Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy
Yıl: 2019 Cilt: 8 Sayı: 3 Sayfa Aralığı: 520 - 525 Metin Dili: İngilizce DOI: 10.5455/medscience.2018.07.8991 İndeks Tarihi: 14-10-2020
Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy
Öz: The purpose of the study is to assess the advantages of diffusion weighted resonance imaging (DWI) prospectively in the metastasis and benign differentiation of small (≤ 10 mm) focal liver lesions (FLL) detected in routine ultrasonography and/or computed tomography screening of patients with extrahepatic primary malignancy. A total of 77 small FLLs (33 metastasis, 27 cyst, 17 hemangioma) of 53 patients who received DWI in addition to conventional magnetic resonance imaging were assessed by 2 independent readers prospectively. Apparent diffusion coefficient (ADC) values were measured for each FLL. T-test was used to assess the statistically significant difference between average ADC values in differentiating between metastasis and benign FLLs. In the metastasis and benign differentiation of small FLLs, optimum cutoff values of ADC values were found by using receiver operating characteristic (ROC) analysis. Average ADC values of small focal liver metastases were statistically significantly lower than those of benign FLL (p < 0.001). Small focal liver metastases were differentiated from benign FLL with 100% sensitivity and 97.1% specificity by using 1.44 x 10-3 s/mm2 cutoff ADC value. This study shows that DWI can be useful in differentiating whether incidentally found small FLL is metastasis in patients who have extrahepatic primary malignancy.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Khalil HI, Patterson SA, Panicek DM. Hepatic lesions deemed too small to characterize at CT: prevalence and importance in women with breast cancer. Radiol. 2005;235:872-8.
- 2. Holalkere NS, Sahani DV, Blake MA, et al. Characterization of small liver lesions: added role of MR after MDCT. J Comput Assist Tomogr. 2006;30:591-6.
- 3. Tello R, Fenlon HM, Gagliano T, et al. Prediction rule for characterization of hepatic lesions revealed on MR imaging: estimation of malignancy. AJR Am J Roentgenol. 2001;176:879-84.
- 4. Hammerstingl R, Huppertz A, Breuer J, et al. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol. 2008;18:457-67.
- 5. Sadowski EA, Bennett LK, Chan MR, et al. Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiol. 2007;243:148-57.
- 6. Taouli B, Koh DM. Diffusion-weighted MR Imaging of the Liver. Radiology. 2010;254:47-66.
- 7. Diagnosis of focal liver lesions suspected of metastases by diffusion-weighted imaging (DWI): systematic comparison favors free-breathing technique. Clin Imag. 2013;97-103.
- 8. Gourtsoyianni S, Papanikolaou N, Yarmenitis S, et al. Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur J Radiol. 2008;18:486-92.
- 9. Kenis C, Deckers F, De Foer B, et al. Diagnosis of liver metastases: Can diffusion-weighted imaging (DWI) be used as a stand alone sequence? Eur J Radiol. 2012;81:1016-23.
- 10. Xia D, Jing J, Shen H, et al. Value of diffusion-weighted magnetic resonance images for discrimination of focal benign and malignant hepatic lesions: a meta-analysis. J Magn Reson Imaging. 2010;32:130-7.
- 11. Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. Am J Roentgenol. 2007;188:1622-35.
- 12. Yu JS, Chung JJ, Kim JH, et al. Detection of small intrahepatic metastases of hepatocellular carcinomas using diffusion-weighted imaging: comparison with conventional dynamic MRI. Magn Reson Imaging. 2011;29:985-92.
- 13. Kim DJ, Yu JS, Kim JH, et al. Small hypervascular hepatocellular carcinomas: value of diffusion-weighted imaging compared with “washout” appearance on dynamic MRI. Br J Radiol. 2012;85:879-86.
- 14. Nam SJ, Yu JS, Cho ES, et al. High-flow haemangiomas versus hypervascular hepatocellular carcinoma showing “pseudo-washout” on gadoxetic acid-enhanced hepatic MRI: value of diffusion-weighted imaging in the differential diagnosis of small lesions. Clin Radiol. 2017;72:247-54.
- 15. Le Moigne F, Boussel L, Haquin A, et al. Grading of small hepatocellular carcinomas (≤2 cm): correlation between histology, T2 and diffusion-weighted imaging. Br J Radiol. 2014;87:20130763.
- 16. Di Martino M, Di Miscio R, De Filippis G, et al. Detection of small (≤2 cm) HCC in cirrhotic patients: added value of diffusion MR-imaging. Abdom Imaging. 2013;38:1254-62.
- 17. Xu P, Zeng M, Liu K, et al. Microvascular invasion in small hepatocellular carcinoma: is it predictable with preoperative diffusion-weighted imaging? J Gastroenterol Hepatol. 2014;29:330-6.
- 18. Xu CC, Tang YF, Ruan XZ, et al. The value of Gd-BOPTA- enhanced MRIs and DWI in the diagnosis of intrahepatic mass-forming cholangiocarcinoma. Neoplasma. 2017;64:945-53.
- 19. Park HJ, Kim YK, Park MJ, et al. Small intrahepatic mass-forming cholangiocarcinoma: target sign on diffusion-weighted imaging for differentiation from hepatocellular carcinoma. Abdom Imaging. 2013;38:793-801.
