TY - JOUR
T1 - Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions
AU - Hennedige, Tiffany P.
AU - Hallinan, James Thomas Patrick Decourcy
AU - Leung, Fiona P.
AU - Teo, Lynette Li San
AU - Iyer, Sridhar
AU - Wang, Gang
AU - Chang, Stephen
AU - Madhavan, Krishna Kumar
AU - Wee, Aileen
AU - Venkatesh, Sudhakar K.
N1 - Funding Information:
The scientific guarantor of this publication is Sudhakar K Venkatesh. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by National Medical Research Council (NMRC), Singapore. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, cross sectional study, performed at one institution.
Publisher Copyright:
© 2015, European Society of Radiology.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - 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 fibrouscomponents 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.
AB - 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 fibrouscomponents 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.
KW - Benign liver lesion
KW - Diffusion-weighted MR imaging
KW - Focal liver lesions
KW - Magnetic resonance elastography
KW - Malignant liver lesion
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U2 - 10.1007/s00330-015-3835-8
DO - 10.1007/s00330-015-3835-8
M3 - Article
C2 - 26032879
AN - SCOPUS:84954360630
SN - 0938-7994
VL - 26
SP - 398
EP - 406
JO - European Radiology
JF - European Radiology
IS - 2
ER -