Evaluation of true diffusion, perfusion factor, and apparent diffusion coefficient in non-necrotic liver metastases and uncomplicated liver hemangiomas using black-blood echo planar imaging

PurposeTo assess the added value of true diffusion (D), perfusion factor (f) and apparent diffusion coefficient at low b-values (ADClow) for differentiation between liver metastases and hemangiomas based on respiratory-triggered high-resolution Black-Blood Single-Shot SpinEcho Echo Planar Imaging (BB SS SE-EPI).Materials and methodsTwenty-five patients suspected for malignant colorectal liver lesions were included in this study. A total of 106 lesions were examined. Different b-value images were compared for lesion conspicuity, image quality and artifacts using rank order statistic (RIDIT) and Student's t-test. D, f, and ADClow values were calculated. Pearson correlation coefficient is used for comparison of interobserver variability.ResultsBest lesion conspicuity (p < 0.05) was achieved with BB SS SE-EPI (b = 0 and 10 s/mm2); best image quality (p < 0.05) with b = 10 s/mm2. Image artifacts were lowest (p < 0.05) with b = 0 s/mm2. Over the whole sample, D in metastases (Dmet) was significantly (p < 0.05) lower than D in hemangiomas (Dhem); f and ADClow of metastases (fmet, respectively, ADClow met) were significantly (p < 0.05) higher than f and ADClow of hemangiomas (fhem, respectively, ADClow hem). All Pearson correlations were statistically significant at a 0.01 level.ConclusionsThis preliminary study shows the potential of BB SS SE-EPI as a useful technique to aid in differentiating between liver metastasis and hemangioma. The calculation of D, f and ADClow provides useful additional information for differentiating metastases from hemangiomas.