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HOME > J Liver Cancer > Volume 16(2); 2016 > Article
Original Article Diagnostic Performance of Diffusion-weighted Imaging for Hepatic Neuroendocrine Tumor: Comparison with Combined Diffusion-weighted Imaging and Contrast-enhanced Magnetic Resonance Imaging
Suk Ki Jang1, Jung Hoon Kim2,3, Mi Hye Yu4, Joon Koo Han2,3
Journal of Liver Cancer 2016;16(2):92-100
Published online: September 30, 2016
1Department of Radiology, Bundang Jesaeng Hospital, Seongnam, Korea
2Departments of Radiology,Seoul National University College of Medicine, Seoul, Korea
3Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
4Department of Radiology, Konkuk University School of Medicine, Seoul, Korea
Corresponding author:  Jung Hoon Kim,
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To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrastenhanced magnetic resonance imaging (MRI) .
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).
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).
Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.

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