Role of ADC Value in Differentiation of Malignant and Benign Hepatic Lesion


Background: Apparent diffusion coefficient ADC value used in this research for differentiation of the malignant and benign hepatic lesions, which has an impact on the management of these lesions by surgery or conservatively. Aim: To analyze the role of diffusion weighted imaging (DWI) with the apparent diffusion coefficient (ADC) values in the differentiation of malignant from benign hepatic lesions.Materials and methods: this is a prospective cross-sectional study 80 patients with 118 focal hepatic lesions contributed. MRI with DWI examination was carried out for all patients. After DWI examination, an ADC map was created and ADC values were measured for 118 focal hepatic lesions.Results: out of 118 hepatic lesions, 62 were benign and 56 were malignant. Benign lesions comprised 30 hemangiomas and 21 simple cysts, 6 focal nodular hyperplasia (FNH), 4 abscesses and 1 adenoma. Malignant lesions comprised 47 metastases, 6 hepatocellular carcinomas (HCC), 2 fibrolamellar hepatocellular carcinomas and 1 case intra hepatic cholangiocarcinoma. The highest ADC values were measured for cysts. The mean ADC value of benign lesions was 2.27 ± 0.7 x 10ˉ³mm²/sec, whereas malignant lesions had a mean ADC value of 0.85 ± 0.18 × 10ˉ³mm²/sec. The mean ADC value of benign lesions was significantly higher than that of malignant lesions (P < 0.001).Conclusion: DWI and quantitative measurement of ADC values shows promising result in characterization of benign and malignant hepatic lesions, with other MRI sequences of dynamic contrast study. Especially, when contrast is contraindicated.