Role of Diffusion Weighted MRI Imaging in Characterization of Hepatic Focal Lesions in Cirrhotic Patients in Comparison to Dynamic Cross Sectional Imaging

Abstract

DWI MRI and the calculation of the ADC are great non invasive possible tools to detect and characterize hepatic focal lesions as well as to differentiate benign from malignant lesions in cirrhotic patients especially in patients with renal impairment and allergy to contrast media also to avoid unnecessary biopsies, a suggested ADC cut-off value of (< 0.98 x 10-3 mm2/s) is considered for malignant hepatic focal lesion while (> 0.98 x 10-3 mm2/s) is considered for benign hepatic focal lesion. Limitations to our study were: 1) Our study sample size was relatively small, so future larger number of patients would be recommended. 2) No histopathological correlation was done as the diagnosis was established using imaging criteria with dynamic contrast for focal lesions characterization into categories based on LIRADS into benign and malignant lesions this was to avoid the invasive nature and risks of biopsies. 3) In our study we used b-values of 0, 400 and 800 however future further studies with standardized acquisition protocol for breath hold DWI is recommended.