Application of diffusion kurtosis imaging in differential diagnosis of focal liver lesions

Joanna Podgórska; Katarzyna Pasicz; Witold Skrzyński; Bogumił Gołębiewski; Piotr Kuś; Jakub Jasieniak; Agnieszka Rogowska; Paweł Kukołowicz; Andrzej Cieszanowski

doi:10.5114/pjr.2023.131911

Application of diffusion kurtosis imaging in differential diagnosis of focal liver lesions

Pol J Radiol. 2023 Oct 4:88:e455-e460. doi: 10.5114/pjr.2023.131911. eCollection 2023.

Authors

Affiliations

¹ 2 Department of Clinical Radiology, Warsaw Medical University, Poland.
² Department of Radiology 1, the Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
³ Department of Medical Physics, the Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
⁴ Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.
⁵ Department of Oncological Gastroenterology, the Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

Abstract

Purpose: Diffusion kurtosis imaging (DKI) is an MRI method related to diffusion imaging (DWI) that is distinguished by a non-Gaussian calculation of water particles movements in tissues. The aim of the study was to assess DKI advantage over DWI in differentiating benign and malignant liver lesions.

Material and methods: Analysis included prospectively acquired group of 83 patients referred consecutively for 3T-MRI liver tumor examination, with 95 liver lesions (31 benign, 59 malignant). MRI assessments were performed with standard protocol and DKI sequence with seven b-values (0-2,000 s/mm²). Quantitative data were acquired by placing ROIs in liver tumors on all b-value images, ROI data extracted, and calculation of DWI and DKI parameters. ADC was calculated for all b-values (ADC_0-2000) and for three values of b = 0, 500, and 750 (s/mm²) (ADC_0-500-750). DKI and ADC parameters for benign and malignant lesions were compared, and ROC curves were plotted.

Results: Significant differences were obtained for all DKI and ADC parameters. ROC analysis showed AUC of D_K, K, ADC_0-2000, and ADC_0-500-750 was 0.74, 0.77, 0.77, and 0.75, respectively. The highest sensitivity (of 0.91) was obtained for ADC_0-2000. The highest specificity (0.65) and accuracy (0.80) was obtained for K.

Conclusion: DKI technique yields statistically comparable results with DWI technique.

Keywords: MRI; diffusion kurtosis imaging (DKI); diffusion weighted imaging (DWI); liver tumor.