Computed diffusion weighted imaging of the liver using extrapolation technique in patients who underwent liver transplantation with hepatocellular carcinomas: Initial experience and feasibility study

Objective This study aimed to evaluate the feasibility and image quality of computed diffusion weighted imaging (DWI) of the liver in patients with hepatocellular carcinoma (HCC). Methods Twenty-four patients who underwent liver transplantation with HCC were enrolled. Computed DWI was synthesized for b-values of 800 (cDWI₈₀₀) and 1200 s/mm² (cDWI₁₂₀₀) using directly acquired DWI with b-values of 0, 50, and 500 s/mm². Signal intensity of HCC, background liver, and contrast-to-noise ratio were evaluated for directly acquired DWI of 800 s/mm² (dDWI₈₀₀), cDWI_800, and cDWI₁₂₀₀. Two radiologists evaluated the image quality for contrast between HCC and liver, suppression of background signal and T2 shine-through, and overall image quality. Results cDWI₁₂₀₀ showed the lowest contrast-to-noise ratio. Qualitative scores for background suppression and decreased T2 shine-through were highest for cDWI₁₂₀₀. However, contrast between HCC and background liver was worst in cDWI₁₂₀₀. Conclusions In computed DWI of high b-values, contrast between HCC and background liver was very low.