Acta Biomedica Scientia

DIAGNOSTIC UTILITY OF DIFFUSION-WEIGHTED IMAGING AND APPARENT DIFFUSION COEFFICIENT IN DIFFERENTIATING BENIGN AND MALIGNANT FOCAL LIVER LESIONS: A CROSS-SECTIONAL STUDY

Ravi Kumar P1, Rupesh D

drpebyreddy@gmail.com

Focal liver lesions, diffusion-weighted imaging, apparent diffusion coefficient, MRI, liver cancer, hepatic abscess, diagnostic imaging, non-invasive diagnosis

The liver is a common site for various focal liver lesions (FLLs), ranging from benign conditions to malignant tumors. Accurate differentiation between benign and malignant FLLs is crucial for effective patient management. This study evaluates the role of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values in characterizing FLLs. Conducted in the Department of Radio-Diagnosis at Sri Lakshmi Narayana Institute of Medical Sciences, Pondichery, India, over a two-year period, this cross-sectional study analyzed 94 patients diagnosed with FLLs through ultrasonography (USG), multi-detector computed tomography (MDCT), and magnetic resonance imaging (MRI). DWI, a non-invasive MRI technique, leverages differences in water proton mobility to differentiate between tissue types. This study found that all malignant FLLs (n=39) exhibited true diffusion restriction on DWI and lower ADC values (mean: 1.0155 ± 0.147 × 10?³ mm²/s) compared to benign lesions (mean: 2.1952 ± 0.308 × 10?³ mm²/s). The ADC value ranges for malignant and benign lesions (excluding abscesses) were 0.8-1.3 × 10?³ mm²/s and 1.5-3.5 × 10?³ mm²/s, respectively. Notably, hepatic abscesses, despite being benign, also showed restricted diffusion with overlapping ADC values (mean: 0.9 × 10?³ mm²/s), necessitating additional clinical and imaging evaluation to distinguish them from malignant lesions. This study underscores the utility of DWI and ADC mapping as effective tools in differentiating benign from malignant FLLs, particularly when contrast agents are contraindicated. DWI, combined with conventional MRI sequences, can significantly reduce the need for invasive procedures like biopsies. The findings suggest that DWI should be integrated into routine liver imaging protocols for its high diagnostic accuracy.