Title
Diagnosis of liver metastases : can diffusion-weighted imaging (DWI) be used as a stand alone sequence? Diagnosis of liver metastases : can diffusion-weighted imaging (DWI) be used as a stand alone sequence?
Author
Faculty/Department
University Hospital Antwerp
Publication type
article
Publication
Stuttgart ,
Subject
Computer. Automation
Source (journal)
European journal of radiology. - Stuttgart
Volume/pages
81(2012) :5 , p. 1016-1023
ISSN
0720-048X
ISI
000303108000049
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
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. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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https://repository.uantwerpen.be/docman/iruaauth/4ea2ee/ec810322.pdf
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