Aim: To compare the apparent diffusion coefficient (ADC) derived from conventional diffusion-weighted imaging (DWI), and parameters derived from intra-voxel incoherent motion (IVIM) diffusion, in the differentiation of common focal malignant liver masses. Methods: DWI of 53 patients with 85 focal liver masses (47 hepatocellular cancers [HCCs], 18 cholangiocarcinomas, and 20 metastases) were recruited to receive a 3.0T MR scanner with 2 b values (0, 700 s/mm ) to measure the ADC values and with 7 b values (0, 50, 100, 250, 500, 750, 1000 s/mm  ) to measure IVIM derived parameters: true diffusion coefficient (D), perfusion related diffusion coefficient (DFNx01) and perfusion fraction (f). The mean of each parameter was compared by the Dunnett multiple comparison test. Results: Both ADC and D were significantly higher in cholangiocarcinomas than in HCCs (ADC: 1.49 ± 0.27 × 10−3 vs. 1.20 ± 0.26 × 10−3 mm 2 /s and D: 0.94 ± 0.17 × 10−3 vs. 0.53 ± 0.23 × 10−3 mm 2 /s, respectively; P = 0.002 and P < 0.001) with D providing higher areas under the receiver operating characteristic curve of 0.936 and ADC 0.794. Neither ADC nor IVIM derived parameters could differentiate metastases from HCCs and cholangiocarcinomas. Conclusion: D improved the accuracy of differentiating HCCs and cholangiocarcinomas compared to ADC
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