Hepatocellular carcinoma and diffusion-weighted MRI: Detection and evaluation of treatment response

Jill S. Gluskin, Fabrizio Chegai, Serena Monti, Ettore Squillaci, Lorenzo Mannelli

Research output: Contribution to journalReview articlepeer-review


Differentiating between cancerous tissue and healthy liver parenchyma could represent a challenge with the only conventional Magnetic Resonance (MR) imaging. Diffusion weighted imaging (DWI) exploits different tissue characteristics to conventional Magnetic Resonance Imaging (MRI) sequences that enhance hepatocellular carcinoma (HCC) detection, characterization, and post-treatment evaluation. Detection of HCC is improved by DWI, infact this technology increases conspicuity of lesions that might otherwise not be identified due to obscuration by adjacent vessels or due to low contrast between the lesion and background liver. It is important to remember that DWI combined with contrast-enhanced MRI has higher sensitivity than DWI alone, and that some patients are not eligible for use of contrast on CT and MRI; in these patients DWI has a prominent role. MRI has advanced beyond structural anatomic imaging to now showing pathophysiologic processes. DWI is a promising way to characterize lesions utilizing the inherent contrast within the liver and has the benefit of not requiring contrast injection. DWI improves detection and characterization of HCC. Proposed clinical uses for DWI include: assessing prognosis, predicting response, monitoring response to therapy, and distinguishing tumor recurrence from treatment effect. Ideally, DWI will help risk stratify patients and will participate in prognostic modeling.

Original languageEnglish
Pages (from-to)1565-1570
Number of pages6
JournalJournal of Cancer
Issue number11
Publication statusPublished - 2016


  • Diffusion weighted imaging (DWI)
  • Hepatic carcinogenesis
  • Hepatocellular carcinoma

ASJC Scopus subject areas

  • Oncology


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