Cyprus Journal of Medical Sciences
Original Article

Can Liver Imaging for Focal Lesions be Limited with Only Diffusion-Weighted Sequences in Patients without Known Malignancy?


Department of Radiology, Near East University School of Medicine, Mersin, Turkey

Cyprus J Med Sci 2019; 4: 43-51
DOI: 10.5152/cjms.2019.670
Read: 1215 Downloads: 141 Published: 23 July 2019






Our purpose is to investigate whether the diffusion-weighted imaging (DWI) can be used as an initial and decisive sequence to shorten liver magnetic resonance imaging (MRI) study, rather than being complementary to conventional sequences especially in patients without known malignancy.





The MRI characteristics of 105 focal liver lesions (FLLs) were classified as benign or malignant by visually assessing the DWI features, and the lesions were compared with a complete liver MRI protocol. Hyperintensity or isointensity of a lesion in apparent diffusion coefficient map by visual assessment was accepted as unrestricted diffusion and benignity, while hypointensity in any part of a lesion was accepted as restricted diffusion and malignancy. Specificity, sensitivity, positive predictive value, negative predictive value, and accuracy of DWI were calculated.



The visual assessment of DWI alone had 74.29% sensitivity, 94.29% specificity, 86.67% positive predictive value, 88.00% negative predictive value, and 87.62% accuracy in differentiating malignant lesions from the benign ones. In 28 of 32 patients without malignancy, DWI results were in concordance with the final diagnosis of benign lesions. The misinterpreted lesions in these patients were three abscesses and a hemorrhagic adenoma.



Visual DWI characteristics of FLLs in patients without known malignancy can accurately classify the lesions as benign or malignant. In appropriately selected patients, a liver MRI examination can be completed with only DWI, resulting decrease in time and cost related to intravenous contrast media usage.



Cite this article as: Gezgin S, Kocaoğlu M. Can Liver Imaging for Focal Lesions be Limited with Only Diffusion-Weighted Sequences in Patients without Known Malignancy?. Cyprus J Med Sci 2019; 4(1): 43-51.

ISSN2149-7893 EISSN 2536-507X