Application of diffusion kurtosis imaging in differential diagnosis of focal liver lesions

Purpose: Diffusion kurtosis imaging (DKI) is an MRI method related to diffusion imaging (DWI) that is distinguished by a non-Gaussian calculation of water particles movements in tissues. The aim of the study was to assess DKI advantage over DWI in differentiating benign and malignant liver lesions. Material and methods: Analysis included prospectively acquired group of 83 patients referred consecutively for 3T-MRI liver tumor examination, with 95 liver lesions ( 31 benign, 59 malignant). MRI assessments were performed with standard protocol and DKI sequence with seven b-values (0-2,000 s/mm(2)). Quantitative data were acquired by placing ROIs in liver tumors on all b-value images, ROI data extracted, and calculation of DWI and DKI parameters. ADC was calculated for all b-values ( ADC(0-2000)) and for three values of b = 0, 500, and 750 (s/mm(2)) (ADC(0-500-750)). DKI and ADC parameters for benign and malignant lesions were compared, and ROC curves were plotted. Results: Significant differences were obtained for all DKI and ADC parameters. ROC analysis showed AUC of D-K, K, ADC(0-2000), and ADC(0-500-750) was 0.74, 0.77, 0.77, and 0.75, respectively. The highest sensitivity (of 0.91) was obtained for ADC(0-2000). The highest specificity (0.65) and accuracy (0.80) was obtained for K. Conclusion: DKI technique yields statistically comparable results with DWI technique.