title: Utility of R2* obtained from T2*-weighted imaging in differentiating hepatocellular carcinomas from cavernous hemangiomas of the liver.
abstract: OBJECTIVE
  To evaluate the feasibility of applying R2* values to differentiate hepatocellular carcinomas (HCC) from cavernous hemangiomas of the liver (CHL).
  
  
  METHODS
  This retrospective study was approved by the participating Institutional Review Board and written informed consent for all subjects were obtained. Seventy-three patients with 79 pathologically identified HCCs and 65 patients with 91 clinically or pathologically identified CHLs were enrolled in this study. All subjects underwent a breath-hold multi-echo T2* weighted MR imaging on a 1.5 T clinical MR scanner. R2* values from HCC and CHL groups were compared using the Mann-Whitney non-parametric U test. A cut-off value of R2* was evaluated with receiver operator characteristic (ROC) analysis.
  
  
  RESULTS
  The mean R2* value was 23.32 ± 12.23 Hz (95% confidence interval [CI]: 20.58 Hz, 26.06 Hz) for the HCC group, and 3.66 ± 2.37 Hz (95% CI: 3.17 Hz, 4.15 Hz) for the CHL group. The mean R2* value for HCC was significantly higher than that of CHL (p<0.001). A threshold of 9.48 Hz for the minimum R2* value in the diagnosis of HCC resulted in a sensitivity of 96.20% (76 out of 79 patients), and a specificity of 97.80% (89 out of 91 patients). The positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy for HCC were 97.44% (76 out of 78 patients), 96.74% (89 out of 92 patients) and 97.06% (165 out of 170 patients), respectively. The AUC for differentiation between these two groups was 0.994 (95% CI: 0.980, 1.000).
  
  
  CONCLUSIONS
  R2* is a significant MRI biomarker to differentiate HCC from CHL with satisfying sensitivity and specificity.
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Meiyu
authors.initials: M
authors.lastname: Sun
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China; Department of CT and MRI, Fuxin Mineral Hospital, Fuxin, Liaoning, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Song
authors.affiliation: Department of Ultrasound, Hunan Provincial Tumor Hospital and Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, Hunan, China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Heqing
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Dianxiu
authors.initials: D
authors.lastname: Ning
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.affiliation: Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Ailian
authors.initials: A
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies