Diagnostic Value of Semiquantitative Analysis of Dynamic Susceptibility Contrast Magnetic Resonance Imaging with GD-EOB-DTPA in Focal Liver Lesions Characterization: A Feasibility Study.

Abstract

Purpose. To assess the diagnostic accuracy of dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSCE-MRI) in differentiation between benign and malignant liver lesions by assessment of tumoral perfusion parameters. Methods Materials. Seventy-three patients with known focal liver lesions, including 45 benign (16 FNH, 27 angiomas, and 2 abscesses) and 28 malignant ones (17 metastases, 9 HCCs, and 2 cholangiocarcinoma) underwent 1.5 T MRI upper abdominal study, with standard protocol that included dynamic contrast-enhanced sequences. On dedicated workstation, time-intensity curves were determined and the following perfusion parameters were calculated: relative arterial, venous and late enhancement (RAE, RVE, RLE), maximum enhancement (ME), relative enhancement (RE), and time to peak (TTP). Results. All diagnoses were established either by histopathology or imaging follow-up. Perfusion mean values calculated in benign lesions were RAE 33.8%, RVE 66.03%, RLE 80.63%, ME 776.00%, MRE 86.27%, and TTP 146.95 sec. Corresponding perfusion values calculated in malignant lesions were RAE 22.47%, RVE 40.54%, RLE 47.52%, ME 448.78%, MRE 49.85%, and TTP 183.79 sec. Statistical difference (p < 0.05) was achieved in all the perfusion parameters calculated, obtaining different cluster of perfusion kinetics between benign and malignant lesions. Conclusions. DSCE-MRI depicts kinetic differences in perfusion parameters among the different common liver lesions, related to tumour supply and microvascular characteristics.