Diagnostic value of Diffusion Weighted Imaging in assessment of malignant focal liver lesions

Introduction: The study was designed to determine if there was a difference between apparent diffusion coefficient (ADC) values using diffusion weighted imaging (DWI) MRI technique between different malignant focal liver lesions. Patients and methods: The study included 63 patients with focal hepatic lesions: fourteen patients (22.2%) with hepatocellular carcinoma (HCC), 16 patients (25.4%) with hepatic metastatic colorectal tumors, 17 patients (26.9%) with cavernous haemangioma and 16 patients (25.4%) with hepatic cysts. MRI was performed with 1.5T scanner, using EPI sequence with ADC values being determined for all lesions based on three b values. Results: ADC values were statistically different among the groups (F=70.7, p<0.01): HCC patients 1.11+0.29x10- 3 s/mm2, metastatic tumours 2.18+0.15x10-3 s/mm2, haemangioma 2.22+0.32x10-3 s/mm2, cysts 3.08+0.03 x10-3 s/mm2. Furthermore, there was statistically significant difference between benign lesions (haemangioma and cysts, 2.36+0.43x10-3 s/mm2), and malignant diseases (HCC and secondary tumors, 1.52+0.58x10-3 s/mm2), t=5,6, p<0.01. Conclusion: DWI technique could be helpful in defining the focal liver lesions.

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Role of Quantitative Diffusion-Weighted Imaging in Differentiating Benign and Malignant Orbital Masses

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1730120 ◽

2021 ◽

Author(s):

Preeti Mundhada ◽

Sudarshan Rawat ◽

Ullas Acharya ◽

Dhananjay Raje

Keyword(s):

Roc Curve ◽

Diffusion Weighted Imaging ◽

Care Hospital ◽

Adc Value ◽

Diffusion Weighted ◽

Significant Difference ◽

Orbital Masses ◽

Adc Values ◽

Orbital Lesions

Abstract Aim To determine the role of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) values in differentiating benign and malignant orbital masses. Materials and Methods After obtaining institutional ethical board approval and informed consent from all patients, an observational study was done for a period of 24 months in the radiology department of a tertiary care hospital in South India. Conventional magnetic resonance imaging and DWI using a 3T scanner was done for all patients with suspected orbital mass lesion. ADC value and clinicohistopathological correlation were studied for every patient. Chi-square test was used to compare the signal characteristics of DWI and ADC maps between benign and malignant lesions. A comparison of mean ADC values for benign and malignant masses was performed using Student’s t-test for independent samples. The cut-off value for ADC was obtained using the receiver operating characteristic (ROC) curve. Results Of 44 patients with orbital lesions, 70% were benign and 30% were malignant. There was a significant difference in the mean ADC values of benign and malignant orbital masses. Using ROC curve analysis, an optimal ADC threshold of 1.26 × 10−3 mm2/s was calculated for the prediction of malignancy with 100% sensitivity, 80.65% specificity, and 86.36% accuracy (95% confidence interval: 0.872, 1.00, p < 0.0001). Two ADC thresholds were used to characterize the orbital masses with more than 90% confidence. Conclusion Quantitative assessment of ADC is a useful noninvasive diagnostic tool for differentiating benign and malignant orbital masses. Malignant orbital lesions demonstrate significantly lower ADC values as compared with benign lesions.

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Efficiency of diffusion-weighted MRI for differentiating radiologically similar simple and type I hydatid cysts of the liver

Acta Radiologica ◽

10.1177/0284185120988131 ◽

2021 ◽

pp. 028418512098813

Author(s):

Ilyas Dundar ◽

Mesut Ozgokce ◽

Fatma Durmaz ◽

Sercan Ozkacmaz ◽

Saim Turkoglu ◽

...

Keyword(s):

Treatment Options ◽

Type I ◽

Hydatid Cysts ◽

Liver Cysts ◽

Diffusion Weighted ◽

Significant Difference ◽

Mean Diameter ◽

Apparent Diffusion ◽

Adc Values ◽

Hepatic Lesions

Background Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications. Purpose To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances. Material and Methods This single-center prospective study was conducted during 2016–2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test. Results Of 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5–82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2–7.6 cm) and ADCmean value was 3.03 ± 0.47 (range 2.64–5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8–14 cm) and ADCmean value was 2.99 ± 0.29 (range 2.36–3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs Conclusion Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.

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The role of quantitative diffusion-weighted imaging in characterization of hypovascular liver lesions: A prospective comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient

PLoS ONE ◽

10.1371/journal.pone.0247301 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247301

Author(s):

Jelena Djokić Kovač ◽

Marko Daković ◽

Aleksandra Janković ◽

Milica Mitrović ◽

Vladimir Dugalić ◽

...

