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Cui Y, Dyvorne H, Besa C, Cooper N, Taouli B. IVIM Diffusion-weighted Imaging of the Liver at 3.0T: Comparison with 1.5T. Eur J Radiol Open 2015; 2:123-128. [PMID: 26393236 PMCID: PMC4573456 DOI: 10.1016/j.ejro.2015.08.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose To compare intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) of the liver between 1.5 T and 3.0 T in terms of parameter quantification and inter-platform reproducibility. Materials and methods In this IRB approved prospective study, 19 subjects (17 patients with chronic liver disease and 2 healthy volunteers) underwent two repeat scans at 1.5 T and 3.0 T. Each scan included IVIM DWI using 16 b values from 0 to 800 s/mm2. A single observer measured IVIM parameters for each platform and estimated signal to noise ratio (eSNR) at b0, 200, 400 and 800 s/mm2. Wilcoxon paired tests were used to compare liver eSNR and IVIM parameters. Inter-platform reproducibility was assessed by calculating within-subject coefficient of variation (CV) and Bland–Altman limits of agreement. An ice water phantom was used to test ADC variability between the two MRI systems. Results The mean invitro difference in ADC between the two platforms was 6.8%. eSNR was significantly higher at 3.0T for all selected b values (p = 0.006–0.020), except for b0 (p = 0.239). Liver IVIM parameters were significantly different between 1.5 T and 3.0 T (p = 0.005–0.044), except for ADC (p = 0.748). The inter-platform reproducibility of true diffusion coefficient (D) and ADC were good, with mean CV of 10.9% and 11.1%, respectively. Perfusion fraction (PF) and pseudodiffusion coefficient (D*) showed more limited inter-platform reproducibility (mean CV of 22.6% for PF and 46.9% for D*). Conclusion Liver D and ADC values showed good reproducibility between 1.5 T and 3.0 T platforms; while there was more variability in PF, and large variability in D* parameters between the two platforms. These findings may have implications for drug trials assessing the role of IVIM DWI in tumor response and liver fibrosis.
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Affiliation(s)
- Yong Cui
- Department of Radiology/Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 USA
| | - Hadrien Dyvorne
- Department of Radiology/Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 USA
| | - Cecilia Besa
- Department of Radiology/Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 USA
| | - Nancy Cooper
- Department of Radiology/Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 USA
| | - Bachir Taouli
- Department of Radiology/Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 USA
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Cercueil JP, Petit JM, Nougaret S, Soyer P, Fohlen A, Pierredon-Foulongne MA, Schembri V, Delhom E, Schmidt S, Denys A, Aho S, Guiu B. Intravoxel incoherent motion diffusion-weighted imaging in the liver: comparison of mono-, bi- and tri-exponential modelling at 3.0-T. Eur Radiol 2014; 25:1541-50. [PMID: 25527431 DOI: 10.1007/s00330-014-3554-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 10/31/2014] [Accepted: 12/03/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE To determine whether a mono-, bi- or tri-exponential model best fits the intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) signal of normal livers. MATERIALS AND METHODS The pilot and validation studies were conducted in 38 and 36 patients with normal livers, respectively. The DWI sequence was performed using single-shot echoplanar imaging with 11 (pilot study) and 16 (validation study) b values. In each study, data from all patients were used to model the IVIM signal of normal liver. Diffusion coefficients (Di ± standard deviations) and their fractions (fi ± standard deviations) were determined from each model. The models were compared using the extra sum-of-squares test and information criteria. RESULTS The tri-exponential model provided a better fit than both the bi- and mono-exponential models. The tri-exponential IVIM model determined three diffusion compartments: a slow (D1 = 1.35 ± 0.03 × 10(-3) mm(2)/s; f1 = 72.7 ± 0.9 %), a fast (D2 = 26.50 ± 2.49 × 10(-3) mm(2)/s; f2 = 13.7 ± 0.6 %) and a very fast (D3 = 404.00 ± 43.7 × 10(-3) mm(2)/s; f3 = 13.5 ± 0.8 %) diffusion compartment [results from the validation study]. The very fast compartment contributed to the IVIM signal only for b values ≤15 s/mm(2) CONCLUSION: The tri-exponential model provided the best fit for IVIM signal decay in the liver over the 0-800 s/mm(2) range. In IVIM analysis of normal liver, a third very fast (pseudo)diffusion component might be relevant. KEY POINTS • For normal liver, tri-exponential IVIM model might be superior to bi-exponential • A very fast compartment (D = 404.00 ± 43.7 × 10 (-3) mm (2) /s; f = 13.5 ± 0.8 %) is determined from the tri-exponential model • The compartment contributes to the IVIM signal only for b ≤ 15 s/mm(2).
