Utility of volumetric contrast‐enhanced and diffusion‐weighted MRI in differentiating between common primary hypervascular liver tumors

Zarghampour, Manijeh; Fouladi, Daniel Fadaei; Pandey, Ankur; Ghasabeh, Mounes Aliyari; Pandey, Pallavi; Varzaneh, Farnaz Najmi; Khoshpouri, Pegah; Shao, Nan; Pan, Li; Grimm, Robert; Kamel, Ihab R.

doi:10.1002/jmri.26032

Cited by 20 publications

(7 citation statements)

References 35 publications

(93 reference statements)

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“…This restriction is substantially lower than in malignant lesions, but the difference may not be noticeable to naked eye in DWI/ADC evaluation. In their recent study, Zarghampour et al, reported that ADC is successful in HA-HCC and HA-FNH differentiation while being unsuccessful in FNH-HCC differentiation [23]. Similar to the mentioned study, our study found that ADC is unsuccessful in FNH-HCC differentiation.…”

Section: Original Articlesupporting

confidence: 88%

Effectiveness of ADC histogram analysis in the diagnosis of focal liver lesions; is a contrast agent necessary?

TANYERI

CILDAG

KOSEOGLU

2022

Marmara Medical Journal

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Objective: The diagnostic success of apparent diffusion coefficient (ADC) histogram analysis in focal liver lesions, and the effects of quantitative data added to contrast-enhanced abdominal magnetic resonance imaging (MRI) on the diagnostic accuracy were investigated. Materials and Methods: The conventional MRI findings of 524 lesions in total were retrospectively examined. Contrast enhancement kinetics and ADC values for each lesion were found through an image analysis software. Results: Three hundred and fifty (67%) of the lesions were diagnosed as benign and 174 (33%) as malignant. Statistically significant difference was found between the benign and malignant lesion groups in terms of the minimum, maximum and mean ADC values (p<0.001). When optimal thresholds for minimum, maximum and mean ADC were taken as 1.47x10-3mm2/s; 1.85x10-3mm2/s; 1.72x10-3mm2/s respectively, sensitivity was found to be 97%; 83%; 95%, specificity was 100%; 98%; 99%, NPV was 100%; 99%; 99%, and PPV was 93%; 74%; 90%. ADC values added to MRI increased the diagnostic success for metastases (92%→96%), HCC (63%→73%), hemangioma (90%→99%) and FNH (56%→75%). Conclusion: ADC measurement could not show reasonable success in the diagnosis of specific lesions while being successful in the differentiation of benign and malignant lesions. Minimum ADC is more successful than mean and maximum ADC. A non-contrastenhanced MRI protocol based on the ADC measurement applicable to the selected patient group may be helpful.

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Section: Original Articlesupporting

confidence: 88%

Effectiveness of ADC histogram analysis in the diagnosis of focal liver lesions; is a contrast agent necessary?

TANYERI

CILDAG

KOSEOGLU

2022

Marmara Medical Journal

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“…Various imaging modalities have been applied in the distinction between HCC and FNH, such as CT [1,9,10], Doppler ultrasound [11,12] and MRI [1,3,5,[13][14][15]. In previous studies, the gadoxetic acid-enhanced MRI is being increasingly used in differentiating focal liver lesions.…”

