Value of Diffusion-Weighted Magnetic Resonance Images for Discrimination of Focal Benign and Malignant Hepatic Lesions: A Meta-Analysis

Purpose: To evaluate the ability of DW-MRI in differentiating malignant hepatic tumors from benign lesions. Materials and Methods: Meta-analysis of 14 diagnostic studies was used. A systematic search in Medline, Embase, Web of Science (from January, 1966, to October, 2009), and Cochrane Controlled Clinical Trials Register Database (through third Quarter 2009) was used with screening of the literature. Results: A meta-analysis of all 95 published studies was performed. Fourteen studies fulfilled the inclusion criteria (804 patients with 1665 hepatic lesions). The global sensitivity was 0.91 (95% confidence interval [CI], 0.86-0.94), the specificity was 0.93 (95% CI. 0.86-0.97), the positive likelihood ratio (PLR) was 13.10 (95% CI, 6.30-27.26), the negative likelihood ratio (NLR) was 0.10 (95% CI, 0.06-0.15), and the diagnostic odds ratio (DOR) was 133.76 (95% CI, 49.77-359.45). The area under the curve of the summary receiver operator characteristic (SROC) was 0.96 (95% CI 0.94-0.98). Conclusion: Diffusion-weighted magnetic resonance imaging is potential technically feasible to differentiate malignant from benign focal liver lesions. Apparent diffusion coefficient measurements can be useful in providing rapid quantifiable information.