Detection of small intrahepatic metastases of hepatocellular carcinomas using diffusion-weighted imaging: comparison with conventional dynamic MRI

Magn Reson Imaging. 2011 Sep;29(7):985-92. doi: 10.1016/j.mri.2011.04.010. Epub 2011 May 25.

Abstract

Purpose: The purpose of our study was to compare diffusion-weighted MR imaging (DWI) with conventional dynamic MRI in terms of the assessment of small intrahepatic metastases from hepatocellular carcinoma (HCC).

Materials and methods: In 24 patients with multifocal, small (≤2 cm) intrahepatic metastatic foci of advanced HCC, a total of 134 lesions (≤1 cm, n=81; >1 cm, n=53) were subjected to a comparative analysis of hepatic MRI including static and gadopentetate dimeglumine-enhanced dynamic imaging, and DWI using a single-shot spin-echo echo-planar MRI (b values=50, 400 and 800 s/mm(2)), by two independent reviewers.

Results: A larger number of the lesions were detected and diagnosed as intrahepatic metastases on DWI [Reviewer 1, 121 (90%); Reviewer 2, 117 (87%)] than on dynamic imaging [Reviewer 1, 107 (80%); Reviewer 2, 105 (78%)] (P<.05). For the 81 smaller lesions (≤1 cm), DWI was able to detect more lesions than dynamic imaging [Reviewer 1, 68 (84%) vs. 56 (69%), P=.008; Reviewer 2, 65 (80%) vs. 55 (68%), P=.031], but there was no statistically significant difference between the two image sets for larger (>1 cm) lesions.

Conclusion: Due to its higher detection rate of subcentimeter lesions, DWI could be considered complementary to dynamic MRI in the diagnosis of intrahepatic metastases of HCCs.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / pathology*
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Gadolinium DTPA / pharmacology
  • Hepatectomy / methods
  • Humans
  • Liver / pathology
  • Liver Neoplasms / pathology*
  • Magnetic Resonance Imaging / methods
  • Male
  • Medical Oncology / methods
  • Middle Aged
  • Neoplasm Metastasis

Substances

  • Gadolinium DTPA