Pitfalls in Abdominal Diffusion-Weighted Imaging How Specific Is Restricted Water Diffusion for Malignancy?

Sebastian Feuerlein¹, Sandra Pauls¹, Markus S. Juchems¹, Hans-Juergen Brambs¹, Andrea S. Ernst¹

As DWI is increasingly implemented into routine protocols of abdominal MRI, positive findings both in expected as in unexpected locations become more common. The aim of our study was to investigate the potential pitfalls of false positive findings in abdominal DWI by identifying benign lesions that have restricted diffusion. Restricted diffusion is generally considered to be associated with malignant tumors as a result of high cellularity. However, when interpreting DW images, it should be kept in mind that a number of benign lesions, as high as 22% in our cohort, could demonstrate restricted diffusion, thus mimicking malignancy.