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

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

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

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 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.

Original languageEnglish (US)
Pages (from-to)398-406
Number of pages9
JournalEuropean radiology
Volume26
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • Benign liver lesion
  • Diffusion-weighted MR imaging
  • Focal liver lesions
  • Magnetic resonance elastography
  • Malignant liver lesion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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