This retrospective study was to investigate whether adding diffusion-weighted imaging (DWI) to Gd-EOB-DTPA-enhanced MRI (EOB-MRI) improved the detection of liver metastasis in radiology resident and board-certified radiologist groups. It was approved by our institutional review board. We selected 18 patients with 35 liver metastases and 12 patients without liver tumors. Five board-certified radiologists and 5 radiology residents participated in the observer performance study. Each observer first interpreted T1- and T2-weighted-, plain-, arterial phase-, and hepatobiliary phase images and specified the location of the liver metastases. The software subsequently displayed the DWI images simultaneously and all participants repeated the reading. We used Jackknife alternative free-response receiver operating characteristic (JAFROC) analysis to compare the observer performance in detecting liver metastases. The mean values for the area under the curve (AUC) for EOB-MRI without and with DWI were 0.78 ± 0.13 [standard deviation: SD] and 0.87 ± 0.09, respectively, for the radiology residents, and the difference was statistically significant (p = 0.045). For the board- certified radiologists these values were 0.92 ± 0.02 and 0.96 ± 0.01, respectively, and the difference was not statistically significant (p = 0.092).　　

EOB-MRI with DWI significantly improved the performance of radiology residents in the identification of liver metastases.