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Liver Metastases ◽

Diffusion Weighted Imaging ◽

Intraclass Correlation ◽

Intravoxel Incoherent Motion ◽

Liver Lesions ◽

Diffusion Weighted ◽

Significant Difference ◽

Apparent Diffusion

Background The utility of intravoxel incoherent motion (IVIM) related parameters in differentiation of hypovascular liver lesions is still unknown. Purpose The purpose of this study was to evaluate the value of IVIM related parameters in comparison to apparent diffusion coefficient (ADC) for differentiation among intrahepatic mass-forming cholangiocarcinoma (IMC), and hypovascular liver metastases (HLM). Methods Seventy-four prospectively enrolled patients (21 IMC, and 53 HLM) underwent 1.5T magnetic resonance examination with IVIM diffusion-weighted imaging using seven b values (0–800 s/mm2). Two independent readers performed quantitative analysis of IVIM-related parameters and ADC. Interobserver reliability was tested using a intraclass correlation coefficient. ADC, true diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (ƒ) were compared among the lesions using Kruskal-Wallis H test. The diagnostic accuracy of each parameter was assessed by receiver operating characteristic (ROC) curve analysis. Results The interobserver agreement was good for ADC (0.802), and excellent for D, D*, and ƒ (0.911, 0.927, and 0.942, respectively). ADC, and D values were significantly different among IMC and HLM (both p < 0.05), while there was no significant difference among these lesions for ƒ and D* (p = 0.101, and p = 0.612, respectively). ROC analysis showed higher diagnostic performance of D in comparison to ADC (AUC = 0.879 vs 0.821). Conclusion IVIM-derived parameters in particular D, in addition to ADC, could help in differentiation between most common hypovascular malignant liver lesions, intrahepatic mass—forming cholangiocarcinoma and hypovascular liver metastases.

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Clinical suspicion of spondylodiscitis with equivocal MRI findings: does diffusion-weighted imaging prove helpful here?

Acta Radiologica ◽

10.1177/0284185120927905 ◽

2020 ◽

pp. 028418512092790

Author(s):

Jeanette Henkelmann ◽

Kristina Bremicker ◽

Timm Denecke ◽

Karl-Titus Hoffmann ◽

Ralf Henkelmann ◽

...

Keyword(s):

Diffusion Weighted Imaging ◽

Characteristic Curve ◽

Area Under The Curve ◽

Region Of Interest ◽

High Sensitivity ◽

Diagnostic Value ◽

Mri Findings ◽

Adc Value ◽

Diffusion Weighted ◽

Adc Values

Background Despite the high sensitivity of magnetic resonance imaging (MRI), early detection of spondylodiscitis (SpD) remains challenging due to its low specificity. Purpose To assess the diagnostic value of diffusion-weighted imaging (DWI) in suspected cases of SpD with ambiguous early MRI findings in the differentiation of degenerative disorders (DD). Material and Methods In this prospective study, 52 patients suspected of having SpD underwent a whole-spine 3-T MRI scan comprising sagittal DWI. Of 58 conspicuous, T2-weighted, signal increased discs, 39 were successfully evaluated using DWI. Apparent diffusion coefficient (ADC) values and ADC maps were blindly analyzed using the region of interest of the conspicuous disc and a normal adjacent reference disc. Intraindividual ratios (conspicuous disc: reference disc) were calculated. Results All conspicuous discs showed increased absolute ADC values, which did not differ significantly between SpD (n = 22) and DD (n = 17). However, ADC ratio was significantly higher in SpD vs. DD ( P < 0.05). In receiver operating characteristic curve analysis, an ADC ratio threshold of 1.6 resulted in 45% sensitivity and 88% specificity (area under the curve = 0.69) for SpD diagnosis. Conclusion The absolute ADC value does not provide a reliable diagnosis of SpD. Increased diffusivity can be an indication of infection but should always be discussed in the context of existing disc degeneration.

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Diagnosis of focal liver lesions suspected of metastases by diffusion-weighted imaging (DWI): systematic comparison favors free-breathing technique

Clinical Imaging ◽

10.1016/j.clinimag.2012.02.018 ◽

2013 ◽

Vol 37 (1) ◽

pp. 97-103 ◽

Cited By ~ 12

Author(s):

Pascal A.T. Baltzer ◽

Juliane Schelhorn ◽

Matthias Benndorf ◽

Matthias Dietzel ◽

Werner A. Kaiser

Keyword(s):

Diffusion Weighted Imaging ◽

Free Breathing ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Systematic Comparison ◽

Diffusion Weighted

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Diffusion-Weighted Imaging with Two Differentb-Values in Detection of Solid Focal Liver Lesions

BioMed Research International ◽

10.1155/2016/8128207 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9

Author(s):

Da-wei Yang ◽

Ke-yang Wang ◽

Xun Yao ◽

Hui-yi Ye ◽

Tao Jiang ◽

...

