Value of Apparent Diffusion Coefficient (ADC) Ratio To discriminate Common Benign and Malignant Hepatic Focal Lesions at MRI diffusion study.

Abd El Basset, Ahmed Sayed; Mosaad, Ramy Mohie Eldeen Zarif; Saeed, Ahmed Hesham Mohamed; Abd Elhady, Marwa Shehata

doi:10.21608/ejmr.2024.276544.1586

Value of Apparent Diffusion Coefficient (ADC) Ratio To discriminate Common Benign and Malignant Hepatic Focal Lesions at MRI diffusion study.

Document Type : Original Article

Authors

Radiology department, Faculty of Medicine, Beni-Suef University, Egypt

10.21608/ejmr.2024.276544.1586

Abstract

Background: Diffusion-weighted imaging (DWI) is a novel imaging technique with a growing application in onco- imaging. This modality evaluates the diffusion of water molecules in various tissues, which is restricted in hypercellular regions such as malignant tissue. Apparent diffusion coefficient (ADC) is a method that can quantify the degree of restriction in tissues and can have diagnostic roles in the characterization of hepatic lesions. The ratio of ADC values between a lesion and the background liver can potentially negate these external factors and provide a more accurate representation of change in the diffusion with respect to normal tissue. Aim: Our study aimed to investigate the usefulness of ADC ratio of a solid liver lesion to liver parenchyma to discriminate between benign and malignant lesions. Methods: This was a cross sectional study conducted on all patients with hepatic solid focal lesion (benign or malignant), starting from 10-2019 to 4-2020. All patients were subjected to: Full history taking including, Radiological investigations, and Laboratory investigations. Result: There was significant difference between benign and malignant group as regards lesion: liver ADC ratio. Conclusion: Lesion to background liver ADCratio is superior in discriminating between benign and malignant focal lesions compared to absolute ADC values of the hepatic lesions. With increasing ADCratio, there is a trend towards benignity. A cut off of ADCratio below 0.9 reflected malignancies while ADCratio above 1.5 reflected benign aetiology. These cut offs can be validated further with further studies with larger number of individual malignant and benign lesions.

Keywords

Main Subjects

Diagnostic

References

Caraiani C, Chiorean L, Fenesan DI (2015) Diffusion weighted magnetic resonance imaging for the classification of focal liver lesions as benign or malignant, J.Gastrointest. Liver Dis. 9 309–317.
Jain TP, Ter Kan W, Edward S, Fernon H, Naider RK (2018) Evaluation of ADCratio on liver MRI diffusion to discriminate benign versus malignant solid liver lesions. European Journal of Radiology Open, 5, 209-214.
Testa M, Chojniak R, Sene L (2014) Is DWI/ADC a useful tool in the characterization of focal hepatic lesions suspected of malignancy?", PLoS One 9
Colagrande S, Regini F, Pasquinelli F (2013) Focal liver lesion classification and characterization in non-cirrhotic liver: a prospective comparison of diffusion weighted magnetic resonance-related parameters, J. Comput. Assist. Tomogr. 37 560–567.
Tang L, Zhou XJ (2019) Diffusion MRI of cancer: From low to high b‐values. Journal of Magnetic Resonance Imaging, 49(1), 23-40.
Alnaghy EA, El-Nahas MA, Sadek AG, Gwely NN, Elrakhawy MM (2018) Role of diffusion-weighted magnetic resonance imaging in the differentiation of benign and malignant pulmonary lesions. Polish Journal of Radiology, 83, 585-594.
Xia Q, Feng Y, Wu C, Huang G, Liu J, Chen T, et al (2015) Differentiation between malignant and benign solitary lesions in the liver with 18FDG PET/CT: accuracy of age-related diagnostic standard. Journal of Cancer, 6(1), 40.
Jiang ZP, Zeng KY, Huang JY, Yang J, Yang R, Li JW, et al (2022) Differentiating malignant and benign focal liver lesions in children using CEUS LI-RADS combined with serum alpha-fetoprotein. World Journal of Gastroenterology, 28(21), 2350-2360.
Bröker ME, Ijzermans JN, Witjes CD, van Vuuren HJ, de Man RA (2014) The predictive value of Golgi protein 73 in differentiating benign from malignant liver tumors. PLoS One, 9(7), e100187.
Abdurrahman LA, Ali AH, Abdelmotelb EM (2020) Role of diffusion weighted MRI in differentiation between benign and malignant hepatic focal lesions. QJM: An International Journal of Medicine, 113(Supplement_1), hcaa068-021a.
Yılmaz FG, Yıldırım AE (2018) Relative contribution of Apparent Diffusion Coefficient (ADC) values and ADC ratios of focal hepatic lesions in the characterization of benign and malignant lesions. Eur J Ther, 24(3), 150-7.
Cieszanowski A, Anysz-Grodzicka A, Szeszkowski W, Kaczynski B, Maj E, Gornicka B, et al (2012) Characterization of focal liver lesions using quantitative techniques: comparison of apparent diffusion coefficient values and T2 relaxation times. European radiology, 22(11), 2514-2524.
Koike N, Cho A, Nasu K, Seto K, Nagaya S, Ohshima Y, Ohkohchi N (2009) Role of diffusion-weighted magnetic resonance imaging in the differential diagnosis of focal hepatic lesions. World journal of gastroenterology: WJG, 15(46), 5805.
Karim MA, Nehad MF, Tharwat M (2021) Characterization of Hepatic Focal Lesions by Diffusion Tensor Imaging and How Far it Can Predict Post-Treatment Response?. The Medical Journal of Cairo University, 89(June), 1263-1273.
Abugamra S, Yassin A, Abdel-Rehim ASM, Sheha DS (2020) Apparent diffusion coefficient for differentiating between benign and malignant hepatic focal lesions. Egyptian Liver Journal, 10(1), 1-8.
Hasan NMA, Zaki KF, Alam-Eldeen MH, Hamedi HR (2016) Benign versus malignant focal liver lesions: Diagnostic value of qualitative and quantitative diffusion weighted MR imaging. The Egyptian journal of radiology and nuclear medicine, 47(4), 1211-1220.