title: Apparent Diffusion Coefficient Quantification in Determining the Histological Diagnosis of Malignant Liver Lesions.
abstract: OBJECTIVE
  Diffusion Weighted Imaging is an established diagnostic tool for accurate differential diagnosis between benign and malignant liver lesions. The aim of our study was to evaluate the role of Histogram Analysis of ADC quantification in determining the histological diagnosis as well as the grade of malignant liver tumours. To our knowledge, there is no study evaluating the role of Histogram Analysis of ADC quantification in determining the histological diagnosis as well as the grade of malignant liver tumours.
  
  
  METHODS
  During five years, 115 patients with known liver lesions underwent Diffusion Weighted Imaging in 3Tesla MR scanner prior to core needle biopsy. Histogram analyses of ADC in regions of interest were drawn and were correlated with biopsy histological diagnosis and grading.
  
  
  RESULTS
  Histogram analysis of ADC values shows that 5th and 30th percentile parameters have statistically significant potency of discrimination between primary and secondary lesions groups (p values 0.0036 and 0.0125 respectively). Skewness of the histogram can help discriminate between good and poor differentiated (p value 0.17). Discrimination between primary malignancy site in metastases failed for the present number of patients in each subgroup.
  
  
  CONCLUSIONS
  Statistical parameters reflecting the shape of the left side of the ADC histogram can be useful for discriminating between primary and secondary lesions and also between well differentiated versus moderate or poor. For the secondary malignancies, they failed to predict the original site of tumour.
authors.affiliation: 1. Department of Radiology, Interbalkan Medical Centre, Thessaloniki, Greece;
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Drevelegas
authors.affiliation: 2. Research & Development, N.Papanikolaou & Associates LLC, Crete, Greece;
authors.forename: Katerina
authors.initials: K
authors.lastname: Nikiforaki
authors.affiliation: 1. Department of Radiology, Interbalkan Medical Centre, Thessaloniki, Greece;
authors.forename: Manolis
authors.initials: M
authors.lastname: Constantinides
authors.affiliation: 2. Research & Development, N.Papanikolaou & Associates LLC, Crete, Greece;
authors.forename: Nickolas
authors.initials: N
authors.lastname: Papanikolaou
authors.affiliation: 3. Department of Internal Medicine-Gastroenterology, Interbalkan Medical Centre, Thessaloniki, Greece;
authors.forename: Lavrentios
authors.initials: L
authors.lastname: Papalavrentios
authors.affiliation: 5. Department of Microbiolgy, George Gennimatas Hospital, Thessaloniki, Greece;
authors.forename: Ioanna
authors.initials: I
authors.lastname: Stoikou
authors.affiliation: 6. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: 6. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: Georgia
authors.initials: G
authors.lastname: Pitsiou
authors.affiliation: 6. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: Athanasia
authors.initials: A
authors.lastname: Pataka
authors.affiliation: 6. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: John
authors.initials: J
authors.lastname: Organtzis
authors.affiliation: 6. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: Eleni
authors.initials: E
authors.lastname: Papadaki
authors.affiliation: 6. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Porpodis
authors.affiliation: 7. Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Kougioumtzi
authors.affiliation: 6. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
authors.affiliation: 4. Department of Radiology, Ahepa University Hospital, Thessaloniki, Greece;
authors.forename: Constantinos
authors.initials: C
authors.lastname: Kouskouras
authors.affiliation: 3. Department of Internal Medicine-Gastroenterology, Interbalkan Medical Centre, Thessaloniki, Greece;
authors.forename: Evaggelos
authors.initials: E
authors.lastname: Akriviadis
authors.affiliation: 1. Department of Radiology, Interbalkan Medical Centre, Thessaloniki, Greece;
authors.forename: Antonios
authors.initials: A
authors.lastname: Drevelegas
keywords: Diffusion Weighted Imaging; biopsy.; histogram analysis; liver lesions