title: Comparison of the Accuracy of DWI and Ultrasonography in Screening Hepatocellular Carcinoma in Patients With Chronic Liver Disease.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a neoplasm usually arising in a cirrhotic liver by a multistep carcinogenesis process. Early detection of HCC and accurate assessment of tumor burden are crucial to successful treatment planning and long-term survival.
  
  
  OBJECTIVE
  In this study, we compared the accuracy of diffusion weighted imaging (DWI) combined with limited sequence magnetic resonance imaging (MRI) set as a potentially quick and practical MR candidate with ultrasonography (US) for screening of HCC in patients with cirrhosis.
  
  
  METHODS
  Of 96 patients with cirrhosis, 30 who had concomitant HCC proved by pathology were selected. MRI, DWI, and US of the liver were performed for the patients. Sensitivity, specificity, and accuracy of DWI alone, limited sequences MRI alone, a combination of them, and US were calculated for the detection of HCC in these patients and then comparison between these modalities was performed.
  
  
  RESULTS
  Combination of limited sequences MRI and DWI had the highest accuracy (94.79%) followed by DWI alone followed by limited sequence MRI alone. The least accuracy was for US (78.12%) with a statistically significant difference.
  
  
  CONCLUSIONS
  Due to the significant improvement in the treatment of early stage of HCC compared to the previous decade, we suggest a fast, non-invasive, more accurate, but more expensive method (HASTE, OP/IP T1W sequences MRI combined with DWI) rather than US for the screening of HCC in liver cirrhosis.
authors.affiliation: Colorectal Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Jalli
authors.affiliation: Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Hamed
authors.initials: SH
authors.lastname: Jafari
authors.affiliation: Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Sefidbakht
authors.affiliation: Department of General Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Kazemi
keywords: Diffusion Magnetic Resonance Imaging; Hepatocellular Carcinoma; Liver Cirrhosis; Ultrasonography