Diffusion weighted imaging in the liver

Table 1 Reported ADC values in different types of lesions in the liver

Study	Type of lesion	n	ADC value mm2/s, BH (SD)	ADC value mm2/s, RT (SD)
Taouli et al[10]
b-values	Benign	18	2.21 (0.60)	2.39 (0.44)
0, 50, 500 s/mm2	Malignant	11	1.04 (0.27)	1.16 (0.33)
Goshima et al[13]
b-values	Hemangioma	12	1.23-2.23 (0.2-1.2)2
100, 200, 400, 800 s/mm2	Cyst	15	3.70-4.72 (0.9-1.2)2
	Metastases	7	0.99-1.70 (0.5-1.1)2
	HCC	21	1.08-1.79 (0.3-10.9)2
Kandpal et al[14]
b-value	Hemangioma	11	2.22 (0.45)	2.36 (0.48)
0, 500 s/mm2	Cyst	11	2.66 (0.44)	2.90 (0.51)
	FNH	3	2.03 (0.24)	2.15 (0.18)
	Abscess	6	1.21 (0.36)	1.13 (0.43)
	Metastases	38	1.06 (0.36)	1.13 (0.41)
	HCC	12	1.22 (0.34)	1.27 (0.42)
Gourtsoyianni et al[18]1
b-values	Hemangioma	7		1.90
0, 50, 500, 1000 s/mm2	Cyst	15		2.55
	Metastases	13		0.99 (0.22)
	HCC	2		1.38
Oner et al[19]
b-values	Hemangioma	5	1.72 (0.30)
0, 500 s/mm2	Cyst	3	2.34 (0.36)
	Metastases	6	1.03 (0.24)
Demir et al[23]1
0, 1000 s/mm2	Benign	24	1.09-3.36 (0.32/0.28)3
	Malignant	17	0.54-1.24 (0.07/0.14)3
Bruegel et al[24]1
b-values	Hemangioma	56		1.92 (0.34)
50, 300, 600 s/mm2	Cyst	51		3.02 (0.31)
	FNH	4		1.40 (0.15)
	Metastases	82		1.22 (0.31)
	HCC	11		1.05 (0.09)
Holzapfel et al[25]1
b-values	Hemangioma	18		1.69 (0.34)
50, 300, 600 s/mm2	Cyst	71		2.61 (0.57)
	FNH/adenoma	6/9		1.43 (0.22)
	Metastases	76		1.08 (0.32)
	HCC	17		1.12 (0.28)

¹These studies found significantly higher ADC values in benign liver lesions than in malignant liver lesions;

²This study evaluated the ADC values at different b-values. The lowest and highest ADC values are reported here. The lowest ADC value corresponds with the highest b-value, the highest ADC value with the lowest b-value;

³This study evaluated the ADC values of different types of benign and malignant lesions. The lowest and highest ADC values are reported here. ADC: Apparent diffusion coefficient; BH: Breath-hold; RT: Respiratory triggered; SD: Standard deviation; FNH: Focal nodular hyperplasia; HCC: Hepatocellular carcinoma.

Table 2 Performance of DWI and conventional MRI in the detection of liver metastases n (%)

Study	Sensitivity	Specificity	Accuracy	PPV	NPV
Vandecaveye et al[30]
> 20 mm
B600 SI ratio	100	81.8	94.9	93.3	100
T2-CE MRI	96.4	81.8	92.3	93.1	90.0
< 20 mm
B600SI ratio	91.2	82.9	86.7	81.6	91.9
T2-CE MRI	67.6	61.0	64.0	59.0	69.4
Koh et al[32]1
MnDPDP MRI	81.3	93.0	88-92
DWI 0, 150, 500 BH	78.3	95.0	83-90
MnDPDP MRI and DWI	92.2	97.0	94-96
DWI RT	88-91
T2 MRI	45-62
Nasu et al[36]
DWI RT (0, 500)	82	94
SPIO MRI	66	90

¹In this study, 2 observers reviewed the images. The given values in sensitivity, specificity and diagnostic accuracy refer to the separate results of both observers. PPV: Positive predictive value; NPV: Negative predictive value.