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Lu PX, Huang H, Yuan J, Zhao F, Chen ZY, Zhang Q, Ahuja AT, Zhou BP, Wáng YXJ. Decreases in molecular diffusion, perfusion fraction and perfusion-related diffusion in fibrotic livers: a prospective clinical intravoxel incoherent motion MR imaging study. PLoS One 2014; 9:e113846. [PMID: 25436458 PMCID: PMC4250077 DOI: 10.1371/journal.pone.0113846] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 11/02/2014] [Indexed: 12/21/2022] Open
Abstract
Purpose This study was aimed to determine whether pure molecular-based diffusion coefficient (D) and perfusion-related diffusion parameters (perfusion fraction f, perfusion-related diffusion coefficient D*) differ in healthy livers and fibrotic livers through intra-voxel incoherent motion (IVIM) MR imaging. Material and Methods 17 healthy volunteers and 34 patients with histopathologically confirmed liver fibrosis patients (stage 1 = 14, stage 2 = 8, stage 3& 4 = 12, METAVIR grading) were included. Liver MR imaging was performed at 1.5-T. IVIM diffusion weighted imaging sequence was based on standard single-shot DW spin echo-planar imaging, with ten b values of 10, 20, 40, 60, 80, 100, 150, 200, 400, 800 sec/mm2 respectively. Pixel-wise realization and regions-of-interest based quantification of IVIM parameters were performed. Results D, f, and D* in healthy volunteer livers and patient livers were 1.096±0.155 vs 0.917±0.152 (10−3 mm2/s, p = 0.0015), 0.164±0.021 vs 0.123±0.029 (p<0.0001), and 13.085±2.943 vs 9.423±1.737 (10−3 mm2/s, p<0.0001) respectively, all significantly lower in fibrotic livers. As the fibrosis severity progressed, D, f, and D* values decreased, with a trend significant for f and D*. Conclusion Fibrotic liver is associated with lower pure molecular diffusion, lower perfusion volume fraction, and lower perfusion-related diffusion. The decrease of f and D* in the liver is significantly associated liver fibrosis severity.
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Affiliation(s)
- Pu-Xuan Lu
- Department of Radiology, The Shenzhen No. 3 People's Hospital, Guangdong Medical College, Shenzhen, China
| | - Hua Huang
- Department of Radiology, The Shenzhen No. 3 People's Hospital, Guangdong Medical College, Shenzhen, China
| | - Jing Yuan
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Feng Zhao
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Zhi-Yi Chen
- Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qinwei Zhang
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Anil T. Ahuja
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Bo-Ping Zhou
- Department of Hepatology, The Shenzhen No. 3 People's Hospital, Guangdong Medical College, Shenzhen, China
| | - Yì-Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
- * E-mail:
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Hu G, Chan Q, Quan X, Zhang X, Li Y, Zhong X, Lin X. Intravoxel incoherent motion MRI evaluation for the staging of liver fibrosis in a rat model. J Magn Reson Imaging 2014; 42:331-9. [PMID: 25384923 DOI: 10.1002/jmri.24796] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/23/2014] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To explore the characteristics of intravoxel incoherent motion (IVIM) in various stages of liver fibrosis, and their relationships with fibrotic stages in rats. MATERIALS AND METHODS Fifty rats were given various doses of carbon tetrachloride (CCl4 ) to induce various fibrotic stages in rats; 15 untreated rats served as controls. Diffusion-weighted magnetic resonance imaging (MRI) was performed and eight b-values (0-800 s/mm(2) ) were applied to obtain IVIM parameters (D, pure molecular diffusion; f, perfusion fraction; D*, pseudodiffusion). The stages of liver fibrosis (stages F0-F4) were evaluated histologically using METAVIR scores. Fifty-seven rats (15 controls and 42 with fibrosis) were analyzed by nonparametric methods and receiver operating characteristic curves to determine diagnostic accuracy. RESULTS Significant differences (P < 0.001) were found between stages (stages F0-F4) by D, f, D*, and apparent diffusion coefficient (ADC). There were inverse correlations between fibrosis stages and D, f, D*, ADC (r = -0.657, r = -0.631, r = -0.711 r = -0.719, respectively). Multivariate analysis showed that the combination models (D, f, D*) were better than the individual parameter (ADC) for the evaluation fibrosis stages (area under the curve [AUC]: 0.821-1.000 vs. AUC: 0.753-0.918) CONCLUSION: IVIM-derived parameters showed significant correlations with stages of liver fibrosis in a rat model.
