title: Diagnostic accuracy of diffusion-weighted MRI for identifying hepatocellular carcinoma with liver explant correlation.
abstract: BACKGROUND
  The goal of this study was to use liver explant correlation to assess the diagnostic accuracy of diffusion-weighted (DW)-MRI for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Thirty-seven patients were retrospectively identified who had undergone liver transplantation and had preoperative, respiratory-triggered, single-shot echo-planar DW-MRI. Two independent blinded observers evaluated the DW-MRI images for HCC and comparison was made with the explanted specimens.
  
  
  RESULTS
  By pathology, 29 HCCs (mean largest diameter 2.0 cm; range 0.7-4.0 cm) were identified in 20 patients. Sensitivity and specificity for reader 1 were 55 and 92%, and for reader 2 were 45 and 100%. There was 'substantial' inter-observer agreement (kappa = 0.64).
  
  
  CONCLUSIONS
  DW-MR is not sensitive enough for HCC to be used as a stand-alone sequence, although its high specificity suggests that it is likely valuable as a component of a liver MRI protocol.
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina 29401, USA. andrewdhardie@gmail.com
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hardie
authors.forename: Michael K
authors.initials: MK
authors.lastname: Kizziah
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Boulter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity