title: Characterizing focal hepatic lesions by free-breathing intravoxel incoherent motion MRI at 3.0 T.
abstract: BACKGROUND
  Diffusion-weighted (DW) imaging is commonly used to distinguish between benign and malignant liver lesions.
  
  
  OBJECTIVE
  To prospectively evaluate the true molecular-diffusion coefficient (D), perfusion-related diffusion coefficient (D*), perfusion fraction (f), and ADC of focal hepatic lesions using a free-breathing intravoxel incoherent motion (IVIM) DW sequence, and to determine if these parameters are useful for characterizing focal hepatic lesions.
  
  
  METHODS
  One hundred and twenty hepatic lesions (34 metastases, 32 hepatocellular carcinoma [HCC], 33 hemangiomas, and 21 liver cysts) in 74 patients were examined. Mean D, D*, f, and ADC values of hepatic lesions were compared among pathologies. ROC curve analyses were performed to assess the performances of D, D*, f, and ADC values for the characterization of liver lesions as benign or malignant.
  
  
  RESULTS
  The mean D and ADC values of benign lesions were greater than those of malignant lesions (P < 0.001). Although the mean D and ADC values of liver cysts were greater than those of hemangiomas (P < 0.001), and these values were not significantly different between metastases and HCCs (P = 0.99). Area under the ROC curve for ADC values (0.98) was significantly greater (P = 0.048) than that for D values (0.96) for the differentiation of benign and malignant lesions. Sensitivity and specificity for the detection of malignant lesion were 89% and 98%, respectively, when an ADC cut-off value of 1.40 was applied.
  
  
  CONCLUSIONS
  D and ADC values have more potential for characterizing focal hepatic lesions than D* or f values, and for the differentiation of malignancy and benignity.
authors: Department of Radiology, Gifu Central Hospital, Gifu, Japan Department of Radiology, Gifu University Hospital, Gifu, Japan haruwow860@yahoo.co.jp.
authors: Haruo
authors: H
authors: Watanabe
authors: Department of Radiology, Gifu University Hospital, Gifu, Japan Radiology Services, Gifu University Hospital, Gifu, Japan.
authors: Masayuki
authors: M
authors: Kanematsu
authors: Department of Radiology, Gifu University Hospital, Gifu, Japan.
authors: Satoshi
authors: S
authors: Goshima
authors: Radiology Services, Gifu University Hospital, Gifu, Japan.
authors: Kimihiro
authors: K
authors: Kajita
authors: Department of Radiology, Gifu University Hospital, Gifu, Japan.
authors: Hiroshi
authors: H
authors: Kawada
authors: Department of Radiology, Gifu University Hospital, Gifu, Japan.
authors: Yoshifumi
authors: Y
authors: Noda
authors: Department of Radiology, Gifu University Hospital, Gifu, Japan.
authors: Yukichi
authors: Y
authors: Tatahashi
authors: Department of Radiology, Gifu University Hospital, Gifu, Japan.
authors: Nobuyuki
authors: N
authors: Kawai
authors: Department of Radiology, Gifu University Hospital, Gifu, Japan.
authors: Hiroshi
authors: H
authors: Kondo
authors: Research Center for Cancer Prevention and Screening, National Cancer Center Hospital, Tsukiji, Japan.
authors: Noriyuki
authors: N
authors: Moriyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D003560:Cysts / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012119:Respiration; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Hepatic nodule; Intravoxel incoherent motion; diffusion