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Characterization of focal liver lesions using quantitative techniques: comparison of apparent diffusion coefficient values and T2 relaxation times.

Cieszanowski A, Anysz-Grodzicka A, Szeszkowski W, Kaczynski B, Maj E, Gornicka B, Grodzicki M, Grudzinski IP, Stadnik A, Krawczyk M, Rowinski O - Eur Radiol (2012)

Bottom Line: The mean ADC value of malignant tumours (1.07 × 10(-3) mm(2)/s) was significantly lower (P < 0.05) than that of benign lesions (1.86 × 10(-3) mm(2)/s ); however, with the use of the optimal cut-off value of 1.25 × 10(-3) mm(2)/s, 20 false positive (FP) and 20 false negative (FN) diagnoses of malignancy were noted, generating 79 % sensitivity, 82.6 % specificity and 80.9 % accuracy.The mean T2 relaxation time of malignant tumours (64.4 ms) was significantly lower (P < 0.05) than that of benign lesions (476.1 ms).At the threshold of 107 ms 22 FP and 1 FN diagnoses were noted; the sensitivity was 99 %, specificity 80.9 % and accuracy 89.3 %.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Clinical Radiology, Medical University of Warsaw, Ul. Banacha 1A, 02-097, Warsaw, Poland. andrzej.cieszanowski@wum.edu.pl

ABSTRACT

Objectives: To compare the efficacy of two quantitative methods for discrimination between benign and malignant focal liver lesions (FLLs): apparent diffusion coefficient (ADC) values and T2 relaxation times.

Methods: Seventy-three patients with 215 confirmed FLLs (115 benign, 100 malignant) underwent 1.5-T MRI with respiratory-triggered single-shot SE DWI (b = 50, 400, 800) and dual-echo T2TSE (TR = 3,000 ms; TE1 = 84 ms; TE2 = 228 ms). ADC values and T2 relaxation times of FLLs were calculated. Sensitivity, specificity and accuracy of both techniques in diagnosing malignancy were assessed.

Results: The mean ADC value of malignant tumours (1.07 × 10(-3) mm(2)/s) was significantly lower (P < 0.05) than that of benign lesions (1.86 × 10(-3) mm(2)/s ); however, with the use of the optimal cut-off value of 1.25 × 10(-3) mm(2)/s, 20 false positive (FP) and 20 false negative (FN) diagnoses of malignancy were noted, generating 79 % sensitivity, 82.6 % specificity and 80.9 % accuracy. The mean T2 relaxation time of malignant tumours (64.4 ms) was significantly lower (P < 0.05) than that of benign lesions (476.1 ms). At the threshold of 107 ms 22 FP and 1 FN diagnoses were noted; the sensitivity was 99 %, specificity 80.9 % and accuracy 89.3 %.

Conclusions: Quantitative analysis of T2 relaxation times yielded significantly higher sensitivity and accuracy in diagnosing malignant liver tumour than ADC values.

Key points: • Diffusion-weighted magnetic resonance imaging is increasingly used for liver lesions. • But ADC values demonstrated only moderate accuracy for differentiation of liver lesions. • T2 relaxation times yielded higher accuracy in diagnosing malignant liver tumours. • Both ADC and T2 values overlapped between focal nodular hyperplasia and malignant lesions. • Nevertheless T2 liver mapping could be valuable for evaluating focal liver lesions.

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Related in: MedlinePlus

Box plots of ADC values of 115 benign and 100 malignant liver lesions show that despite ADC values of benign lesions being significantly higher than those of malignant tumours (P < 0.001), ADC values of both lesion types considerably overlapped. Median is shown as a small box inside each bar
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Fig1: Box plots of ADC values of 115 benign and 100 malignant liver lesions show that despite ADC values of benign lesions being significantly higher than those of malignant tumours (P < 0.001), ADC values of both lesion types considerably overlapped. Median is shown as a small box inside each bar

Mentions: The mean ADC value of malignant FLLs was 1.07 × 10−3 mm2/s, ranging from 0.74 × 10−3 to 2.2 × 10−3 mm2/s, whereas the mean ADC value of benign FLLs was 1.86 × 10−3 mm2/s, ranging from 0.67 × 10−3 to 3.22 × 10−3 mm2/s (Fig. 1). The difference between mean ADC values of malignant and benign FLLs was statistically significant (P < 0.001). The calculated area under the ROC curve for diagnosing malignant lesion was 0.874 (95 % CI 0.823, 0.962), with a sensitivity of 79 % and a specificity of 82.6 %, using a cut-off ADC value of 1.25 × 10−3 mm2/s.Fig. 1


Characterization of focal liver lesions using quantitative techniques: comparison of apparent diffusion coefficient values and T2 relaxation times.

