HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Supplemental Tables All Versions of this Article: 2463070432v1 246/3/812    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Parikh, T. Articles by Taouli, B. Search for Related Content PubMed PubMed Citation Articles by Parikh, T. Articles by Taouli, B.

Focal Liver Lesion Detection and Characterization with Diffusion-weighted MR Imaging: Comparison with Standard Breath-hold T2-weighted Imaging¹

¹ From the Department of Radiology, New York University Medical Center, 530 First Ave, MRI, New York, NY 10016. Received March 6, 2007; revision requested May 14; revision received June 21; accepted July 19; final version accepted September 17. Partially funded by an award received by T.P. from the Society of Body CT and MRI in 2006. Address correspondence to B.T. (e-mail: bachir.taouli{at}med.nyu.edu).

Purpose: To retrospectively compare diffusion-weighted (DW) magnetic resonance (MR) imaging with standard breath-hold T2-weighted MR imaging for focal liver lesion (FLL) detection and characterization, by using consensus evaluation and other findings as the reference standard.

Materials and Methods: Approval for this retrospective HIPAA-compliant study was obtained from the institutional review board; informed consent was waived. Fifty-three consecutive patients (30 men, 23 women; mean age, 60.7 years) with at least one FLL of 1 cm or greater in diameter were evaluated. Two independent observers reviewed DW (b values of 0, 50, and 500 sec/mm²) and T2-weighted images for FLL detection and characterization. Reference standard for diagnosis was obtained from consensus review by the two observers of DW, T2-weighted, and dynamic contrast material–enhanced images, pathologic data, and follow-up imaging results. Apparent diffusion coefficient (ADC) was measured for FLLs identified at consensus review. DW and T2-weighted images were compared for FLL detection and characterization by using a binary logistic regression model. Receiver operating characteristic curve analyses were conducted to evaluate the utility of ADC for diagnosis of malignancy.

Results: Two hundred eleven FLLs (136 malignant, 75 benign) were detected at consensus review. Overall detection rate (averaged for two observers) was significantly higher for DW (87.7%) versus T2-weighted (70.1%) imaging (P < .001). FLL characterization was not significantly different between DW (89.1%) and T2-weighted (86.8%) imaging (P = .51). ADCs of malignant FLLs were significantly lower than those of benign FLLs (P < .001). The area under the curve for diagnosis of malignancy was 0.839, with sensitivity of 74.2%, specificity of 77.3%, positive predictive value of 85.5%, negative predictive value of 62.3%, and accuracy of 75.3%, by using a threshold ADC of less than 1.60 x 10^–3 mm²/sec.

Conclusion: DW MR imaging was better than standard breath-hold T2-weighted imaging for FLL detection and was equal to breath-hold T2-weighted imaging for FLL characterization.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2463070432/DC1

© RSNA, 2008

This article has been cited by other articles:

				C. J. Lisanti and D. B. Douglas Effects of Breath-Hold and Cardiac Cycle on the MRI Appearance of the Aorta and Inferior Vena Cava in T2 Abdominal Imaging Am. J. Roentgenol., May 1, 2009; 192(5): 1348 - 1358. [Abstract] [Full Text] [PDF]

				H. Watanabe, M. Kanematsu, H. Kondo, S. Goshima, Y. Tsuge, M. Onozuka, and N. Moriyama Preoperative T Staging of Urinary Bladder Cancer: Does Diffusion-Weighted MRI Have Supplementary Value? Am. J. Roentgenol., May 1, 2009; 192(5): 1361 - 1366. [Abstract] [Full Text] [PDF]

				A. C. Silva, J. M. Evans, A. E. McCullough, M. A. Jatoi, H. E. Vargas, and A. K. Hara MR Imaging of Hypervascular Liver Masses: A Review of Current Techniques RadioGraphics, March 1, 2009; 29(2): 385 - 402. [Abstract] [Full Text] [PDF]

				A. C. Braithwaite, B. M. Dale, D. T. Boll, and E. M. Merkle Short- and Midterm Reproducibility of Apparent Diffusion Coefficient Measurements at 3.0-T Diffusion-weighted Imaging of the Abdomen Radiology, February 1, 2009; 250(2): 459 - 465. [Abstract] [Full Text] [PDF]

				E. J. Heffernan, T. Geoghegan, P. L. Munk, S. G. Ho, and A. C. Harris Recurrent Pyogenic Cholangitis: From Imaging to Intervention Am. J. Roentgenol., January 1, 2009; 192(1): W28 - W35. [Abstract] [Full Text] [PDF]