Diagnostic value of diffusion weighted MRI and ADC in differential diagnosis of cavernous hemangioma of the liver

Tokgöz, Özlem; Ünlü, Ebru; Ünal, İlker; Şerifoğlu, İsmail; Öz, İlker; Aktaş, Elif; Çağlar, Emrah

doi:10.4314/ahs.v16i1.30

Cited by 10 publications

(12 citation statements)

References 25 publications

(23 reference statements)

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“…Studies in different types of cancer have also proposed DW-MRI as a marker to distinguish benign and malignant tumors and to evaluate the aggressiveness of cancer based on ADC-values, but that goes beyond the scope of the present study [36][37][38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Diffusion weighted magnetic resonance imaging (DW-MRI) as a non-invasive, tissue cellularity marker to monitor cancer treatment response

et al. 2020

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Background: Diffusion weighted magnetic resonance imaging (DW-MRI) holds great potential for monitoring treatment response in cancer patients shortly after initiation of radiotherapy. It is hypothesized that a decrease in cellular density of irradiated cancerous tissue will lead to an increase in quantitative apparent diffusion coefficient (ADC) values. DW-MRI can therefore serve as a non-invasive marker of cell death and apoptosis in response to treatment. In the present study, we aimed to investigate the applicability of DW-MRI in preclinical models to monitor radiation-induced treatment response. In addition, we compared DW-MRI with ex vivo measures of cell density, cell death and apoptosis. Methods: DW-MRI was tested in two different syngeneic mouse models, a colorectal cancer (CT26) and a breast cancer (4 T1). ADC values were compared with quantitative determinations of apoptosis and cell death by flow cytometry. Furthermore, ADC-values were also compared to histological measurement of cell density on tumor sections. Results: We found a significant correlation between ADC-values and apoptotic state in the CT26 model (P = 0.0031). A strong correlation between the two measurements of ADC-value and apoptotic state was found in both models, which were also present when comparing ADC-values to cell densities. Conclusions: Our findings demonstrate that DW-MRI can be used for non-invasive monitoring of radiation-induced changes in cell state during cancer therapy. ADC values reflect ex vivo cell density and correlates well with apoptotic state, and can hereby be described as a marker for the cell state after therapy and used as a non-invasive response marker.

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Section: Discussionmentioning

confidence: 99%

Diffusion weighted magnetic resonance imaging (DW-MRI) as a non-invasive, tissue cellularity marker to monitor cancer treatment response

et al. 2020

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“…Some studies in the past which reported DWI and ADC values to be useful in distinguishing benign vs malignant liver lesion included simple cysts [ 6 , 8 , 10 , 16 ]. In daily practice, simple liver cysts are easily identified as they demonstrate distinct fluid MRI signal characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…There has been promising evidence that ADC may be a viable tool to help discriminate benign versus malignant character of a hepatic lesion [ 1 , 6 , [8] , [9] , [10] , [11] , [12] , [13] ]. However, there have been conflicting reports in literature regarding the usefulness of DWI in this regard.…”

Section: Introductionmentioning

confidence: 99%

“…This significantly limits the reliability of ADC as a discriminating tool. Many studies conducted to assess the discriminating ability of ADC also included simple cysts [ 6 , 8 , 11 ]. As ADC value of simple cysts is usually significantly higher than solid lesions, inclusion of cysts in the category of benign lesions may have led to a significant difference in ADC values between benign and malignant lesions, leading these investigators to believe that ADC and DWI are useful tools.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of ADCratio on liver MRI diffusion to discriminate benign versus malignant solid liver lesions

