Utility of diffusion-weighted magnetic resonance imaging in diagnosing hepatocellular carcinoma in cirrhotic liver

Abstract

We aimed to introduce the utility of diffusion-weighted images(DWI) in differentiating hepatocellular carcinoma (HCC) fromdysplastic nodules (DN) in cirrhotic liver. DWI studies of thepatients who had cirrhosis and HCC or cirrhosis and DN wereevaluated retrospectively. Signal intensities of the lesions wereclassified as hyper-, iso- or hypointense on DWI. Apparent diffusion coefficient (ADC) and ADC ratios (the ratio between lesionADC, and ADC of the surrounding liver parenchyma) was obtained, and mean values were compared. Statistical significancewas set at p<0.05. Ninety-five lesions were diagnosed with HCCand forty-four lesions with DN from a total of 87 patients. Thehyperintensity on DWI, mean ADC, and ADC ratio of HCCs werestatistically significant (p<0.001 for all parameters). An ADC value of ? 1.316x10-3 mm²/s and an ADC ratio of ? 0.94 obtained byROC curve analysis, were found to be the best cut-off values. DWIalone has a limited capability to detect HCC, but it can be used forimaging cirrhotic liver to supply ancillary findings in addition todynamic contrast-enhanced MRI in diagnosing HCC.