Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions.

Autor: Hennedige TP; Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore., Hallinan JT; Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore., Leung FP; Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore.; South West Radiology, Liverpool, NSW, Australia., Teo LL; Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore., Iyer S; Department of Surgery, National University Health System, Singapore, Singapore., Wang G; Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore.; University of Calgary, Alberta, Canada., Chang S; Department of Surgery, National University Health System, Singapore, Singapore., Madhavan KK; Department of Surgery, National University Health System, Singapore, Singapore., Wee A; Department of Pathology, National University Hospital, National University Health System, Singapore, Singapore., Venkatesh SK; Department of Radiology, Mayo Clinic, 200, First Street SW, Rochester, MN, 55905, USA. venkatesh.sudhakar@mayo.edu.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2016 Feb; Vol. 26 (2), pp. 398-406. Date of Electronic Publication: 2015 Jun 02.
DOI: 10.1007/s00330-015-3835-8
Abstrakt: Objectives: Comparison of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) for differentiating malignant and benign focal liver lesions (FLLs).
Methods: Seventy-nine subjects with 124 FLLs (44 benign and 80 malignant) underwent both MRE and DWI. MRE was performed with a modified gradient-echo sequence and DWI with a free breathing technique (b = 0.500). Apparent diffusion coefficient (ADC) maps and stiffness maps were generated. FLL mean stiffness and ADC values were obtained by placing regions of interest over the FLLs on stiffness and ADC maps. The accuracy of MRE and DWI for differentiation of benign and malignant FLL was compared using receiver operating curve (ROC) analysis.
Results: There was a significant negative correlation between stiffness and ADC (r = -0.54, p < 0.0001) of FLLs. Malignant FLLs had significantly higher mean stiffness (7.9kPa vs. 3.1kPa, p < 0.001) and lower mean ADC (129 vs. 200 × 10(-3)mm(2)/s, p < 0.001) than benign FLLs. The sensitivity/specificity/positive predictive value/negative predictive value for differentiating malignant from benign FLLs with MRE (cut-off, >4.54kPa) and DWI (cut-off, <151 × 10(-3)mm(2)/s) were 96.3/95.5/97.5/93.3% (p < 0.001) and 85/81.8/88.3/75% (p < 0.001), respectively. ROC analysis showed significantly higher accuracy for MRE than DWI (0.986 vs. 0.82, p = 0.0016).
Conclusion: MRE is significantly more accurate than DWI for differentiating benign and malignant FLLs.
Key Points: • MRE is superior to DWI for differentiating benign and malignant focal liver lesions. • Benign lesions with large fibrous components may have higher stiffness with MRE. • Cholangiocarcinomas tend to have higher stiffness than hepatocellular carcinomas. • Hepatocellular adenomas tend to have lower stiffness than focal nodular hyperplasia. • MRE is superior to conventional MRI in differentiating benign and malignant liver lesions.
Databáze: MEDLINE
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