Meta-analysis of intravoxel incoherent motion magnetic resonance imaging in differentiating focal lesions of the liver

Introduction: Accurate detection and characterization of focal liver lesions, including differentiation between malignant and benign lesions, are particularly important. The objective of this meta-analysis was to evaluate the parameters of intravoxel incoherent motion (IVIM), including apparent diffusion coefficient (ADC), pure molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (f) in differentiating focal liver lesions. Methods: IVIM method employed for focal liver lesion and the quality assessment of diagnostic studies were evaluated. Standardized mean differences and 95% confidence intervals were calculated. The heterogeneity was quantified with the I-2 statistic. Results: The difference between groups was analyzed according to the I2 values from 6 different studies using fixed effects or random effects models. Significant differences in ADC (P<. 001) and D (P<. 001) were observed between benign and malignant lesions. Moreover, significant differences in ADC (P<. 001), D (P<. 001), and f (P=. 01) were found between hemangioma and hepatocellular carcinoma (HCC). In addition, no significant difference was observed between the metastases and HCC. Conclusions: D and ADC values were useful for the differentiation between benignity and malignancy; higher values of ADC, D, and f were observed in hemangioma compared to HCC. Nevertheless, IVIM did not result as the optimal approach for differentiation between the metastases and HCC.