- 20. Holzapfel K, Bruegel M, Eibera M, et al. Characterization of small (≤10mm) focal liver lesions: Value of respiratory-triggered echo-planar diffusion-weighted MR imaging. Eur J Radiol. 2010;76:89-95
- 21. Jeon SK, Lee JM, Joo I, et al. Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT. Eur Radiol. 2018;28:4475.
- 22. Song KD, Kim YK, Lee WJ, et al. Detection and characterization of small focal hepatic lesions (≤ 2.5 cm in diameter): a comparison of diffusion-weighted images before and after administration of gadoxetic acid disodium at 3.0T Acta Radiol. 2012;53:485-93.
- 23. Semelka RC, Brown ED, Ascher SM, et al. Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium enhanced gradient-echo MR images. Radiology. 1994;192:401-6.
- 24. Bartolozzi C, Cioni D, Donati F, et al. Focal liver lesions: MR imaging pathologic correlation. Eur Radiol. 2001;11:1374-88.
- 25. Pierpaoli C, Jezzard P, Basser PJ, et al. Diffusion tensor MR imaging of the human brain. Radiology. 1996;201:637-48.
- 26. Nasu K, Kuroki Y, Fujii H, et al. Hepatic pseudo-anisotropy: a specific artifact in hepatic diffusion-weighted images obtained with respiratory triggering. Magma. 2007;20:205-11.
- 27. Holalkere NS, Sahani DV, Blake MA, et al. Characterization of small liver lesions: added role of MR after MDCT. J Comput Assist Tomogr. 2006;30:591-6.
- 28. Mueller GC, Hussain HK, Carlos RC, et al. Effectiveness of MR imaging in characterizing small hepatic lesions: routine versus expert interpretation. AJR Am J Roentgenol. 2003;180:673-80.
- 29. Parikh T, Drew SJ, Lee VS, et al. Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology. 2008;246:812-22.
- 30. Coenegrachts K, Delanote J, Ter Beek L, et al. Improved focal liver lesion detection: comparison of single-shot diffusion-weighted echoplanar and single-shot T2 weighted turbo spin echo techniques. Br J Radiol. 2007;80:524-31.
- 31. Coenegrachts K, Orlent H, ter Beek L, et al. Improved focal liver lesion detection: comparison of single-shot spin-echo echo-planar and superparamagnetic iron oxide (SPIO)-enhanced MRI. J Magn Reson Imaging. 2008;27:1117-24.
- 32. Dijkstra H, Baron P, Kappert P, et al. Effects of microperfusion in hepatic diffusion weighted imaging. Eur Radiol. 2012;22:891-9.
| APA | SOYUCOK A, Aslan K, DANACI M, CAMLİDAG I (2019). Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. , 520 - 525. 10.5455/medscience.2018.07.8991 |
| Chicago | SOYUCOK Ahmet,Aslan Kerim,DANACI Murat,CAMLİDAG Ilkay Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. (2019): 520 - 525. 10.5455/medscience.2018.07.8991 |
| MLA | SOYUCOK Ahmet,Aslan Kerim,DANACI Murat,CAMLİDAG Ilkay Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. , 2019, ss.520 - 525. 10.5455/medscience.2018.07.8991 |
| AMA | SOYUCOK A,Aslan K,DANACI M,CAMLİDAG I Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. . 2019; 520 - 525. 10.5455/medscience.2018.07.8991 |
| Vancouver | SOYUCOK A,Aslan K,DANACI M,CAMLİDAG I Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. . 2019; 520 - 525. 10.5455/medscience.2018.07.8991 |
| IEEE | SOYUCOK A,Aslan K,DANACI M,CAMLİDAG I "Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy." , ss.520 - 525, 2019. 10.5455/medscience.2018.07.8991 |
| ISNAD | SOYUCOK, Ahmet vd. "Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy". (2019), 520-525. https://doi.org/10.5455/medscience.2018.07.8991 |
| APA | SOYUCOK A, Aslan K, DANACI M, CAMLİDAG I (2019). Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. Medicine Science, 8(3), 520 - 525. 10.5455/medscience.2018.07.8991 |
| Chicago | SOYUCOK Ahmet,Aslan Kerim,DANACI Murat,CAMLİDAG Ilkay Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. Medicine Science 8, no.3 (2019): 520 - 525. 10.5455/medscience.2018.07.8991 |
| MLA | SOYUCOK Ahmet,Aslan Kerim,DANACI Murat,CAMLİDAG Ilkay Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. Medicine Science, vol.8, no.3, 2019, ss.520 - 525. 10.5455/medscience.2018.07.8991 |
| AMA | SOYUCOK A,Aslan K,DANACI M,CAMLİDAG I Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. Medicine Science. 2019; 8(3): 520 - 525. 10.5455/medscience.2018.07.8991 |
| Vancouver | SOYUCOK A,Aslan K,DANACI M,CAMLİDAG I Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy. Medicine Science. 2019; 8(3): 520 - 525. 10.5455/medscience.2018.07.8991 |
| IEEE | SOYUCOK A,Aslan K,DANACI M,CAMLİDAG I "Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy." Medicine Science, 8, ss.520 - 525, 2019. 10.5455/medscience.2018.07.8991 |
| ISNAD | SOYUCOK, Ahmet vd. "Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy". Medicine Science 8/3 (2019), 520-525. https://doi.org/10.5455/medscience.2018.07.8991 |
