3D variable flip angle T1 mapping for differentiating benign and malignant liver lesions at 3T: comparison with...

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Focal liver lesions (FLL) diagnosis can be challenging due to atypical imaging characteristics on MRI.
• Magnetic resonance imaging (MRI) is a preferred non-radiation imaging modality for FLL.
• Differentiating benign from malignant FLLs is crucial for appropriate patient management.

Purpose of the Study:

• To compare the diagnostic performance of T1 mapping and diffusion-weighted imaging (DWI) for differentiating benign and malignant FLLs.
• To evaluate the quantitative parameters derived from T1 mapping (native T1, enhanced T1, ΔT1%) and DWI (apparent diffusion coefficient - ADC).
• To assess the accuracy of these parameters in classifying FLLs.

Main Methods:

• A retrospective study analyzed 294 FLLs (150 benign, 144 malignant).
• Whole liver T1 mapping was performed before and after Gd-DTPA administration.
• Diffusion-weighted imaging (DWI) was used to generate ADC maps; quantitative parameters were statistically analyzed.

Main Results:

• Significant differences in native T1, enhanced T1, ΔT1%, and ADC were found between benign and malignant FLLs.
• Enhanced T1 and ΔT1% demonstrated high sensitivity and specificity (0.911/0.976 and 0.901/0.905, respectively).
• ADC showed excellent diagnostic accuracy (0.975/0.952), while native T1 was particularly effective for distinguishing cysts and hemangiomas (AUC 0.990).

Conclusions:

• 3D Variable flip angle T1 mapping with Gd-DTPA shows high clinical potential for FLL characterization.
• Enhanced T1 and ΔT1% offer diagnostic accuracy comparable to DWI for FLL evaluation.
• Native T1 mapping provides superior performance over DWI in differentiating specific benign liver lesions.