Use of a b-Value of 3000 s/mm to Differentiate Benign from Malignant Hepatic Masses in Liver Diffusion-Weighted Imaging Using a 3T MR Scanner with a Peak Gradient of 100 mT/m.

OBJECTIVES

This study aimed to evaluate the clinical utility of a b-value of 3000 s/mm in liver diffusion-weighted imaging (DWI) for differentiating between benign and malignant hepatic masses using a 3T MR scanner with a peak gradient of 100 mT/m.

MATERIALS

Fifty-four patients (33 men, 21 women; mean age: 65 years) with hepatic masses, including 13 hepatocellular carcinomas (HCCs), 18 hepatic metastases, 12 hepatic hemangiomas, and 11 hepatic cysts, were prospectively enrolled.

METHODS

Liver DWI was performed at b-values of 1000 and 3000 s/mm. Quantitative analyses included signal-to-noise ratio (SNR), contrast ratio (CR), and apparent diffusion coefficient (ADC). Two independent readers assessed qualitative signal intensity (SI) scores of hepatic masses. The diagnostic performance for differentiating between benign and malignant hepatic masses was evaluated using receiver operating characteristic (ROC) analysis and compared between the two b-values.

RESULTS

A b-value of 3000 s/mm provided significantly higher AUCs for SNR, CR, and SI scores than 1000 s/mm (P < 0.05). The SI score at 3000 s/mm achieved an AUC of 1.00, with 100% sensitivity and specificity. While malignant masses maintained high SI across both b-values, benign masses showed significantly lower SI at 3000 s/mm (P < 0.001). ADC values were significantly lower at 3000 s/mm.

CONCLUSIONS

Liver DWI at a b-value of 3000 s/mm enhances diagnostic accuracy in differentiating hepatic masses. The use of this higher b-value preserves the high SI of malignancies while effectively reducing false positives from the T2 shine-through effect, making it a valuable imaging approach for clinical applications.