title: Diffusion weighted MR and apparent diffusion coefficient measurement in classification and characterization of noncystic focal liver lesions: does a clinical role exist?
abstract: The objective of this study was to assess the clinical role of apparent diffusion coefficient (ADC) analysis in noncystic focal liver lesion (FLL) classification/characterization.Six hundred liver magnetic resonances with multi-b (b = 50, 400, 800 s/mm) diffusion-weighted imaging (DwI) were retrospectively reviewed. Mean ADC was measured in 388 lesions (195 benign and 193 malignant) excluding internal necrotic areas. Cystic benign lesions were excluded from analysis. Sensitivity and specificity in distinguishing benign from malignant lesions were calculated. Analysis of variance was performed to detect differences among subgroups of solid lesions.Mean ADC of malignant lesions was 0.980 × 10 mm/s, significantly (P < 0.05) lower than mean ADC of benign lesions (1.433 × 10 mm/s). Applying an ADC cutoff of 1.066 × 10 mm/s, specificity and sensitivity for malignancy were respectively 86.6% and 73.6%. Of all lesions, >1/3 (39.5%) presented values lower than 1 × 10 mm/s, with 90.0% chance of malignancy. Above 1.5 × 10 mm/s (about 20% of all lesions) chance of malignancy was 9.5%.DwI cannot assist in noncystic FLL characterization, but can help in FLL classification in about half the cases.
authors: Department of Radiology (MM, MPB, LG), Institute of Hygiene, Epidemiology and Public Health, University of Brescia, Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, Department of Radiology (AV), Ospedale S. Cuore di Gesù, Viale Principe di Napoli, 14/A, Benevento, and Department of Experimental and Clinical Biomedical Sciences (FM, SC), Radiodiagnostic Unit no. 2 and Department of Physics (LNM), University of Florence, Azienda Ospedaliero, Universitaria Careggi, Largo Brambilla 3, Florence, Italy.
authors: Francesco
authors: F
authors: Mungai
authors: Mario
authors: M
authors: Morone
authors: Alberta
authors: A
authors: Villanacci
authors: Maria Pia
authors: MP
authors: Bondioni
authors: Lorenzo Nicola
authors: LN
authors: Mazzoni
authors: Luigi
authors: L
authors: Grazioli
authors: Stefano
authors: S
authors: Colagrande
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000145:classification* / Q000175:diagnosis / Q000473:pathology*; D008113:Liver Neoplasms / Q000145:classification* / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012015:Reference Standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity