title: Comparison of the accuracy of diffusion-weighted imaging versus dynamic contrast enhancement magnetic resonance imaging in characterizing focal liver lesions.
abstract: OBJECTIVE
  The aim of this study was to compare the accuracy of liver magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) versus dynamic contrast enhancement (DCE) versus DWI and DCE in characterizing benign versus malignant lesions and in making correct diagnosis of focal liver lesions.
  
  
  METHODS
  Sixty-six adult patients with 115 lesions were evaluated by 2 readers for differentiating benign versus malignant lesions and for lesion diagnosis. The readers evaluated the lesions using unenhanced MRI with DWI and, 4 weeks later, using MRI with DCE and, subsequently, using MRI and DCE with DWI. The final pathologic diagnosis was reached by biopsy or with imaging follow-up.
  
  
  RESULTS
  The accuracy of differentiating benign versus malignant lesions of both readers 1 and 2 using DWI was 90.4%; using DCE, 91.3% and 90.4%, respectively; and using DCE with DWI, 98.3% and 95.7%, respectively. The accuracy of diagnosis of readers 1 and 2 using DWI was 83.5% and 80%; using DCE, 87% and 84.4%; and using DCE with DWI, 93.9% and 91.3%, respectively.
  
  
  CONCLUSIONS
  Unenhanced MRI with DWI and MRI with DCE have similar accuracy for characterizing focal liver lesions. Magnetic resonance imaging with DCE and DWI has increased accuracy compared with either sequence alone.
authors.affiliation: From the *Penn State Hershey Medical Center, Hershey, PA; and †Assiut University Hospital, Assiut, Egypt.
authors.forename: Rafel
authors.initials: R
authors.lastname: Tappouni
authors.forename: Reem Mohamed Ali
authors.initials: RM
authors.lastname: ElKady
authors.forename: Nabeel
authors.initials: N
authors.lastname: Sarwani
authors.forename: Thomas
authors.initials: T
authors.lastname: Dykes
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000473:pathology*; D019786:Gadolinium DTPA; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA