J Liver Cancer.  2016 Sep;16(2):92-100. 10.17998/jlc.2016.16.2.92.

Diagnostic Performance of Diffusion-weighted Imaging for Hepatic Neuroendocrine Tumor: Comparison with Combined Diffusion-weighted Imaging and Contrast-enhanced Magnetic Resonance Imaging

• Jang SK
• Kim JH
• Yu MH
• Han JK

• KMID: 2357338
• DOI: http://doi.org/10.17998/jlc.2016.16.2.92

Abstract

BACKGROUND/AIMS
To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrast-enhanced magnetic resonance imaging (MRI).
METHODS
Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC).
RESULTS
Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P〈0.05) and the DWI set (FOM=0.682, 0.620, P〈0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (〈1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589).
CONCLUSIONS
Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.

Keyword

Diffusion-weighted imaging; Hepatic neuroendocrine tumor; Contrast-enhanced MRI; Comparison study

MeSH Terms

Humans
Magnetic Resonance Imaging*
Neuroendocrine Tumors*
Sensitivity and Specificity