Diffusion weighted magnetic resonance imaging of liver: Principles, clinical applications and recent updates

Table 2 Liver lesion characterization based on ADC values[33,35,44,45,102]

Ref.	Lesion type	Mean ADC (10-3mm2/s)	Sample size	b-values	Conclusion
Parsai et al[44]	Cyst	2.66	2	100, 200, 500, 750, and 1000 mm2/s	ADC cutoff value threshold of 1.6 × 10-3 mm2/s yielded higher accuracy for differentiating benign from malignant lesions. DWI is not reliable to differentiate malignant from benign solid lesions
	HCC	1.07	26
	Metastases	1.04	39
Taouli et al[98]	Cyst	3.63	52	0, 500	Threshold ADC value of 1.5 × 10-3 mm2/s to differentiate between benign and malignant lesions, but with a significant overlap between benign hepatocellular lesions and HCCs
	HCC	1.33
	Metastases	0.94
Parikh et al[35]	Cyst	2.54	211	0, 50, 500	Accuracy of 75.3% for differentiating benign from malignant, by using a threshold ADC of less than 1.60 × 10-3mm2/s . Equivalent performance of DW imaging and T2- weighted imaging for lesion characterization
	HCC	1.31
	Metastases	1.5
Bruegel et al[33]	Cyst	3.02	204	50, 300, 600	88% of lesions were correctly classified as benign or malignant using a threshold value of 1.63 × 10-3 mm2/s. Measurements of the ADCs of focal liver lesions on the basis of a respiratory triggered DW-SS-EPI sequence may constitute a useful supplementary method for lesion characterization
	HCC	1.05
	Metastases	1.22
Gourtsoyianni et al[102]	Cyst	2.55	37	0, 50, 500, 1000	Sensitivity and specificity of 100% for differentiating benign from malignant lesions using a cutoff ADC value of 1.47 × 10-3 mm2/s
	HCC	1.38
	Metastases	0.99

HCC: Hepatocellular carcinoma; DWI: Diffusion-weighted imaging.