Diagnosis of focal liver lesions suspected of metastases by diffusion-weighted imaging (DWI): systematic comparison favors free-breathing technique

Two echo planar imaging diffusion-weighted imaging (DWI) techniques [one breath hold (DWIbh), repetition time/echo time (TR/TE) 2100/62 ms; one at free breathing (DWIfb), TR/TE 2000/65 ms] were compared regarding diagnosis of focal liver lesions (FLLs) in 45 patients with suspected liver metastasis without prior treatment. Apparent diffusion coefficient values of 46 benign and 67 malignant FLLs were analyzed by receiver operating characteristics (ROC) analysis. DWIfb detected more malignant lesions than DWIbh (P=.002). Lesion size ≤10 mm was associated with FLLs missed by DWIbh (P=.018). Area under the ROC curve of DWIfb (0.801) was higher compared to that of DWIbh (0.669, P<.0113), demonstrating the diagnostic superiority of DWIfb.