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Title
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Diagnosis of liver metastases : can diffusion-weighted imaging (DWI) be used as a stand alone sequence?
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Author
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Abstract
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| 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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Language
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English
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Source (journal)
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European journal of radiology. - Stuttgart
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Publication
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Stuttgart
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2012
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ISSN
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0720-048X
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DOI
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10.1016/J.EJRAD.2011.02.019
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Volume/pages
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81
:5
(2012)
, p. 1016-1023
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ISI
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000303108000049
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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