Diffusion-Weighted Imaging for the Diagnosis of Bland Versus Tumor Thrombosis in the Portal and Renal Veins.

Jignesh M. Patel¹, Elizabeth M. Hecht¹, Danny C. Kim¹, James S. Babb¹, Bachir Taouli¹, Ruth P. Lim¹

Differentiating bland from tumor thrombus is essential for appropriate management. We assessed the diagnostic performance of DWI for the differentiation of bland versus tumor thrombus in renal and hepatic malignancies. The ability to distinguish bland from tumor thrombus on high b-value DWI images was significant with an overall sensitivity, specificity, NPV and PPV of 0.87, 0.89, 0.73 and 0.95 respectively. In addition, the mean ADC was significantly lower in tumor thrombus (1.16 x 10-3 mm2/sec) when compared to bland (1.71 x 10-3 mm2/sec), p< 0.001.