Value of apparent diffusion coefficient measurement for discrimination of focal benign and malignant hepatic masses

The purpose of our study was to investigate the value of diffusion-weighted magnetic resonance imaging (DW-MRI) to discriminate benign and malignant focal lesions of the liver using parallel imaging technique. A total of 77 patients and 65 healthy controls were enrolled in the study. DW-MRI was performed with b-factors of 0, 500 and 1000 s/mm(2), and the apparent diffusion coefficients (ADC) values of the normal liver and the lesions were calculated. The mean ADC value of the focal liver lesions were as follows: simple cysts (3.16 +/- 0.18 x 10(-3) mm(2)/s), hydatid cysts (2.58 +/- 0.53 x 10(-3) mm(2)/s), hemangiomas (1.97 +/- 0.49 x 10(-3) mm(2)/s), metastases (1.14 +/- 0.41 x 10(-3) mm(2)/s) and hepatocellular carcinomas (HCC) (1.15 +/- 0.36 x 10(-3) mm(2)/s). The mean ADC values of all the disease groups were statistically significant when compared with the mean ADC value of the normal liver (1.56 +/- 0.14 x 10(-3) mm(2)/s), (P < 0.01). There were also statistically significant differences among the ADC values of hemangiomas and HCC metastases (P < 0.01), and simple and hydatid cysts (P < 0.008). However, there was no statistically significant difference between HCC and metastases. The present study showed that ADC measurement has the potential to differentiate benign and malignant focal hepatic lesions. We propose to add DW sequence in the MR protocol for the detection and quantitative discrimination of hepatic pathologies.