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Table 1.

MRI sequence parameters for FloCo and monopolar DWI sequences.

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Fig 1.

Participant flow diagram.

Footnote: FloCo = Flow-compensated. DWI = diffusion-weighted imaging.

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Table 2.

Patient demographics and disease characteristics.

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Fig 2.

Diffusion-weighted b800 images of the liver in a 42-year-old patient with metastatic medullary thyroid carcinoma.

Three adjacent slices, left-side flow-compensated (FloCo), right-side conventional monopolar diffusion encoding. There are considerable pulsation artifacts with monopolar diffusion encoding, which mask focal lesions in the left liver lobe (thick arrows). One of the arrow-marked small lesions was not reported by either of the two readers in the monopolar dataset. The other arrow-marked small lesion was not reported by one of the readers in the monopolar dataset.

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Fig 3.

Diffusion-weighted b800 images of the liver in a 39-year-old patient with a metastatic neuroendocrine tumor of the jejunum.

Four adjacent slices, left-side flow-compensated (FloCo), right-side monopolar diffusion encoding. The arrow-marked large lesion was detected by both readers but is much less visible in the monopolar dataset.

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Fig 4.

Diffusion-weighted b800 images of the liver in a 61-year-old patient with a metastatic neuroendocrine tumor of the ileum.

Four adjacent slices, left-side flow-compensated (FloCo), right-side monopolar diffusion encoding. The arrow-marked small lesion was not reported by either of the two readers in the monopolar dataset. The adjacent lesion is barely visible in the monopolar dataset.

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Fig 5.

Diffusion-weighted b800 images of the liver in a 70-year-old patient with a metastatic neuroendocrine tumor of unknown primary.

Four adjacent slices, left-side flow-compensated (FloCo), right-side monopolar diffusion encoding. The conspicuity was rated higher for the FloCo data by both readers (with a Likert score of 2).

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Fig 6.

Individual subject ADC values for monopolar, FloCo, and mixed diffusion schemes.

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Table 3.

Descriptive statistics of the quantitative lesion evaluation.

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Fig 7.

Histograms of the qualitative lesion evaluation.

The scales in a) to d) range from 1 (worst) to 5 (best). Difference in number of visible lesions (Δlesions) is plotted in e) and calculated as number of lesions visible with flow-compensated (FloCo) minus number of lesions visible with monopolar diffusion encoding. A positive score indicates that more lesions were found with FloCo diffusion encoding.

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Table 4.

Qualitative Likert score evaluation by reader 1 and reader 2 (same data as in Fig 7).

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Table 5.

Lesion conspicuity and the difference in detectable lesions (Δlesions) (same data as in Fig 7).

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