The apparent diffusion coefficient ratio for discriminating benign and malignant lesions in clinical practice

Abstract

Objective: The primary aim was to assess the efficacy of Apparent Diffusion Coefficient (ADC) ratios in differentiating between benign and malignant liver lesions.
Methods: A descriptive cross-sectional study of 69 patients was conducted from January 2023 to December 2023. Participants underwent standard MRI scans on Siemens 1.5-Tesla scanners using conventional sequences and diffusion sequences with b=50, b=400, and b=800s/mm2. Based on radiological features, histopathological findings, and biochemical tests, liver lesions were classified as benign or malignant.
Results: The dataset comprised 69 lesions, 20 benign and 49 malignant lesions, with a median age of 57 ± 14 years a male/female ratio of 1.65. The average lesion to liver ADCratio1 and average lesion to spleen ADCratio2 of benign lesions were significantly higher than those of malignant lesions, 1.86 vs. 1.05 and 2.25 vs. 1.47, p < 0.001, respectively. Optimal cut-off values for ADCratio 1 and ADCratio 2 to differentiate between benign and malignant lesions were 1.17 and 1.66, respectively, resulting in sensitivities of 95% and 85% and specificities of 75.5% and 77.5%, respectively.
Conclusion: This study demonstrates significant differences in ADC ratios between benign and malignant solid liver lesions, establishing specific cut-off values with high sensitivity and specificity for differentiation.