THE ROLE OF DIFFUSION WEIGHTED MRI IN THE DIFFERENTIATION BETWEEN BENIGN AND MALIGNANT HEPATIC FOCAL LESION
Mohammed Uday Hatim;
Abstract
Accurate detection and characterization of focal liver lesions (FLLs) are important for treatment planning for patients with liver neoplasms such as hepatocellular carcinoma (HCC) and metastases. According to number and distribution of the lesions (if proved malignant); surgery, radiofrequency ablation, alcohol injection or chemo-embolization was decided.
Unfortunately, not all cases with HCC having high alpha fetoprotein and not all cases having typical imaging criteria of HCC and also, not all lesions detected by US are seen in the dynamic CT study.
MRI having many sequences, markedly helps in the detection of small lesions and in reaching the diagnosis easily even without contrast injection or the need for biopsy as in cysts and hemangiomas.
For hepatic focal lesions detection and characterization, conventional MRI relies on T1-weighted, T2-weighted, and dynamic gadolinium-enhanced T1- weighted imaging.
DW MRI in the liver is a relative new and increasingly used imaging technique. The ADC maps can also provide quantitative measurements of tissue water diffusivity, which can be used not only for disease assessment, but also for the evaluation of disease response to treatment.
In our study we concluded that diffusion-weighted MRI sequence with quantitative ADC measurements can be useful in the differentiation of benign and malignant liver lesions.
Both qualitative evaluation of high b-value DW-MR images and quantitative evaluation of ADC maps are employed for lesion characterization. The ADC values of benign lesions are significantly higher than those of malignant lesions, with variable degrees of overlap between the pathological entities.
DWI proved to be helpful in the characterization of focal liver lesions, but should always be used in conjunction with traditional MRI since there is great overlap between ADC values of benign and malignant lesions. It seems reasonable to use DWI in conjunction to conventional imaging.
Unfortunately, not all cases with HCC having high alpha fetoprotein and not all cases having typical imaging criteria of HCC and also, not all lesions detected by US are seen in the dynamic CT study.
MRI having many sequences, markedly helps in the detection of small lesions and in reaching the diagnosis easily even without contrast injection or the need for biopsy as in cysts and hemangiomas.
For hepatic focal lesions detection and characterization, conventional MRI relies on T1-weighted, T2-weighted, and dynamic gadolinium-enhanced T1- weighted imaging.
DW MRI in the liver is a relative new and increasingly used imaging technique. The ADC maps can also provide quantitative measurements of tissue water diffusivity, which can be used not only for disease assessment, but also for the evaluation of disease response to treatment.
In our study we concluded that diffusion-weighted MRI sequence with quantitative ADC measurements can be useful in the differentiation of benign and malignant liver lesions.
Both qualitative evaluation of high b-value DW-MR images and quantitative evaluation of ADC maps are employed for lesion characterization. The ADC values of benign lesions are significantly higher than those of malignant lesions, with variable degrees of overlap between the pathological entities.
DWI proved to be helpful in the characterization of focal liver lesions, but should always be used in conjunction with traditional MRI since there is great overlap between ADC values of benign and malignant lesions. It seems reasonable to use DWI in conjunction to conventional imaging.
Other data
| Title | THE ROLE OF DIFFUSION WEIGHTED MRI IN THE DIFFERENTIATION BETWEEN BENIGN AND MALIGNANT HEPATIC FOCAL LESION | Other Titles | دور الرنين المغناطيسي بطريقة الانتشار في التفرقة بين البؤر الكبدية الحميدة و الخبيثة | Authors | Mohammed Uday Hatim | Issue Date | 2017 |
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