Diagnostic Efficacy of Diffusion Weighted MRI in Discriminating Between Benign and Malignant Hepatic Focal Lesions: A Comparative Study with Conventional Imaging Modalities

Abstract

Context: Making informed decisions about treatment and prognosis depends critically on the precise identification and description of hepatic localized lesions. Distinguishing between benign and malignant liver lesions has demonstrated potential with diffusion-weighted magnetic resonance imaging (DW-MRI).

Goal: to evaluate the effectiveness of DW-MRI in comparison to other imaging modalities and to determine its diagnostic accuracy in separating benign from malignant hepatic focal lesions.

Techniques: 150 individuals with hepatic focal lesions who had DW-MRIs between January 2019 and December 2022 were the subjects of a retrospective investigation. The reference standard for evaluating the diagnostic performance of DW-MRI was histological examination. The following metrics were computed: accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Conventional imaging modalities such as computed tomography (CT), conventional magnetic resonance imaging (MRI), and ultrasonography (US) were compared.

Findings: DW-MRI showed 92% sensitivity, 88% specificity, and 92% accuracy in separating benign from malignant liver lesions. 0.94 was the area under the ROC curve (AUC). A comparative study showed that DW-MRI performed better in terms of diagnosis than US, CT, and traditional MRI. For the purpose of distinguishing between benign and malignant lesions, the ideal apparent diffusion coefficient (ADC) cutoff values were 1.2 x10^-3 mm³/s for highest specificity and 1.1 x10^-3 mm²/s for maximum sensitivity.

Conclusion: When it comes to the diagnostic algorithm for hepatic focal lesions, DW-MRI is a useful tool since it performs better than traditional imaging modalities and has great diagnostic accuracy in differentiating between benign and malignant lesions.