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Eur J Radiol. 2012 May;81(5):1016-23. doi: 10.1016/j.ejrad.2011.02.019. Epub 2011 Mar 4.

Diagnosis of liver metastases: can diffusion-weighted imaging (DWI) be used as a stand alone sequence?

Author information

1
Department of Radiology, GZA Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk, Belgium. christophkenis@hotmail.com

Abstract

OBJECTIVES:

To evaluate if diffusion-weighted MRI (DWI) can replace gadolinium-enhanced MRI (Gd-MRI) for diagnosing liver metastases. The diagnostic accuracy of both techniques alone and in combination are compared.

MATERIALS AND METHODS:

Sixty-eight patients with histologically proven primary extrahepatic tumors were included in this retrospective study. Lesions included 62 metastases and 130 benign lesions. Three image sets (unenhanced T1 and T2/gadolinium enhanced T1 (Gd-MRI), DWI and combination of both) were reviewed independently by 3 observers. The areas under the receiver operating characteristic curves (A(z)), sensitivity and specificity for the 3 image sets were compared. The standard of reference was either histopathology or multi-modality and clinical follow-up.

RESULTS:

Pooled data showed higher diagnostic accuracy for the combined set (A(z)=0.93) compared to Gd-MRI (p=0.001) and DWI (p<0.0001). No difference was found between the performance of Gd-MRI and DWI (p=0.09). Sensitivity for the combined set was higher than Gd-MRI (p=0.0003) and DWI (p=0.0034). Specificity for DWI was lower than Gd-MRI (p<0.0001) and the combined set (p<0.0001).

CONCLUSION:

The diagnostic performance of DWI is equal to that of Gd-MRI. DWI alone can be used in patients where gadolinium contrast administration is not allowed. Combination of Gd-MRI and DWI significantly increases diagnostic accuracy.

PMID:
21377305
DOI:
10.1016/j.ejrad.2011.02.019
[Indexed for MEDLINE]
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