Cieszanowski A, Anysz-Grodzicka A, Szeszkowski W, Kaczynski B, Maj E, Gornicka B, Grodzicki M, Grudzinski IP, Stadnik A, Krawczyk M, Rowinski O - Eur Radiol (2012)

Box plots of ADC values of 115 benign and 100 malignant liver lesions show that despite ADC values of benign lesions being significantly higher than those of malignant tumours (P < 0.001), ADC values of both lesion types considerably overlapped. Median is shown as a small box inside each bar
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3472073&req=5

Fig1: Box plots of ADC values of 115 benign and 100 malignant liver lesions show that despite ADC values of benign lesions being significantly higher than those of malignant tumours (P < 0.001), ADC values of both lesion types considerably overlapped. Median is shown as a small box inside each bar
Mentions: The mean ADC value of malignant FLLs was 1.07 × 10−3 mm2/s, ranging from 0.74 × 10−3 to 2.2 × 10−3 mm2/s, whereas the mean ADC value of benign FLLs was 1.86 × 10−3 mm2/s, ranging from 0.67 × 10−3 to 3.22 × 10−3 mm2/s (Fig. 1). The difference between mean ADC values of malignant and benign FLLs was statistically significant (P < 0.001). The calculated area under the ROC curve for diagnosing malignant lesion was 0.874 (95 % CI 0.823, 0.962), with a sensitivity of 79 % and a specificity of 82.6 %, using a cut-off ADC value of 1.25 × 10−3 mm2/s.Fig. 1

Bottom Line: The mean ADC value of malignant tumours (1.07 × 10(-3) mm(2)/s) was significantly lower (P < 0.05) than that of benign lesions (1.86 × 10(-3) mm(2)/s ); however, with the use of the optimal cut-off value of 1.25 × 10(-3) mm(2)/s, 20 false positive (FP) and 20 false negative (FN) diagnoses of malignancy were noted, generating 79 % sensitivity, 82.6 % specificity and 80.9 % accuracy.The mean T2 relaxation time of malignant tumours (64.4 ms) was significantly lower (P < 0.05) than that of benign lesions (476.1 ms).At the threshold of 107 ms 22 FP and 1 FN diagnoses were noted; the sensitivity was 99 %, specificity 80.9 % and accuracy 89.3 %.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Clinical Radiology, Medical University of Warsaw, Ul. Banacha 1A, 02-097, Warsaw, Poland. andrzej.cieszanowski@wum.edu.pl

ABSTRACT

Objectives: To compare the efficacy of two quantitative methods for discrimination between benign and malignant focal liver lesions (FLLs): apparent diffusion coefficient (ADC) values and T2 relaxation times.

Methods: Seventy-three patients with 215 confirmed FLLs (115 benign, 100 malignant) underwent 1.5-T MRI with respiratory-triggered single-shot SE DWI (b = 50, 400, 800) and dual-echo T2TSE (TR = 3,000 ms; TE1 = 84 ms; TE2 = 228 ms). ADC values and T2 relaxation times of FLLs were calculated. Sensitivity, specificity and accuracy of both techniques in diagnosing malignancy were assessed.

Results: The mean ADC value of malignant tumours (1.07 × 10(-3) mm(2)/s) was significantly lower (P < 0.05) than that of benign lesions (1.86 × 10(-3) mm(2)/s ); however, with the use of the optimal cut-off value of 1.25 × 10(-3) mm(2)/s, 20 false positive (FP) and 20 false negative (FN) diagnoses of malignancy were noted, generating 79 % sensitivity, 82.6 % specificity and 80.9 % accuracy. The mean T2 relaxation time of malignant tumours (64.4 ms) was significantly lower (P < 0.05) than that of benign lesions (476.1 ms). At the threshold of 107 ms 22 FP and 1 FN diagnoses were noted; the sensitivity was 99 %, specificity 80.9 % and accuracy 89.3 %.

Conclusions: Quantitative analysis of T2 relaxation times yielded significantly higher sensitivity and accuracy in diagnosing malignant liver tumour than ADC values.

Key points: • Diffusion-weighted magnetic resonance imaging is increasingly used for liver lesions. • But ADC values demonstrated only moderate accuracy for differentiation of liver lesions. • T2 relaxation times yielded higher accuracy in diagnosing malignant liver tumours. • Both ADC and T2 values overlapped between focal nodular hyperplasia and malignant lesions. • Nevertheless T2 liver mapping could be valuable for evaluating focal liver lesions.

Show MeSH
Related in: MedlinePlus