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European Radiology
Published in: European Radiology 2/2016

01-02-2016 | Hepatobiliary-Pancreas

Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions

Authors: Tiffany P. Hennedige, James Thomas Patrick Decourcy Hallinan, Fiona P. Leung, Lynette Li San Teo, Sridhar Iyer, Gang Wang, Stephen Chang, Krishna Kumar Madhavan, Aileen Wee, Sudhakar K. Venkatesh

Published in: European Radiology | Issue 2/2016

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Abstract

Objectives

Comparison of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) for differentiating malignant and benign focal liver lesions (FLLs).

Methods

Seventy-nine subjects with 124 FLLs (44 benign and 80 malignant) underwent both MRE and DWI. MRE was performed with a modified gradient-echo sequence and DWI with a free breathing technique (b = 0.500). Apparent diffusion coefficient (ADC) maps and stiffness maps were generated. FLL mean stiffness and ADC values were obtained by placing regions of interest over the FLLs on stiffness and ADC maps. The accuracy of MRE and DWI for differentiation of benign and malignant FLL was compared using receiver operating curve (ROC) analysis.

Results

There was a significant negative correlation between stiffness and ADC (r = −0.54, p < 0.0001) of FLLs. Malignant FLLs had significantly higher mean stiffness (7.9kPa vs. 3.1kPa, p < 0.001) and lower mean ADC (129 vs. 200 × 10−3mm2/s, p < 0.001) than benign FLLs. The sensitivity/specificity/positive predictive value/negative predictive value for differentiating malignant from benign FLLs with MRE (cut-off, >4.54kPa) and DWI (cut-off, <151 × 10−3mm2/s) were 96.3/95.5/97.5/93.3 % (p < 0.001) and 85/81.8/88.3/75 % (p < 0.001), respectively. ROC analysis showed significantly higher accuracy for MRE than DWI (0.986 vs. 0.82, p = 0.0016).

Conclusion

MRE is significantly more accurate than DWI for differentiating benign and malignant FLLs.

Key points

• MRE is superior to DWI for differentiating benign and malignant focal liver lesions.
• Benign lesions with large fibrous components may have higher stiffness with MRE.
• Cholangiocarcinomas tend to have higher stiffness than hepatocellular carcinomas.
• Hepatocellular adenomas tend to have lower stiffness than focal nodular hyperplasia.
• MRE is superior to conventional MRI in differentiating benign and malignant liver lesions.
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Metadata
Title
Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions
Authors
Tiffany P. Hennedige
James Thomas Patrick Decourcy Hallinan
Fiona P. Leung
Lynette Li San Teo
Sridhar Iyer
Gang Wang
Stephen Chang
Krishna Kumar Madhavan
Aileen Wee
Sudhakar K. Venkatesh
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3835-8

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