title: Additional Value of Diffusion-weighted MRI to Gd-EOB-DTPA-enhanced Hepatic MRI for the Detection of Liver Metastasis: the Difference Depending on the Experience of the Radiologists.
abstract: This retrospective study was to investigate whether adding diffusion-weighted imaging (DWI) to Gd-EOB-DTPA-enhanced MRI (EOB-MRI) improved the detection of liver metastasis in radiology resident and board-certified radiologist groups. It was approved by our institutional review board. We selected 18 patients with 35 liver metastases and 12 patients without liver tumors. Five board-certified radiologists and 5 radiology residents participated in the observer performance study. Each observer first interpreted T1- and T2-weighted-, plain-, arterial phase-, and hepatobiliary phase images and specified the location of the liver metastases. The software subsequently displayed the DWI images simultaneously and all participants repeated the reading. We used Jackknife alternative free-response receiver operating characteristic (JAFROC) analysis to compare the observer performance in detecting liver metastases. The mean values for the area under the curve (AUC) for EOB-MRI without and with DWI were 0.78 ± 0.13 [standard deviation: SD] and 0.87 ± 0.09, respectively, for the radiology residents, and the difference was statistically significant (p = 0.045). For the board- certified radiologists these values were 0.92 ± 0.02 and 0.96 ± 0.01, respectively, and the difference was not statistically significant (p = 0.092). EOB-MRI with DWI significantly improved the performance of radiology residents in the identification of liver metastases.
authors.forename: Wataru
authors.initials: W
authors.lastname: Fukumoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Toru
authors.initials: T
authors.lastname: Higaki
authors.forename: Fuminari
authors.initials: F
authors.lastname: Tatsugami
authors.forename: Makoto
authors.initials: M
authors.lastname: Iida
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
mesh_terms: D019540:Area Under Curve; D002568:Certification; D002983:Clinical Competence; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D019786:Gadolinium DTPA; D006801:Humans; D007396:Internship and Residency; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary*; D015588:Observer Variation; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA