Measurement of the apparent diffusion coefficient in the liver: is it a reliable index for hepatic disease diagnosis?

Purpose: The aim of this study was to determine the validity of the hepatic apparent diffusion coefficient (ADC) measurement. The influence of differences in measured location and administration of Buscopan (hyoscine butylbromide) for ADC were assessed.

Materials And Methods: SENSE-DWI (b = 0, 500) was obtained before and after Buscopan administration to 30 patients suspected of having a liver tumor. In this sequence, respiration gating was employed, but cardiac triggering was not. ADC measurement was performed in the hepatic parenchyma of both right and left lobes in selected slices. A statistical analysis was performed to estimate the correlation among ADC, measured location, Buscopan, and pulse rate. The images were visually evaluated to categorize the subcardiac signal loss in the left lobe.

Results: The ADC showed higher values in the left lobe than in the right lobe in both pre- and postloaded studies (P < 0.001). In a comparison between ADCs in the pre- and postloaded studies, the differences were not significant in the left lobe (P = 0.93) or the right lobe (P = 0.41). No correlation was noted between ADCs and the pulse rate. Visual evaluation revealed that the subcardiac signal loss was more prominent in the postloaded study.

Conclusion: ADC measurement of the left hepatic lobe was far more incorrect than that of the right lobe if cardiac gating was not employed. The administration of Buscopan worsened the image quality of the left lobe and made visual evaluation difficult.