Keyword(s):

Liver Disease ◽

Prospective Study ◽

Diffusion Weighted Imaging ◽

Detection Rate ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Diffusion Weighted ◽

Subgroup Analyses ◽

To Receive ◽

Mr Sequences

One hundred and eighty-two consecutive patients with suspected liver disease were recruited to receive diffusion-weighted imaging (DWI) with two differentb-values, in comparison with T2-weighted imaging (T2WI). The detection rate of three MR sequences in solid focal liver lesions (FLLs) and subgroup analyses were performed. Our prospective study found that DWI600 was equivalent to DWI100 and T2WI for the detection of solid FLLs overall but was significantly more accurate in the detection of malignant solid FLLs and lesions larger than 10 mm.

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The Correlation between Diffusion-Weighted Imaging and Histopathological Evaluation of 356 Prostate Biopsy Sites in Patients with Prostatic Diseases

ISRN Urology ◽

10.5402/2012/252846 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

R. Kilinç ◽

O. G. Doluoglu ◽

B. Sakman ◽

D. S. Ciliz ◽

E. Yüksel ◽

...

Keyword(s):

Prostate Biopsy ◽

Diffusion Weighted Imaging ◽

Definitive Treatment ◽

Apparent Diffusion Coefficients ◽

Prostate Biopsies ◽

Diffusion Weighted ◽

Significant Difference ◽

Adc Values ◽

The Difference ◽

Prostatic Diseases

Purpose. The aim of this study is to investigate the reliability of diffusion MRI for detection of cancer foci by comparing diffusion-weighted imaging (DWI) results and pathology results of prostate biopsy sites. Methods. Of the patients who applied with lower urinary tract symptoms, 36 patients who had suspected DRE and/or PSA ≥2.5 ng/mL were included in the study. Patients underwent DWI prior to 10 cores-prostate biopsy. 356 biopsy cores were obtained from the patients. Foci from the patients with prostate cancer were labeled as malignant or benign foci, likewise foci from the patients with benign pathology were grouped as BPH and inflammation foci. Apparent diffusion coefficients (ADCs) of biopsy groups were compared with each other in order to measure the reliability of DWI in detection of PCa foci. Results. When ADC values of adenocarcinoma foci and BPH foci were compared, a statistically significant difference was found (P<0.001). When ADC values obtained from adenocarcinoma foci and chronic inflammation foci are compared, the difference between two groups is statistically significant, too (P<0.001). Conclusions. Biopsies focused on suspected regions after formation of ADC maps by means of DWI would provide to start definitive treatment immediately as well as being beneficial to prevent morbidity related to repeated prostate biopsies.

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Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions

European Radiology ◽

10.1007/s00330-007-0798-4 ◽

2007 ◽

Vol 18 (3) ◽

pp. 486-492 ◽

Cited By ~ 174

Author(s):

Sofia Gourtsoyianni ◽

Nickolas Papanikolaou ◽

Spyros Yarmenitis ◽

Thomas Maris ◽

Apostolos Karantanas ◽

...

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Diffusion Weighted Imaging ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Diffusion Weighted ◽

Apparent Diffusion

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Diagnostic value of Virtual Touch Quantification (VTQ®) for differentiation of hemangiomas from malignant focal liver lesions

Medical Ultrasonography ◽

10.11152/mu-2062 ◽

2019 ◽

Vol 21 (4) ◽

pp. 371 ◽

Cited By ~ 1

Author(s):

Giovanni Galati ◽

Antonio De Vincentis ◽

Paolo Gallo ◽

Alessandro Guidi ◽

Umberto Vespasiani-Gentilucci ◽

...

Keyword(s):

Liver Metastases ◽

Shear Wave Velocity ◽

Abdominal Ultrasound ◽

Diagnostic Value ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Lower Shear ◽

Hepatocellular Carcinomas ◽

Significant Difference ◽

Malignant Lesions

Aim: To evaluate the diagnostic value of Virtual Touch Quantification (VTQ®) for characterizing benign vs. malignant focal liver lesions (FLLs).Material and methods: From January 2015 to January 2016 all consecutive FLLs visualized during a conventional abdominal ultrasound (US), underwent VTQ® evaluation, taking five measurements of both the lesion and the surrounding parenchyma.Results: We studied 119 FLLs, consisting of 52 hemangiomas (HEs), 39 hepatocellular carcinomas (HCCs), and 28 liver metastases (METs). HEs showed a significantly lower shear wave velocity (SWV) values compared to malignant FLLs (HEs SWV median value 1.34 m/sec, IQR 0.9; malignant lesions SWV median value 2.69 m/sec, IQR 1.6; p<0.001). Moreover, a nodule-to-parenchyma SWV ratio showed a significant difference in HEs and METs (p<0.001) but not in HCCs (p=0.03). SWV values were able to correctly differentiate malignant lesions with c-statistics of 0.82 (95 % CI 0.74- 0.90) and sensitivity of 74.6%/specificity of 80.7% at a cut-off of 2 m/sec.Conclusions: Our results suggest that VTQ® is able to distinguish HEs from malignant lesions (HCCs and METs) at a SWV cut-off of 2 m/sec.

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