Comparison of the accuracy of diffusion-weighted imaging versus dynamic contrast enhancement magnetic resonance imaging in characterizing focal liver lesions

OBJECTIVE: The aim of this study was to compare the accuracy of liver magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) versus dynamic contrast enhancement (DCE) versus DWI and DCE in characterizing benign versus malignant lesions and in making correct diagnosis of focal liver lesions. METHODS: Sixty-six adult patients with 115 lesions were evaluated by 2 readers for differentiating benign versus malignant lesions and for lesion diagnosis. The readers evaluated the lesions using unenhanced MRI with DWI and, 4 weeks later, using MRI with DCE and, subsequently, using MRI and DCE with DWI. The final pathologic diagnosis was reached by biopsy or with imaging follow-up. RESULTS: The accuracy of differentiating benign versus malignant lesions of both readers 1 and 2 using DWI was 90.4%; using DCE, 91.3% and 90.4%, respectively; and using DCE with DWI, 98.3% and 95.7%, respectively. The accuracy of diagnosis of readers 1 and 2 using DWI was 83.5% and 80%; using DCE, 87% and 84.4%; and using DCE with DWI, 93.9% and 91.3%, respectively. CONCLUSIONS: Unenhanced MRI with DWI and MRI with DCE have similar accuracy for characterizing focal liver lesions. Magnetic resonance imaging with DCE and DWI has increased accuracy compared with either sequence alone.