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

Kyoung Doo Song, Young Kon Kim, Won Jae Lee, Min Woo Lee, Min Jung Park, Jiyoung Hwang, Mi Hee Lee

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: As diffusion-weighted imaging (DWI) is routinely incorporated into the standard clinical protocol, it is clinically relevant to determine whether DWI after gadoxetic acid is comparable to pre-contrast DWI, with regard to the detection and characterization of focal liver lesions. Purpose: To compare DWI before and after administration of gadoxetic acid in the detection and characterization of small (≤2.5cm) focal hepatic lesions. Material and Methods: One hundred and fifty-eight patients with 237 focal hepatic lesions (≤2.5cm) (124 HCCs, 50 metastases, 2 cholangiocarcinomas, 43 hemangiomas, and 18 cysts) were included. DWIs were obtained before and after administration of gadoxetic acid. Non-breath-hold DWI was performed with b values of 0,100, and 800 s/mm 2. Signal-to-noise ratio (SNR), lesion-liver contrast-to-noise ratio (CNR), and apparent diffusion coefficients (ADCs) of the liver and lesion were calculated. Lesion detection with each DWI was evaluated with alternative free-response receiver-operating characteristic analysis by two observers. The sensitivity of the characterization of focal hepatic lesions as solid (malignancy) or non-solid (benignity) with each DWI was calculated using a five-point confidence scale. Inter-observer agreement regarding lesion detection and characterization was evaluated using kappa statistics. Results: SNRs of the liver on post-contrast DWI were significantly lower than on unenhanced DWI at b = 800 s/mm 2 (P< 0.05). SNRs, CNRs, and ADCs of focal hepatic lesions were not significantly different between two DWIs (P > 0.05). The diagnostic accuracy (Az) for lesion detection and the sensitivity for lesion characterization did not show significant difference between two DWIs (P > 0.05). With regard to the detection and characterization of focal hepatic lesions, the kappa values for two DWIs indicated good and excellent inter-observer agreement, respectively. Conclusion: Gadoxetic acid-enhanced DWI showed comparable diagnostic capability to unenhanced DWI for the detection and characterization of small focal hepatic lesions.

Original languageEnglish
Pages (from-to)485-493
Number of pages9
JournalActa Radiologica
Volume53
Issue number5
DOIs
StatePublished - Jun 2012

Keywords

  • Diffusion-weighted imaging
  • Gd-EOB-DTPA
  • Magnetic resonance imaging

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