title: IVIM-diffusion-MRI for the differentiation of solid benign and malign hypervascular liver lesions-Evaluation with two different MR scanners.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) as the most common malign and benign liver tumors are both hypervascularized and potentially difficult to differentiate. DWI in liver MRI has been shown to be helpful in the classification of liver lesions, although with a substantial ADC-values-overlap. First results suggest that IVIM allows for improved characterization of liver lesions. In this study we evaluated IVIM-derived parameters in HCC and FNH with two different MR-scanners.
  
  
  METHODS
  72 patients (29 FNH, 43HCC) were examined prospectively using two 1.5 T-MRI scanners (Aera/MagnetomAvanto, Siemens, Germany). Quantitative analysis of IVIM-derived parameters and ADC800-values was performed independently by two radiologists. The concordance between the reviewers was tested using a Pearson-/Spearman-correlation. The mean values for significant differences between FNHs and HCCs and between the two MR scanners were compared using a two-tailed t-test/Mann-Whitney-U test. An ROC analysis assessing the diagnostic performance of the parameters was performed.
  
  
  RESULTS
  The concordance between the two f-, D- and D*-measurements were r=0.81, 0.81 and 0.84, and r=0.58 for ADC-values. D-values and ADC800-values were significantly lower in HCC compared to FNH (p<0.001), there was no significant difference for f and D*. D had the largest AUC (0.76) for the differentiation between the two entities. Most parameters were not significantly different between the two MRIs.
  
  
  CONCLUSIONS
  IVIM-derived D and ADC are comparable for the differentiation between HCC and FNH. Since ADC-measurement means less effort than IVIM, ADC should be used for the differentiation between the two entities. Furthermore, quantitative results obtained from different scanners match closely.
authors.affiliation: University of Heidelberg, Dpt. of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: miriam.klauss@med.uni-heidelberg.de.
authors.forename: Miriam
authors.initials: M
authors.lastname: Klauss
authors.affiliation: University of Heidelberg, Dpt. of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: philipp.mayer1@med.uni-heidelberg.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Mayer
authors.affiliation: DKFZ, Dept. of Medical and Biological Informatics, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. Electronic address: k.maier-hein@dkfz-heidelberg.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Maier-Hein
authors.affiliation: DKFZ, Dept. of Medical Physics in Medicine, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. Electronic address: f.laun@dkfz-heidelberg.de.
authors.forename: Frederik B
authors.initials: FB
authors.lastname: Laun
authors.affiliation: University of Heidelberg, Dpt. of Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: arineb.mehrabi@med.uni-heidelberg.de.
authors.forename: Arineb
authors.initials: A
authors.lastname: Mehrabi
authors.affiliation: University of Heidelberg, Dpt. of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Electronic address: hans-ulrich.kauczor@med.uni-heidelberg.de.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: University of Basel, Dept. of Radiology, Petersgraben 4, 4031 Basel, Switzerland. Electronic address: bram.stieltjes@usb.ch.
authors.forename: Bram
authors.initials: B
authors.lastname: Stieltjes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D055815:Young Adult
keywords: DWI; FNH; HCC; IVIM; Reproducibility