Focal Liver Lesion Classification and Characterization in Noncirrhotic Liver

Stefano Colagrande, Francesco Regini, Filippo Pasquinelli, Lorenzo Nicola Mazzoni, Francesco Mungai, Antonella Filippone, Luigi Grazioli
2013 Journal of computer assisted tomography  
Purpose: The objective of this study was to prospectively verify if diffusion-weighted magnetic resonance (DwMR)-related parameters such as perfusion fraction ( f ) and slow diffusion coefficient (D), according to Le Bihan theory, are more effective than apparent diffusion coefficient (ADC) for classification and characterization of the more frequent focal liver lesions (FLLs) in noncirrhotic liver. Methods: Sixty-seven patients underwent standard liver magnetic resonance imaging (MRI) and
more » ... breath multi-b DwMR study. Two regions of interest were defined by 2 observers, including 1 FLL for each patient (21 hemangiomas, 21 focal nodular hyperplasias, 25 metastases) and part of surrounding parenchyma, respectively. For every FLL, D, f, and ADC were estimated both as absolute value and as ratio between FLL and surrounding parenchyma by fitting the reduced equation of the bicompartmental model to experimental data; t test, analysis of variance, and receiver operating characteristic analysis were performed. Results: t Test showed significant differences in ADC lesion , f lesion , D lesion , ADC ratio , and D ratio values between benign and malignant FLLs, more pronounced for ADC lesion (P < 0.0009) and ADC ratio (P = 0.001). Applying cutoff values of 1.55 × 10 −3 mm 2 /s (ADC lesion ) and 0.89 (ADC ratio ), the DwMR study presented sensitivities and specificities, respectively, of 84% and 80% (for ADC lesion ), 72% and 80% (ADC ratio ). Conclusions: Apparent diffusion coefficient (by fitting procedures) better performs than do D and f in FLL classification, especially when its values are less than 1.30 or greater than 2.00 × 10 −3 mm 2 /s.
doi:10.1097/rct.10.1097/rct.0b013e3182951fe9 pmid:23863532 fatcat:awt5hpjmlva2jp6z3eg6b53mui