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Keywords:
Abdomen, Liver, Oncology, MR, MR-Diffusion/Perfusion, Percutaneous, Comparative studies, Efficacy studies, Statistics, Cancer, Metastases, Haemangioma
Authors:
R. Sudhir; Hyderabad/IN
DOI:
10.1594/ecr2015/C-0725
Aims and objectives
Liver is one of the common sites of haematogenous metastases of most of the primary malignancies in the body.
Gastrointestinal,
breast,
melanoma,
neuroendocrinal and lung cancers are the most common primary cancers responsible for metastatic liver involvement [1,2].
The differentiation between malignant and benign focal liver lesions always remains a diagnostic challenge for a radiologist.
For detection and characterisation of focal liver lesions,
various imaging modalities are being used,
including US,
multi-phase contrast enhanced CT,
CT portography,
MRI and perfusion studies using dedicated contrast media.
Of these,
MRI with contrast is considered the most accurate modality as it has high resolution for soft tissue on T1,
T2 and post contrast images[3].
Diffusion is the Brownian movement of water molecules which is thermally induced randomized microscopic movement in biological tissue.
Diffusion is known to be a sensitive parameter of microscopic tissue characterisation.
It is a marker of cellularity and its quantitative analysis can be obtained by means of apparent diffusion coefficient (ADC) measurements.
A high ADC indicates that water can move more freely,
suggesting low cellularity and a low ADC implies that there is restriction of water movement,
suggesting high cellularity [4].
With the development of fast MRI techniques like echo-planar imaging (EPI) and better coil systems,
diffusion weighted (DW) MR imaging is now available for qualitative and quantitative assessment of diffusivity of water molecule within different liver lesions without injecting the contrast media,
which becomes even more important in Indian patients where cost is one of the main factors in patient management and also in patients with renal dysfunction who are at risk for developing nephrogenic systemic fibrosis [5,6].
The purpose of this study was to evaluate the role of diffusion-weighted MR imaging in differentiating benign and malignant focal liver lesions.