Accuracy of visual analysis vs. apparent diffusion coefficient quantification in differentiating solid benign and...

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Accurate assessment of solid focal liver lesions (FLLs) is crucial for patient management.
• Diffusion-weighted imaging (DWI) is a valuable tool, but its interpretation methods vary.

Purpose of the Study:

• To compare the diagnostic accuracy of visual analysis (VA) of DWI and apparent diffusion coefficient quantification (ADC-Q) for solid FLLs.
• To evaluate the effectiveness of these techniques in differentiating benign from malignant lesions.

Main Methods:

• Retrospective analysis of 50 solid FLLs using a 1.5-T MRI system.
• Two radiologists assessed lesions using DWI visual analysis (signal intensity) and ADC quantification.
• Histology or consensus panel diagnosis served as the reference standard.
• Receiver operating characteristic (ROC) curve analysis was performed.

Main Results:

• ADC-Q demonstrated higher overall accuracy (68.0%) compared to VA (52.0%), primarily due to fewer false negatives for hepatocellular carcinoma.
• VA showed higher accuracy for metastases (75.0%) than ADC-Q (66.0%).
• Significant overlap in ADC values and visual features between benign and malignant FLLs was observed.

Conclusions:

• ADC-Q is more accurate than VA for diagnosing hepatocellular carcinoma, whereas VA is more accurate for metastases.
• The overlap in imaging characteristics limits the overall accuracy of both DWI VA and ADC-Q for solid FLLs.
• Further research may be needed to improve the diagnostic performance of DWI in characterizing liver lesions.