Can diffusion weighted MRI differentiate between benign and malignant hepatic focal lesions

Abstract The aim of this study is to evaluate the role of diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant hepatic focal lesions. Patients and methods Fifty-five hepatic focal lesions in 40 patients. All those patients were subjected to full clinical evaluation and radiological assessment using conventional MRI study of the liver and diffusion-weighted MRI (Different b values: 100, 500 and 750 s/mm 2 ). All lesions were evaluated regarding size, signal intensity, enhancement pattern, qualitative assessments by the different b values and quantitative assessment by measurement of the ADC values. Results ADCs of focal hepatic lesions were significantly different between benign (2.869 × 10 −3  mm 2 /s ± 0.652) and malignant (0.995 × 10 −3  mm 2 /s ± 0. 274) hepatic focal lesions. The mean ADCs were 0.76 × 10 −3  mm 2 /s ± 0.53 for metastases, 1.3 × 10 −3  mm 2 /s ± 0.55 for HCCs, 1.95 × 10 −3  mm 2 /s ± 0.24 for benign hepatocellular lesions, 2.92 × 10 −3  mm 2 /s ± 0.102 for hemangiomas, and 3.64 × 10 −3  mm 2 /s ± 0.14 for cysts. Conclusion Diffusion-weighted imaging (DWI) offers the possibility to obtain criteria for characterization of focal liver lesions with subsequent differentiation between benign and malignant hepatic focal lesions without the need for contrast agent administration-by quantifying diffusion effects via apparent diffusion coefficient (ADC) measurements.