• Xiang Tian Zhao, Wei Xia Li, Wei Min Chai, and Ke Min Chen.
• Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
• J Dig Dis. 2014 Mar 1; 15 (3): 137-45.

ObjectiveTo determine whether adding diffusion-weighted imaging (DWI) to gadoxetic acid-enhanced 3.0T magnetic resonance imaging (MRI) can improve the detection of hepatocellular carcinoma (HCC), particularly for small lesions (≤2 cm) in patients with liver cirrhosis.MethodsData of patients diagnosed with focal liver lesions who had undergone gadoxetic acid-enhanced 3.0T MRI and DWI were retrospectively reviewed. Two radiologists (the observers) reviewed independently MRI images in two reading sessions, that is, gadoxetic acid-enhanced images alone and the combination of DWI (b values: 0 and 600 s/mm(2) ) and gadoxetic acid-enhanced images. They assigned to each lesion a confidence level based on a five-point scale. The area under the receiver operating characteristic curve (AUROC), sensitivity and positive predictive value (PPV) for the detection of HCC were calculated.ResultsBoth observers found the AUROC of the gadoxetic acid-enhanced images was slightly higher than that of the combined DWI and gadoxetic acid-enhanced MRI images in the detection of HCC (observer 1: 0.947 ± 0.030 vs 0.896 ± 0.042, Z = 1.478, P = 0.139; observer 2: 0.917 ± 0.038 vs 0.868 ± 0.048, Z = 1.296, P = 0.195). The sensitivity for the gadoxetic acid set alone was slightly higher than that for the combined set for observer 1 (97% vs 84%) and slightly lower for observer 2 (74% vs 82%). The PPVs were slightly higher for the gadoxetic acid set alone than for the combined set for both observers (observer 1, 89% vs 80%; observer 2, 93% vs 78%); however, none of the differences were statistically significant (P > 0.05).ConclusionThere is no benefit in adding DWI to gadoxetic acid-enhanced MRI for the detection of HCC at 3.0T.© 2013 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

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