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Diagnosis of liver metastases: value of diffusion-weighted MRI compared with gadolinium-enhanced MRI.

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Title: Diagnosis of liver metastases: value of diffusion-weighted MRI compared with gadolinium-enhanced MRI.
Authors: Hardie AD (AUTHOR), Naik M (AUTHOR), Hecht EM (AUTHOR), Chandarana H (AUTHOR), Mannelli L (AUTHOR), Babb JS (AUTHOR), Taouli B (AUTHOR), Hardie, Andrew D1 (AUTHOR), Naik, Mohit (AUTHOR), Hecht, Elizabeth M (AUTHOR), Chandarana, Hersh (AUTHOR), Mannelli, Lorenzo (AUTHOR), Babb, James S (AUTHOR), Taouli, Bachir (AUTHOR)
Source: European Radiology. Jun2010, Vol. 20 Issue 6, p1431-1441. 11p.
Abstract: Objective: The full diagnostic value of diffusion-weighted (DW) MRI in the evaluation of liver metastases remains uncertain. The aim of the present study was to assess the diagnostic accuracy of DW-MRI and contrast-enhanced MRI (CE-MRI) using extracellular gadolinium chelates, with the reference standard established by consensus interpretation of confirmatory imaging and histopathologic data.Methods: MR examinations of 51 patients with extrahepatic malignancies were retrospectively reviewed by two independent observers who assessed DW-MRI and CE-MRI for detection of liver metastases.Results: By reference standard, 93 liver lesions (49 metastases and 44 benign lesions) were identified in 27 patients, 11 patients had no liver lesions, and 13 patients had innumerable metastatic and/or benign lesions. There was no difference in diagnostic performance between the two methods for either observer for the diagnosis of metastatic lesions per patient. For per-lesion analysis, sensitivity of DW-MRI was equivalent to CE-MRI for observer 1 (67.3% vs. 63.3%, p = 0.67), but lower for observer 2 (65.3% vs. 83.7%, p = 0.007). By pooling data from both observers, the sensitivity of DW-MRI was 66.3% (65/98) and 73.5% (72/98) for CE-MRI, with no significant difference (p = 0.171).Conclusion: DW-MRI is a reasonable alternative to CE-MRI for the detection of liver metastases. [ABSTRACT FROM AUTHOR]
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Abstract:<bold>Objective: </bold>The full diagnostic value of diffusion-weighted (DW) MRI in the evaluation of liver metastases remains uncertain. The aim of the present study was to assess the diagnostic accuracy of DW-MRI and contrast-enhanced MRI (CE-MRI) using extracellular gadolinium chelates, with the reference standard established by consensus interpretation of confirmatory imaging and histopathologic data.<bold>Methods: </bold>MR examinations of 51 patients with extrahepatic malignancies were retrospectively reviewed by two independent observers who assessed DW-MRI and CE-MRI for detection of liver metastases.<bold>Results: </bold>By reference standard, 93 liver lesions (49 metastases and 44 benign lesions) were identified in 27 patients, 11 patients had no liver lesions, and 13 patients had innumerable metastatic and/or benign lesions. There was no difference in diagnostic performance between the two methods for either observer for the diagnosis of metastatic lesions per patient. For per-lesion analysis, sensitivity of DW-MRI was equivalent to CE-MRI for observer 1 (67.3% vs. 63.3%, p = 0.67), but lower for observer 2 (65.3% vs. 83.7%, p = 0.007). By pooling data from both observers, the sensitivity of DW-MRI was 66.3% (65/98) and 73.5% (72/98) for CE-MRI, with no significant difference (p = 0.171).<bold>Conclusion: </bold>DW-MRI is a reasonable alternative to CE-MRI for the detection of liver metastases. [ABSTRACT FROM AUTHOR]
ISSN:09387994
DOI:10.1007/s00330-009-1695-9