title: T2-weighted and diffusion-weighted MRI for discriminating benign from malignant focal liver lesions: diagnostic abilities of single versus combined interpretations.
abstract: OBJECTIVE
  To compare the diagnostic accuracies of diffusion-weighted imaging (DWI), T2-weighted imaging (T2WI), and the combination of both sequences in discriminating benign from malignant focal liver lesions (FLLs).
  
  
  METHODS
  In all, 166 patients with 269 FLLs (153 benign and 116 malignant) were retrospectively evaluated. Two abdominal readers visually assessed the DWI, T2WI, and the combined (DWI+T2WI) image sets in an independent and blinded manner. The diagnostic abilities of each image set in discriminating the benign from the malignant FLLs set were compared using a binary logistic regression model. Pathologic results, consensus reading, and follow-up imaging were used as the reference standard.
  
  
  RESULTS
  The overall characterization accuracy in all lesions of the combined set (80.3%) was significantly higher than those of the T2WI set (68.8%) and DWI set (73.2%) (combined vs. T2WI, P < 0.001; combined vs. DWI, P = 0.001), while there was no significant difference between the T2WI and DWI sets (P = 0.058). All image sets were more accurate in the characterization of malignant FLLs than of benign FLLs (P < 0.001).
  
  
  CONCLUSIONS
  T2WI and DWI are complementary in discriminating benign from malignant FLLs; their combination improves diagnostic confidence.
authors.affiliation: Department of Radiology, University of Brescia, Spedali Civili di Brescia, Brescia, Italy. karate.b@gmail.com
authors.forename: Hiroki
authors.initials: H
authors.lastname: Haradome
authors.forename: Luigi
authors.initials: L
authors.lastname: Grazioli
authors.forename: Mario
authors.initials: M
authors.lastname: Morone
authors.forename: Sebastiana
authors.initials: S
authors.lastname: Gambarini
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
authors.forename: Taro
authors.initials: T
authors.lastname: Takahara
authors.forename: Stefano
authors.initials: S
authors.lastname: Colagrande
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult