The value of the apparent diffusion coefficient value in the Liver Imaging Reporting and Data System (LI-RADS) version 2018

Purpose: To assess role of the apparent diffusion coefficient (ADC) in the Liver Imaging Reporting and Data System (LI-RADS) version 2018 for the prediction of hepatocellular carcinoma (HCC). Material and methods: Retrospective analysis of 137 hepatic focal lesions in 108 patients at risk of HCC, who under-went magnetic resonance imaging of the liver. Hepatic focal lesions were classified according to LI-RADS-v2018, and ADC of hepatic lesions was calculated by 2 independent blinded reviewers. Results: The mean ADC of LR-1 and LR-2 were 2.11 +/- 0.47 and 2.08 +/- 0.47 x 10(-3) mm(2)/s, LR-3 were 1.28 +/- 0.12 and 1.36 +/- 0.16 x 10(-3) mm(2)/s, LR-4, LR-5 and LR-TIV were 1.07 +/- 0.08 and 1.08 +/- 0.12 x 10(-3) mm(2)/s and LR-M were 1.02 +/- 0.09 and 1.00 +/- 0.09 x 10(-3) mm(2)/s by both observers, respectively. There was excellent agreement of both readings for LR-1 and LR-2 (r = 0.988), LR-3 (r = 0.965), LR-4, LR-5 and LR-TIV (r = 0.889) and LR-M (r = 0.883). There was excellent correlation between ADC and LI-RADS-v2018 (r = -0.849 and -0.846). The cut-off ADC used to differentiate LR-3 from LR-4, LR-5, and LR-TIV were <= 1.21 and <= 1.23 x 10(-3) mm(2)/s with AUC of 0.948 and 0.926. Conclusions: Inclusion of ADC to LI-RADS-v2018 improves differentiation variable LI-RADS categories and can helps in the prediction of HCC.