Diagnosis of liver metastases: value of diffusion-weighted MRI compared with gadolinium-enhanced MRI.
OBJECTIVE
The full diagnostic value of diffusion-weighted (DW) MRI in the evaluation of liver metastases remains uncertain. The aim of the present study was to assess the diagnostic accuracy of DW-MRI and contrast-enhanced MRI (CE-MRI) using extracellular gadolinium chelates, with the reference standard established by consensus interpretation of confirmatory imaging and histopathologic data.


METHODS
MR examinations of 51 patients with extrahepatic malignancies were retrospectively reviewed by two independent observers who assessed DW-MRI and CE-MRI for detection of liver metastases.


RESULTS
By reference standard, 93 liver lesions (49 metastases and 44 benign lesions) were identified in 27 patients, 11 patients had no liver lesions, and 13 patients had innumerable metastatic and/or benign lesions. There was no difference in diagnostic performance between the two methods for either observer for the diagnosis of metastatic lesions per patient. For per-lesion analysis, sensitivity of DW-MRI was equivalent to CE-MRI for observer 1 (67.3% vs. 63.3%, p = 0.67), but lower for observer 2 (65.3% vs. 83.7%, p = 0.007). By pooling data from both observers, the sensitivity of DW-MRI was 66.3% (65/98) and 73.5% (72/98) for CE-MRI, with no significant difference (p = 0.171).


CONCLUSIONS
DW-MRI is a reasonable alternative to CE-MRI for the detection of liver metastases.
Department of Radiology, NYU Langone Medical Center, 560 First Avenue, New York, NY 10016, USA.
Andrew D
AD
Hardie
Mohit
M
Naik
Elizabeth M
EM
Hecht
Hersh
H
Chandarana
Lorenzo
L
Mannelli
James S
JS
Babb
Bachir
B
Taouli
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000556:secondary*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D019786:Gadolinium DTPA