Diffusion-weighted imaging of the liver: Current applications

Table 1 Detection of fibrosis using diffusion-weighted imaging

	Tesla	Respiratory	Staging	ROI setting	b-value	Diagnostic accuracy of fibrosis F3 or grater
						AUC	Sensitivity	Specificity
Cece et al[91]	1.5	BH	MTAVIR	5 ROIs, Both	0, 500, 1000	0.888	92.9	79.4
Taouli et al[92]	1.5	BH	MTAVIR	4 ROIs, Both	0, 50	0.717	40	100
					0, 300	0.716	50	94.7
					0, 500	0.835	70	85
					0, 700	0.901	66.7	100
					0, 1000	0.832	80	90
					0, 50, 300, 500, 700, 1000	0.896	88.9	80
Kocakoc et al[93]	1.5	BH	Ishak	3 ROIs, Both	100, 600, 1000	0.759	56.5	99.3
Wu et al[47]	3	RT	MTAVIR	5 ROIs, Right	0, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 200, 300, 400, 500, 1000	0.684
Chung et al[48]	1.5	RT	MTAVIR	6 ROIs, Right	0, 100, 200, 900	0.768
					0, 30, 60, 100, 150, 200, 900	0.764
					0, 30, 60, 100, 150, 200, 400, 600, 900	0.754	65.5	82.1
Ding et al[94]	1.5	FB	New Inuyama	Whole right lobe	0, 500	0.61	30.4	90.6
Feier et al[43]	3	NA	MTAVIR	1 ROI, Right	50, 300, 600	0.77	81.08	72.5
Fujimoto et al[95]	1.5	NA	MTAVIR	4 ROIs, Right	0, 1000 (entropy ADC)	0.926	87	84
Do et al[46]	1.5	BT	Ludwig	4 ROIs, Right	0, 50, 500 (normalized ADC)	0.689	56	71
Bonekamp et al[96]	1.5	BT	MTAVIR	9 ROIs, Both	0, 750	0.8	83.9	68.5
Wang et al[44]	1.5	NA	MTAVIR	3 ROIs, Right	50, 500, 1000	0.84	88	76
Lewin et al[41]	1.5	RT	MTAVIR	3 ROIs, Right	0, 200, 400, 800	0.92	87	87
Sandrosegaran et al[40]	1.5	BH		2 ROIs, Both	50, 400	0.656	51.7	71.4

BH: Breath-hold; RT: Respiratory gating.

Table 2 Detection of liver tumor in combination with Gd-EOB-DTPA- enhanced magnetic resonance imaging

	Tesla	Respiratory	b-value (× 10-3 s/mm2)	Tumor	Results
Kim et al[97]	3	RT	0, 100, 800	Mets	Combined EOB-MRI and DWI yielded better accuracy and sensitivity
				(Various)
Chung et al[98]	3	FB	50, 400, 800	Mets	Combined EOB-MRI and DWI yielded better accuracy and sensitivity
				(colorectal)
Koh et al[99]	1.5	FB	0, 50, 100, 250, 500, 750	Mets	Combined EOB-MRI and DWI improved detection
				(colorectal)
Löwenthal et al[100]	1.5	BH	0, 500	Mets	DWI can detect small lesions
				(colorectal)
Shimada et al[101]	3	RT	0, 500	Mets	EOB-MRI showed higher accuracy
				(Various)
Donati et al[102]	1.5	BH	0, 150, 500	Mets	No added value of DWI
				(Various)
Kim et al[103]	1.5	RT	0, 50, 600	Mets, HCC	DWI increases sensitivity for detecting Mets
					No added value of DWI for HCC detection

DWI: Diffusion-weighted imaging; BH: Breath-hold; RT: Respiratory gating; FB: Free breathing; HCC: Hepatocellular carcinoma.

