fourteen patients (all men; mean age, 58.6 years; age range, 45-69 years) with 22 small HCCs (<3 cm and >1 cm in diameter) in cirrhosis were included in the study. DW imaging with breath-hold single-shot echo planar imaging (b = 0, 800 seconds/mm(2)) and T2-weighted imaging with respiratory triggering fat-suppressed fast spin-echo sequence were performed on a 3-T magnetic resonance unit using an eight-channel torso phased-array coil. The signal intensity (SI) of HCC and liver were measured at workstation. Contrast-to-noise ratio (CNR), contrast ratio (CR, SI(lesion)/SI(liver)), and apparent diffusion coefficient (ADC) values were calculated. CNRs and CRs obtained with DW and T2-weighted images, and ADCs of HCC and liver were compared using nonparametric tests.


RESULTS
Two lesions were excluded because of artifacts on DW images. Thus 20 lesions were analyzed. The CNRs obtained with T2-weighted images (27.12 + or - 21.12) were significantly higher (P = .02) than those with DW images (17.52 + or - 13.50). There were no significant difference between the CRs obtained with T2-weighted images (1.83 + or - 0.56) and DW images (2.01 + or - 0.67). There were no significant difference between the mean ADCs of HCC (1.22 x 10(-3) mm(2)/second + or - 0.24) and the cirrhotic liver (1.17 x 10(-3) mm(2)/second + or - 0.17), either.


CONCLUSIONS
DW imaging with high b value was not superior to standard T2-weighted imaging in terms of lesion conspicuity of small HCC in cirrhosis.
Wang
Hua
H
Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.
Wang
Xiao-Ying
XY
Jiang
Xue-Xiang
XX
Ye
Zhao-Xiang
ZX
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity