Image quality and diagnostic performance of free-breathing diffusion-weighted imaging for hepatocellular carcinoma

Figure 1 A 36-year-old male. The HCC in segment 8 of the liver showing hyperintensity on FB-DWI (A) is more clearly described than on RT-DWI (B). The ADC values of HCC were 1.02 × 10⁻³ mm²/s on the ADC map of FB-DWI (C) and 1.16 × 10^-3 mm²/s on the ADC map of RT-DWI (D). HCC: Hepatocellular carcinoma; FB-DWI: Free-breathing diffusion-weighted imaging; RT-DWI: Respiratory-triggering diffusion-weighted imaging; ADC: Apparent diffusion coefficient.

Figure 2 A 78-year-old female. The HCC in segment 5 of the liver was detected by FB-DWI (A), whereas on RT-DWI, it was concealed by a chemical shift artifact (B). HCC: Hepatocellular carcinoma; FB-DWI: Free-breathing diffusion-weighted imaging; RT-DWI: Respiratory-triggering diffusion-weighted imaging.

Figure 3 A 53-year-old female. There was no detectable lesion on FB-DWI (A) but the nodular hyperintensity in segment 7 of the liver was seen on RT-DWI (B). It was diagnosed as a pseudolesion caused by a chemical shift artifact from fat tissue between the liver parenchyma and diaphragm, by referring to precontrast-enhanced imaging (C) and hepatobiliary phase imaging (D) of Gd-EOB-MRI. A follow-up MR examination also showed no progressive lesion (not shown). FB-DWI: Free-breathing diffusion-weighted imaging; RT-DWI: Respiratory-triggering diffusion-weighted imaging; Gd-EOB-MRI: Gadoxetic acid-enhanced magnetic resonance imaging.