R2* value derived from multi-echo Dixon technique can aid discrimination between benign and malignant focal liver lesions

Table 1 Baseline characteristics of malignant and benign focal liver lesions of 73 patients

Characteristic	Malignant	Benign	Total
Per-patient basis
No. of patients (%)	49 (67.1)	24 (32.9)	73
Age (yr)
mean ± SD	56.3 ± 10.3	52.1 ± 12.9	55.0 ± 11.2
Range	40-81	31-73	31-81
Sex, n (%)
Male	30 (61.2)	11 (45.8)	41
Female	19 (38.8)	13 (54.2)	32
Per-lesion basis
No. of lesions	78 (72.3)	30 (27.8)	108
Maximum diameter (mm)
mean ± SD	48.2 ± 37.7	32.3 ± 22.5	43.8 ± 34.8
Range	11-163	14-94	11-163
Methods of diagnosis (%)
Pathology	42 (38.9)	7 (6.5)	49 (45.4)
Imaging follow-up	25 (23.1)	23 (21.3)	48 (44.4)
PET-CT	11 (10.2)	–	11 (10.2)

FFL: Focal liver lesion; PET-CT: Positron emission tomography-computed tomography.

Table 2 Clinicopathological characteristics of 108 focal liver lesions

Characteristic		Malignant		Benign
	HCC	IHCC	Hemangioma	FNH	Abscess
No. of lesions (%)	32 (29.6)	9 (8.3)	37 (34.3)	25 (23.1)	3 (2.8)	2 (1.9)
Maximum diameter (mm)
mean ± SD	66.3 ± 43.0	61.9 ± 5.9	29.1 ± 24.1	29.4 ± 21.8	32.0 ± 8.5	69.5 ± 12.0
Range	15-163	32-111	11-122	14-94	23-40	61-78
Methods of diagnosis (%)
Pathology	29 (26.9)	6 (5.6)	7 (6.5)	5 (4.6)	2 (1.9)	0 (0)
Imaging follow-up	3 (2.8)	3 (2.8)	19 (17.6)	20 (18.5)	1 (0.9)	2 (1.9)
PET-CT	–	–	11 (10.2)	–	–	–
Viral infection
HBV	30	6	34	9	1	2
Non-HBV	2	3	3	9	1	0
NA	0	0	0	7	1	0
Cirrhosis on pathology (%)
Yes	25	–	–	–	–	–
No	1	–	–	–	–	–
NA	6	–	–	–	–	–
AFP (ng/mL)
≤ 25	12	9	29	–	–	–
> 25	20	0	7	–	–	–
NA	0	0	1	–	–	–
CA 19-9 (U/mL)
≤ 34	21	4	15	–	–	–
> 34	9	5	20	–	–	–
NA	2	0	2	–	–	–
CEA (ng/mL)				–	–	–
≤ 5	27	7	15	–	–	–
> 5	5	2	22	–	–	–
NA	0	0	0	–	–	–

APF: -fetoprotein; CA 19-9: Carbohydrate antigen 19-9; CEA: Carcinoma embryonic antigen; FFL: Focal liver lesion; FNH: Focal nodular hyperplasia; HBV: Hepatitis B virus; HCC: Hepatocellular carcinoma; IHCC: Intrahepatic cholangiocarcinoma; NA: Not available; PET-CT: Positron emission tomography-computed tomography. Data are shown as the mean SD.

Table 3 Mean R2* values for different focal liver lesions

FFL	2D-ROI method	VOI method
Malignant
Liver metastasis	44.17 ± 21.90	48.42 ± 23.61
HCC	33.45 ± 10.15	35.41 ± 10.04
IHCC	28.72 ± 10.21	31.34 ± 9.65
Benign
Hemangioma	16.66 ± 8.18	19.36 ± 8.93
FNH	26.21 ± 5.61	27.87 ± 7.46
Abscess	23.29 ± 9.31	25.29 ± 10.46

Numerical data are expressed as the mean ± SD. 2D-ROI: Two-dimensional region of interest; FFL: Focal liver lesion; FNH: Focal nodular hyperplasia; HCC: Hepatocellular carcinoma; IHCC: Intrahepatic cholangiocarcinoma; VOI: Volume of interest.