Section: Introductionmentioning

confidence: 99%

A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver

et al. 2020

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Background: The purpose of this study was to develop and validate a radiomics nomogram for preoperative differentiating focal nodular hyperplasia (FNH) from hepatocellular carcinoma (HCC) in the non-cirrhotic liver. Methods: A total of 156 patients with FNH (n = 55) and HCC (n = 101) were divided into a training set (n = 119) and a validation set (n = 37). Radiomics features were extracted from triphasic contrast CT images. A radiomics signature was constructed with the least absolute shrinkage and selection operator algorithm, and a radiomics score (Radscore) was calculated. Clinical data and CT findings were assessed to build a clinical factors model. Combined with the Rad-score and independent clinical factors, a radiomics nomogram was constructed by multivariate logistic regression analysis. Nomogram performance was assessed with respect to discrimination and clinical usefulness. Results: Four thousand two hundred twenty-seven features were extracted and reduced to 10 features as the most important discriminators to build the radiomics signature. The radiomics signature showed good discrimination in the training set (AUC [area under the curve], 0.964; 95% confidence interval [CI], 0.934-0.995) and the validation set (AUC, 0.865; 95% CI, 0.725-1.000). Age, Hepatitis B virus infection, and enhancement pattern were the independent clinical factors. The radiomics nomogram, which incorporated the Rad-score and clinical factors, showed good discrimination in the training set (AUC, 0.979; 95% CI, 0.959-0.998) and the validation set (AUC, 0.917; 95% CI, 0.800-1.000), and showed better discrimination capability (P < 0.001) compared with the clinical factors model (AUC, 0.799; 95% CI, 0.719-0.879) in the training set. Decision curve analysis showed the nomogram outperformed the clinical factors model in terms of clinical usefulness. Conclusions: The CT-based radiomics nomogram, a noninvasive preoperative prediction tool that incorporates the Rad-score and clinical factors, shows favorable predictive efficacy for differentiating FNH from HCC in the noncirrhotic liver, which might facilitate clinical decision-making process.

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“…Studies conducted by Shankar, 23 Galea, 31 and Saito 47 reported that DWI has limitations for evaluating the differentiation between HCC/liver lesion grades because the tumor grade does not significantly change the ADC values. Furthermore, Sutherland 48–50 concluded that using DWI to differentiate between solid benign and malignant lesions and different sorts of hypervascular hepatic lesions remains challenging because the differences in ADC values were not statistically significant. For example, Sutherland reported an overlap between the cellularity of focal nodular hyperplasia and malignant liver lesions in low ADC values 48 …”

Section: Diffusion‐weighted Image–magnetic Resonance Imagingmentioning

confidence: 99%

The clinical value of dual‐energy computed tomography and diffusion‐weighted imaging in the context of liver cancer: A narrative review

Fan

Chu

Wang

et al. 2022

J of Clinical Ultrasound

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The dual‐energy computed tomography (DECT) and diffusion‐weighted magnetic resonance imaging (DWI‐MRI) are used to diagnose liver cancer. The clinical value of these two examination methods needs to be further summarized. We collected and summarized relevant literature published from 2011 to 2021. The diagnostic performance of DECT was assessed between conventional computed tomography and DWI‐MRI. DWI‐MRI had a 69% sensitivity for detecting small hepatocellular carcinoma (HCC) lesions and a 60% diagnostic specificity for differentiating between types of HCC lesions. DECT had a sensitivity to small liver lesions (<1 cm) of 69%, and the diagnostic specificity for HCC and metastasis was about 60%. DWI was more sensitive (90.3% vs. 74.9%) and accurate (91.9% vs. 76.9%) in diagnosing HCC compared with conventional MRI sequencing. With the aid of contrast media, DWI‐MRI had 90.0% specificity for detecting small HCCs (smaller than 1 cm). Furthermore, DWI‐MRI not only provided physicians with valuable diagnostic information but also delivered histological grading information, with 78% accuracy for all benign lesions and 71% for solid lesions. DECT had relatively high sensitivity and required a lower contrast medium dose. With standardized quantitative parameters, it can be an extremely useful tool for HCC surveillance. DWI‐MRI is the preferred imaging process as it produces high‐contrast images for supporting an early diagnosis (high sensitivity and specificity) and provides histological information using non‐ionizing radiation.

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Utility of volumetric contrast‐enhanced and diffusion‐weighted MRI in differentiating between common primary hypervascular liver tumors

Abstract: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1080-1090.

Cited by 20 publications

References 35 publications

Effectiveness of ADC histogram analysis in the diagnosis of focal liver lesions; is a contrast agent necessary?

Effectiveness of ADC histogram analysis in the diagnosis of focal liver lesions; is a contrast agent necessary?

A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver

The clinical value of dual‐energy computed tomography and diffusion‐weighted imaging in the context of liver cancer: A narrative review

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