The usefulness of diffusion-weighted imaging in the characterization of liver lesions in patients with cirrhosis

Tahir, Bilal; Patel, Aashish; Ramaswamy, R.; Bertrand, Kimberly A.; Akisik, Fatih; Saxena, Romil

doi:10.1016/j.crad.2012.10.023

Cited by 26 publications

(18 citation statements)

References 41 publications

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“…6) 85,94,95 . Well-differentiated HCC may be more frequently isointense than HCCs with higher tumor grade, however visual analysis of DW images alone is not reliable for this distinction 94,96 . The conspicuity and signal intensity of an HCC in a cirrhotic liver ultimately depend on a complex interaction between biologic and technical factors.…”

Section: Liver Applicationsmentioning

confidence: 99%

Diffusion-Weighted Imaging of the Liver

Lewis

Dyvorne

Cui

et al. 2014

Magnetic Resonance Imaging Clinics of North America

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SYNOPSIS Diffusion weighted MRI (DWI) is a technique that assesses the cellularity, tortuosity of the extracellular/extravascular space and cell membrane density based upon differences in water proton mobility in tissues. The strength of the diffusion weighting is reflected by the b-value. DWI using several b-values enables quantification of the apparent diffusion coefficient (ADC). DWI is increasingly employed in liver imaging for multiple reasons: it can add useful qualitative and quantitative information to conventional imaging sequences, it is acquired relatively quickly, it is easily incorporated into existing clinical protocols, and it is a non-contrast technique. DWI is useful for focal liver lesion detection and characterization, for the assessment of post-treatment tumor response and for evaluation of diffuse liver disease. ADC quantification can be used to characterize lesions as cystic/necrotic or solid and for predicting tumor response to therapy. Advanced diffusion methods such as IVIM (intravoxel incoherent motion) may have potential for detection, staging and evaluation of the progression of liver fibrosis and for liver lesion characterization. The lack of standardization of DWI technique including choice of b-values and sequence parameters has somewhat limited its widespread adoption.

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Section: Liver Applicationsmentioning

confidence: 99%

Diffusion-Weighted Imaging of the Liver

Lewis

Dyvorne

Cui

et al. 2014

Magnetic Resonance Imaging Clinics of North America

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“…This approach was initially applied to neurologic disorders [9]. Recently, numerous studies have been implemented to characterize abdominal and pelvic lesions [10–12]. Among them, one of the most promising applications is the detection of PCa with DWI.…”

Section: Introductionmentioning

confidence: 99%

The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis

2014

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ObjectivesTo evaluate the diagnostic performance of diffusion-weighted imaging (DWI) as a single non-invasive method in detecting prostate cancer (PCa) and to deduce its clinical utility.MethodsA systematic literature search was performed to identify relevant original studies. Quality of included studies was assessed by QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). Data were extracted to calculate sensitivity and specificity as well as running the test of heterogeneity and threshold effect. The summary receiver operating characteristic (SROC) curve was drawn and area under SROC curve (AUC) served as a determination of the diagnostic performance of DWI for the detection of PCa.ResultsA total of 21 studies were included, with 27 subsets of data available for analysis. The pooled sensitivity and specificity with corresponding 95 % confidence interval (CI) were 0.62 (95 % CI 0.61–0.64) and 0.90 (95 % CI 0.89–0.90), respectively. Pooled positive likelihood ratio and negative likelihood ratio were 5.83 (95 % CI 4.61–7.37) and 0.30 (95 % CI 0.23–0.39), respectively. The AUC was 0.8991. Significant heterogeneity was observed. There was no notable publication bias.ConclusionsDWI is an informative MRI modality in detecting PCa and shows moderately high diagnostic accuracy. General clinical application was limited because of the absence of standardized DW-MRI techniques.Key points• DWI provides incremental information for the detection and evaluation of PCa• DWI has moderately high diagnostic accuracy in detecting PCa• Patient condition, imaging protocols and study design positively influence diagnostic performance• General clinical application requires optimization of image acquisition and interpretation

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“…In a recent study, a new MRI criteria was proposed, combining the features of lesions after gadolinium-based contrast media administration and hyperintensity on DWI (19) . This significantly improved the sensitivity for the diagnosis of HCC compared to conventional hemodynamic criteria alone, irrespective of tumor size.…”

Section: Ancillary Imaging Features For the Diagnosis Of Hcc Depictedmentioning

confidence: 99%

Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment – Part 2

et al. 2017

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In the second part of this review, we will describe the ancillary imaging features of hepatocellular carcinoma (HCC) that can be seen on standard magnetic resonance imaging (MRI) protocol, and on novel and emerging protocols such as diffusion weighted imaging and utilization of hepatocyte-specific/hepatobiliary contrast agent. We will also describe the morphologic sub-types of HCC, and give a simplified non-invasive diagnostic algorithm for HCC, followed by a brief description of the liver imaging reporting and data system (LI-RADS), and MRI assessment of tumor response following locoregional therapy.

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The usefulness of diffusion-weighted imaging in the characterization of liver lesions in patients with cirrhosis

Cited by 26 publications

References 41 publications

Diffusion-Weighted Imaging of the Liver

Diffusion-Weighted Imaging of the Liver

The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis

Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment – Part 2

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