Table 3 Characteristic differentiation of liver tumors

	Tesla	b-value	ADC (×10-3 mm2)
			Benign			Malignant
			Cyst	Hemangioma	All	HCC	Mets	All
Goshima et al[104]	1.5	0, 100, 200, 400, 800	3.70 ± 0.9	1.23 ± 0.2		1.08 ± 0.3	0.99 ± 0.5
Battal et al[105]	1.5	0, 800			1.94 ± 0.61			0.86 ± 0.13
Gurtosoyianni et al[106]	1.5	0, 50, 500, 1000	2.55	1.9	2.55	1.38	0.99	1.04
Testa et al[71]	1.5	0, 600	2.4				1
Miller et al[73]	1.5	0, 500	3.40 ± 0.48	2.26 ± 0.70	2.50 ± 0.86	1.54 ± 0.44	1.50 ± 0.65	1.52 ± 0.55
Namimoto et al[107]	1.5	30, 1200	3.05	1.95		0.99	1.15	1.04
Kim et al[108]	1.5	3, 57, 192, 408, 517, 705, 846	2.91 ± 1.51	2.04 ± 1.01	2.49 ± 1.39	0.97 ± 0.31	1.06 ± 0.50	1.01 ± 0.38
Taouli et al[67]	1.5	0, 500	3.63 ± 0.56	2.95 ± 0.67		1.33 ± 0.13	0.94 ± 0.60
Cieszanowsk et al[109]	1.5	50, 400, 800	2.45	1,55	1.86	0.94	1.05	1.07
Bruegel et al[72]	1.5	50, 300, 600	3.02 ± 0.31	1.92 ± 0.34		1.05 ± 0.09	1.22 ± 0.31
Kandpal et al[13]	1.5	0, 500	2.90 ± 0.51	2.36 ± 0.48		1.27 ± 0.42	1.13 ± 0.41
Demir et al[110]	1.5	0, 1000	3.05 ± 0.26	2.46 ± 0.21	2.57 ± 0.26	0.90 ± 0.10	0.79 ± 0.11	0.86 ± 0.11
Oner et al[111]	1.5	0, 500	2.34 ± 0.36	1.72 ± 0.30			1.03 ± 0.24
Holzapfel et al[112]	1.5	50, 300, 600	2.61 ± 0.57	1.69 ± 0.34	2.36 ± 0.62	1.12 ± 0.28	1.08 ± 0.32	1.09 ± 0.30

ADC: Apparent diffusion coefficient; HCC: Hepatocellular carcinoma.

Table 4 Histological differentiation of hepatocellular carcinoma using apparent diffusion coefficient

	Tesla	Respiratory	b-value (s/mm2)	Well-diff HCC(×10-3 mm2/s)	Mod diff HCC(×10-3 mm2/s)	Poorly diff HCC(×10-3 mm2/s)	Difference
Saito et al[113]	1.5	RT	100, 800	1.25 ± 0.25	1.12 ± 0.22	1.13 ± 0.23	NS
Nasu et al[114]	1.5	RT	0, 500	1.45 ± 0.35	1.46 ± 0.32	1.36 ± 0.29	NS
Heo et al[77]	1.5	FB	0, 1000	1.2 ± 0.22	1.1 ± 0.10	0.9 ± 0.13	p < w, m
Nakanishi et al[80]	1.5	RT	50, 1000	NA	1.29 ± 0.21	1.07 ± 0.15	p < m
Nishie et al[75]	1.5	RT	0, 500, 1000	1.21 ± 0.11	1.14 ± 0.26	0.76 ± 0.10	p < w, m
Guo et al[79]	3.0	BH	0, 600	1.43 ± 0.09	1.34 ± 0.19	1.16 ± 0.16	p < w, m

RT: Respiratory trigger; BH: Breath holding; FB: Free breathing; ADC: Apparent diffusion coefficient. p < w, m: ADC in poorly differentiated HCC was significantly lower than ADC in well-differentiated HCC and moderately differentiated HCC; p < m: ADC in poorly differentiated HCC was significantly lower than ADC in moderately differentiated HCC; NS: No significant difference in ADC was observed for each histological grade; NA: Not applicable.