PURPOSE: The aim of our study was to determine the diagnostic performance of T1 mapping sequences prior Gadolinium injection and its combination with diffusion-weighted-imaging for focal liver lesions characterization on healthy liver. MATERIAL AND METHODS: This retrospective single-center and observational study included all patients between November 2016 and March 2017 referred to our Department of Radiology for exploring focal liver lesion larger than 15 mm, of fortuitous findings or prior imaging exploration without underlying liver disease. A region of interest was positioned within the lesion on T1 and ADC maps and the mean value pixels intensity was compared to healthy liver parenchymal. T1 ratio was defined as the ratio between T1 value of the lesion and T1 value of healthy liver; ADC ratio was defined as the ratio between ADC value of the lesion and ADC value of healthy liver. Lesion characterization was based on histological study or standard post-contrast MRI findings. RESULTS: In total, 208 lesions were analyzed and pooled into 3 groups: biliary cyst/hemangioma/cystic benign lesion; focal nodular hyperplasia/adenoma; malignant tumor. For a T1 ratio < 1.4, 77% of the lesions were focal nodular hyperplasia/adenomas; for T1 ratio between 1.4 and 2.4, 74.7% of the lesions were malignant tumors and when T1 ratio > 2.4, 54.3% of the lesions were biliary cysts/hemangiomas/cystic benign lesions. When combining a T1 ratio < 1,4 and an ADC ratio < 1.4, 87.5% of the lesions were focal nodular hyperplasia/adenomas but the difference with 77%was not statistically significative. When combining a T1 ratio between 1,4 and 2,4 and an ADC ratio between 1.4 and 2, 83.1% of the lesions were malignant tumors but the difference was not statistically significative with 74,7%. When combining a T1 ratio > 2,4 and an ADC ratio > 2, 81.2% of the lesions were biliary cysts/hemangiomas/cystic benign lesions and the difference with 54,3% was statistically significative (p<0.05). CONCLUSION: Pre-contrast T1 mapping is a promising functional imaging biomarker for the characterization of liver focal lesions since it is directly related to the lesion components and its immediate environment. When T1mapping is combined with other functional sequences such as diffusion-weighted imaging, the diagnostic performance of focal liver lesion is improved especially in cystic benign lesions.