Table 1.
Characteristics of the included studies comparing mean ADC values of malignant and solid benign liver lesions
| Author, year | Design | MRI vendor, filed strength (T) | b value (s/mm2) | Slice thickness (mm) | DW-MRI sequence; breathing pattern | Malignant lesions | Solid benign lesions | Mean (±SD) ADC of malignant vs solid benign (×10−3 mm2/s) | Mean size of malignant vs solid benign lesions (mm) |
|---|---|---|---|---|---|---|---|---|---|
| Aslan et al28 | Retro | Siemens, 1.5 | 0, 500, 1000 | 5 | SS-SE-EPI; free-breathing | 96 lesions (27 HCC, 65 metastases, 3 CCA, one gallbladder carcinoma) | ten lesions (10 FNH) | 0.97 (±0.21) vs 1.31 (±0.23) | 38.9 vs 38.3 mm |
| Di Martino et al29 | Retro | Siemens, 1.5 | 0, 50, 400, 800 | 5 | SS-EPI; breath-hold | 90 HCC | 29 lesions (23 regenerative nodules, 4 DNs, one necrosis, one fibrosis) | 0.97 (±0.20) vs 1.21 (±0.31) | 15 vs 19.41 |
| Filipe et al8 | Retro | Siemens, 1.5 | 50, 700 | 8 | SS-EPI; respiratory- triggered | 30 lesions (12 HCC and 18 metastases) | 14 lesions (10 FNH and 4 HCA) | 1.16 (0.22) vs 1.54 (0.42) | 46.9 vs 35.9 |
| Girometti et al2 | Retro | Siemens, 1.5 | 50, 500, 800 | 6 | SS-EPI; respiratory- triggered | 34 lesions (22 HCC, 12 metastases) | 16 lesions (12 FNH/HCA, 3 DNs, one atypical hemangioma) | 1.08 (±0.36) vs 1.25 (±0.26) | 21.88 vs 25.81 |
| Inchingolo et al30 | Retro | GE, 1.5 | 0, 800 | 8 | SS-EPI; free-breathing | 42 lesions (29 HCC and 13 HGDN) | 11 LGDN | 1.32 (±0.26) vs 1.54 (±0.31) | 21.8 vs 21.4 |
| Muhi et al31 | Retro | GE, 1.5 | 500, 1000 | four to 6 | SS-SE-EPI; respiratory- triggered | 86 HCC | 12 DNs | 0.79 (±0.25) vs 1.0 (±0.22) | NR |
| Mungai et al32 | Retro | Siemens, 1.5 | 50, 400, 800 | 5 | SS-SE-EPI; navigator-triggered | 192 lesions (81 HCC, 77 metastases, and 34 CCA) | 110 lesions (72 FNH and 38 HCA) | 0.96 (±0.23) vs 1.25 (±0.28) | NR |
| Onur et al14 | Pros | GE, 1.5 | 100, 600, 1000 | 5 | SS-SE-EPI; free-breathing | 69 lesions (28 HCC, 33 metastases, 8 CCA) | 26 lesions (14 FNH, 4 HCA, 2 AML, one teratoma, two nodular regenerative hyperplasia, three alveolar echinococcosis) | 1.08 (±0.22) vs 1.52 (±0.47) | 51.26 vs 27.14 |
| Sandrasegaran et al33 | Retro | Siemens, 1.5 | 0, 50, 400 | 6 | SS-EPI; breath-hold | 45 lesions (41 HCC and four metastases) | nine lesions (6 FNH and 3 HCA) | 1.10 (±0.33) vs 1.21 (±0.87) | 36.08 vs 36.0 mm |
| Sandrasegaran et al34 | Retro | Siemens, 1.5 | 0 or 50, 400 or 500, 800 | 6 | SS-EPI; free-breathing | 41 HCC | 29 benign hepatic nodules | 0.94 (±0.24) vs 1.02 (±0.57) | 44 vs 14 mm |
| Sutherland et al35 | Retro | Siemens, 1.5 | 100, 400, 800 | 8 | Breath-hold | eleven lesions (2 CCA and nine metastases) | 47 lesions (40 FNH, 4 HCA, two focal steatosis, one hyalinized scar) | 1.15 vs 1.19 | 24.7 vs 26.5 mm |
| Xu et al36 | Retro | Siemens, 1.5 | 0, 500 | 7 | SS-SE-EPI; breath-hold | 40 HCC | 19 DNs | 1.28 (±0.25) vs 1.53 (±0.33) | 35 vs 25 mm |
| Yang et al37 | Pros | GE, 1.5 | 0, 600 | 6 | SS-EPI; respiratory- triggered | 32 lesions (22 HCC, seven metastases, 2 CCA, one hemangioendothelioma) | 25 lesions (8 FNH, 1 HCA, 1 AML, four inflammatory pseudotumor, eight solitary necrotic nodules, two pseudolipoma.1 ectopic adrenal adenoma) | 1.29 (±.21) vs 1.59 (±0.47) | NR |
| Zarghampour et al38 | Retro | Siemens, 1.5 | 0, 750 | 8 | SS-EPI; breath-hold | 60 HCC | 81 HCA | 1.40 (±0.16) vs 1.07 (±0.23) | 39.64 vs 26.52 mm |
AML, Angiomyolipoma; CCA, Cholangiocarcinoma; DN, Dysplastic nodule; FNH, Focal nodular hyperplasia; HCA, Hepato cellular adenoma; HCC, Hepatocellular carcinoma; HGDN, High-grade dysplasticnodule; LGDN, Low-grade dysplastic nodule; NR, Not reported; Pros, Prospective; Retro, Retrospective; SS-EPI, Single-shot echoplanar imaging; SS-SE-EPI, Single-shot spin-echo echo-planar imaging.
Except in one study38 that volumetric method was used to measure ADC, other studiesapplied placement of region of interest (ROI) for ADC measurement. The primary sites of 106 metastatic lesions out of 225 ones werereported. These included gastrointestinal tract (53 lesions), pancreas (7 lesions), lung (13 lesions), breast (15 lesions), larynx (2lesions), kidney (6 lesions), ovaries and endometrium (6 lesions), and neuroendocrine tumors (4 lesions).