Prediction of high

Recently, diffusion-weighted imaging (DWI) and quantitative enhancement ratio measured at the hepatobiliary phase (HBP) of Gd-EOB-DTPA–enhanced magnetic resonance imaging (MRI) has been established as an effective method for evaluating liver fibrosis. To evaluate which is a more favorable surrogate marker in predicting high-stage liver fibrosis, apparently diffusion coefficient (ADC) value or quantitative enhancement ratio measured on HBP. Eighty-three patients with 99 surgically resected hepatic lesions were enrolled in this study. DWI was performed with b-values of 100 and 800？s/mm2. Regions of interest were set on ADC map, and the HBP of Gd-EOB-DTPA–enhanced MRI, to calculate ADC value, liver-to-muscle ratio (LMR), liver-to-spleen ratio (LSR), and contrast enhancement index (CEI) of liver. We compared these parameters between low-stage fibrosis (F0, F1, and F2) and high-stage fibrosis (F3 and F4). Receiver operating characteristic analysis was performed to compare the diagnostic performance when distinguishing low-stage fibrosis from high-stage fibrosis. LMR and CEI were significantly lower at high-stage fibrosis than at the low stage (P？<？0.01 and P？=？0.04, respectively), whereas LSR did not show a significant difference (P？=？0.053). No significant difference was observed in diagnostic performance between LMR and CEI (P？=？0.185). The best sensitivity and specificity, when an LMR of 2.80 or higher was considered to be low-stage fibrosis, were 82.4% and 75.6%, respectively. ADC value showed no significant differences among fibrosis grades (P？=？0.320). LMR and CEI were both adequate surrogate parameters to distinguish high-stage fibrosis from low-stage fibrosis