Jain

Kan

Edward

et al. 2018

European Journal of Radiology Open

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Purpose: The aim of this project is to investigate the usefulness of the absolute liver lesion ADC value and ratio of Apparent diffusion coefficient (ADC) values of a liver lesion and liver parenchyma to discriminate between a benign and malignant lesion.Methods: Liver MRI scans performed between January 2009 and June 2015 were retrospectively analysed. Scans were performed on either a 1.5 T or 3 T MRI unit. The type of liver lesion (benign or malignant) was determined by its radiological appearance, histology result and clinical management. Lesions with undetermined diagnosis or MRI studies degraded by artifacts were excluded. Liver cysts were also excluded from the analysis. ADC value of a lesion and liver parenchyma was measured and ADCratio was calculated. The values were analysed using independent samples t-testResults:Data set contained 39 benign lesions and 36 malignant lesions. Mean ADC value for benign lesions was 1678, and the mean value for malignant lesions was 1097 with a statistically significant difference of p < 0.001. All lesions with ADC value below 955 were malignant, while all lesions with ADC value above 1880 were benign. ADC value of 1260 was identified as the best available cut-off value for differentiating benign and malignant lesions, achieving sensitivity of 92%, specificity of 80% and an overall accuracy of 89%. The mean lesion to liver ADCratio for benign lesions was 1.3467 and for malignant lesions was 0.9038 with a statistically significant difference of p < 0.001. All lesions with ADCratio measuring <0.9 were malignant while lesions with ADCratio>1.5 were benign. ADCratio of 1.1 was identified statistically as the best available cut-off value for differentiating benign from malignant lesions, with sensitivity of 82%, specificity of 86% and an overall accuracy of 92%.Conclusion:Our dataset indicates that lesion to background liver ADCratio is superior in discriminating between benign and malignant focal lesions compared to absolute ADC values of the hepatic lesions.

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“…In clinical settings, contrast enhancement has been widely used in preoperative qualitative diagnosis of focal lesions in the liver, especially in cases of suspected primary hepatocellular carcinoma. For patients with renal failure and contrast agent contraindications, DWI technology provides a kind of noninvasive examination method that is more conducive to impact on the clinical management [41]. The DKI model, an emerging MRI technology, is more sensitive to tissue microstructural complexity and heterogeneity in high b values.…”

Section: Discussionmentioning

confidence: 99%

Diffusion Kurtosis MR Imaging versus Conventional Diffusion-Weighted Imaging for Distinguishing Hepatocellular Carcinoma from Benign Hepatic Nodules

Jia

Cai

Wang

et al. 2019

Contrast Media & Molecular Imaging

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Objectives. To assess the efficacy of diffusion kurtosis imaging (DKI) and compare DKI-derived parameters with conventional diffusion-weighted imaging (DWI) for distinguishing hepatocellular carcinoma (HCC) from benign hepatic nodules including focal nodular hyperplasia (FNH), hemangioma, and hepatocellular adenoma (HCA). Materials and Methods. 151 patients with 182 hepatic nodules (114 HCCs and 68 benign nodules including 33 FNHs, 29 hemangiomas, and 6 HCAs) were analyzed. Preoperative MRI examinations including DKI (b values: 0, 200, 500, 800, 1500, and 2000 sec/mm2) were performed, and kurtosis (K), diffusivity (D), and apparent diffusion coefficient (ADC) were calculated. The efficacy of DKI-derived parameters K, D, and ADC for distinguishing HCC from these benign nodules was analyzed. Results. ROC (receiver operating characteristic curve) analysis showed the optimal cutoff values of ADC, D, and K for identification of these benign nodules, and HCCs were 1.295 (area under the curve (AUC): 0.826; sensitivity 80.6%; specificity 70.8%), 1.787 (AUC: 0.770; sensitivity 83.6%; specificity 59.6%), and 1.002 (AUC: 0.761; sensitivity 65.5%; specificity 79.0%), respectively. Statistically significant differences were found in ADC, D, and K values between groups of HCC-FNH and HCC-hemangioma (P<0.05). There were significant differences in K and ADC values between groups of FNH-hemangioma and HCA-hemangioma (P<0.05), respectively. Using logistic regression analysis, a regression equation was obtained: LogitP=−1.982X1+1.385X3+1.948(X1: ADC; X3: K), and odds ratios (OR) were 0.138 (95% confidence interval (CI): 0.052, 0.367), and 8.996 (95% CI: 0.970, 16.460), respectively. Conclusion. Both ADC value and DKI-derived parameters K and D values have demonstrated a higher preoperative efficacy in distinguishing HCC from FNH, hemangioma, and HCA. No evidence was shown to suggest D or K value was superior to the ADC value.

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Diagnostic value of diffusion weighted MRI and ADC in differential diagnosis of cavernous hemangioma of the liver

Cited by 10 publications

References 25 publications

Diffusion weighted magnetic resonance imaging (DW-MRI) as a non-invasive, tissue cellularity marker to monitor cancer treatment response

Diffusion weighted magnetic resonance imaging (DW-MRI) as a non-invasive, tissue cellularity marker to monitor cancer treatment response

Evaluation of ADCratio on liver MRI diffusion to discriminate benign versus malignant solid liver lesions

Diffusion Kurtosis MR Imaging versus Conventional Diffusion-Weighted Imaging for Distinguishing Hepatocellular Carcinoma from Benign Hepatic Nodules

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