title: Hepatocellular Carcinoma and Diffusion-Weighted MRI: Detection and Evaluation of Treatment Response.
abstract: Differentiating between cancerous tissue and healthy liver parenchyma could represent a challenge with the only conventional Magnetic Resonance (MR) imaging. Diffusion weighted imaging (DWI) exploits different tissue characteristics to conventional Magnetic Resonance Imaging (MRI) sequences that enhance hepatocellular carcinoma (HCC) detection, characterization, and post-treatment evaluation. Detection of HCC is improved by DWI, infact this technology increases conspicuity of lesions that might otherwise not be identified due to obscuration by adjacent vessels or due to low contrast between the lesion and background liver. It is important to remember that DWI combined with contrast-enhanced MRI has higher sensitivity than DWI alone, and that some patients are not eligible for use of contrast on CT and MRI; in these patients DWI has a prominent role. MRI has advanced beyond structural anatomic imaging to now showing pathophysiologic processes. DWI is a promising way to characterize lesions utilizing the inherent contrast within the liver and has the benefit of not requiring contrast injection. DWI improves detection and characterization of HCC. Proposed clinical uses for DWI include: assessing prognosis, predicting response, monitoring response to therapy, and distinguishing tumor recurrence from treatment effect. Ideally, DWI will help risk stratify patients and will participate in prognostic modeling.
authors.affiliation: 1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C276, New York, NY 10065, USA.
authors.forename: Jill S
authors.initials: JS
authors.lastname: Gluskin
authors.affiliation: 2. Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Chegai
authors.affiliation: 3. IRCCS Fondazione SDN spa , Naples, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Monti
authors.affiliation: 2. Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Squillaci
authors.affiliation: 1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C276, New York, NY 10065, USA.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Mannelli
keywords: Diffusion weighted imaging (DWI); Hepatic carcinogenesis.; Hepatocellular Carcinoma