Determination of malignancy and characterization of hepatic tumor type with diffusion-weighted magnetic resonance imaging: comparison of apparent diffusion coefficient and intravoxel incoherent motion-derived measurements

Sabrina Doblas, Mathilde Wagner, Helena S Leitao, Jean-Luc Daire, Ralph Sinkus, Valérie Vilgrain, Bernard E Van Beers

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58 Citations (Scopus)

Abstract

Objective: The objective of this study was to compare the value of the apparent diffusion coefficient (ADC) determined with 3 b values and the intravoxel incoherent motion (IVIM)–derived parameters in the determination of malignancy and characterization of hepatic tumor type. Materials and Methods: Seventy-six patients with 86 solid hepatic lesions, including 8 hemangiomas, 20 lesions of focal nodular hyperplasia, 9 adenomas, 30 hepatocellular carcinomas, 13 metastases, and 6 cholangiocarcinomas, were assessed in this prospective study. Diffusion-weighted images were acquired with 11 b values to measure the ADCs (with b = 0, 150, and 500 s/mm2) and the IVIM-derived parameters, namely, the pure diffusion coefficient and the perfusion-related diffusion fraction and coefficient. The diffusion parameters were compared between benign and malignant tumors and between tumor types, and their diagnostic value in identifying tumor malignancy was assessed. Results: The apparent and pure diffusion coefficients were significantly higher in benign than in malignant tumors (benign: 2.32 [0.87] × 10−3 mm2/s and 1.42 [0.37] × 10−3 mm2/s vs malignant: 1.64 [0.51] × 10−3 mm2/s and 1.14 [0.28] × 10−3 mm2/s, respectively; P < 0.0001 and P = 0.0005), whereas the perfusion-related diffusion parameters did not differ significantly between the 2 groups. The apparent and pure diffusion coefficients provided similar accuracy in assessing tumor malignancy (areas under the receiver operating characteristic curve of 0.770 and 0.723, respectively). In the multigroup analysis, the ADC was found to be significantly higher in hemangiomas than in hepatocellular carcinomas, metastases, and cholangiocarcinomas. In the same manner, it was higher in lesions of focal nodular hyperplasia than in metastases and cholangiocarcinomas. However, the pure diffusion coefficient was significantly higher only in hemangiomas versus hepatocellular and cholangiocellular carcinomas. Conclusions: Compared with the ADC, the diffusion parameters derived from the IVIM model did not improve the determination of malignancy and characterization of hepatic tumor type.
Original languageEnglish
Pages (from-to)722-728
Number of pages7
JournalInvestigative Radiology
Volume48
Issue number10
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Adult
  • Aged
  • Algorithms
  • Artifacts
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Image Enhancement
  • Image Interpretation, Computer-Assisted
  • Imaging, Three-Dimensional
  • Liver Neoplasms
  • Male
  • Middle Aged
  • Motion
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tumor Burden
  • Young Adult

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