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Affiliation(s)
- Genwen Hu
- Department of Medical Image Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. China.,Department of Medical Image Center, Shenzhen Bao'an Maternal and Child Health Hospital, Shenzhen, Guangdong Province, P.R. China
| | | | - Xianyue Quan
- Department of Medical Image Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. China
| | - Xuhui Zhang
- Department of Medical Image Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. China
| | - Yufa Li
- Department of Pathology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. China
| | - Xing Zhong
- Department of Medical Image Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong Province, P.R. China
| | - Xiaoying Lin
- Department of Medical Image Center, Shenzhen Bao'an Maternal and Child Health Hospital, Shenzhen, Guangdong Province, P.R. China
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105
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Cho GY, Moy L, Zhang JL, Baete S, Lattanzi R, Moccaldi M, Babb JS, Kim S, Sodickson DK, Sigmund EE. Comparison of fitting methods and b-value sampling strategies for intravoxel incoherent motion in breast cancer. Magn Reson Med 2014; 74:1077-85. [PMID: 25302780 DOI: 10.1002/mrm.25484] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 08/11/2014] [Accepted: 09/16/2014] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare fitting methods and sampling strategies, including the implementation of an optimized b-value selection for improved estimation of intravoxel incoherent motion (IVIM) parameters in breast cancer. METHODS Fourteen patients (age, 48.4 ± 14.27 years) with cancerous lesions underwent 3 Tesla breast MRI examination for a HIPAA-compliant, institutional review board approved diffusion MR study. IVIM biomarkers were calculated using "free" versus "segmented" fitting for conventional or optimized (repetitions of key b-values) b-value selection. Monte Carlo simulations were performed over a range of IVIM parameters to evaluate methods of analysis. Relative bias values, relative error, and coefficients of variation (CV) were obtained for assessment of methods. Statistical paired t-tests were used for comparison of experimental mean values and errors from each fitting and sampling method. RESULTS Comparison of the different analysis/sampling methods in simulations and experiments showed that the "segmented" analysis and the optimized method have higher precision and accuracy, in general, compared with "free" fitting of conventional sampling when considering all parameters. Regarding relative bias, IVIM parameters fp and Dt differed significantly between "segmented" and "free" fitting methods. CONCLUSION IVIM analysis may improve using optimized selection and "segmented" analysis, potentially enabling better differentiation of breast cancer subtypes and monitoring of treatment.
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Affiliation(s)
- Gene Young Cho
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.,Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, New York, USA
| | - Linda Moy
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.,New York University Langone Medical Center - Cancer Institute, New York, New York, USA
| | - Jeff L Zhang
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Steven Baete
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Riccardo Lattanzi
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Melanie Moccaldi
- New York University Langone Medical Center - Cancer Institute, New York, New York, USA
| | - James S Babb
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Sungheon Kim
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Daniel K Sodickson
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Eric E Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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106
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Murphy P, Hooker J, Ang B, Wolfson T, Gamst A, Bydder M, Middleton M, Peterson M, Behling C, Loomba R, Sirlin C. Associations between histologic features of nonalcoholic fatty liver disease (NAFLD) and quantitative diffusion-weighted MRI measurements in adults. J Magn Reson Imaging 2014; 41:1629-38. [PMID: 25256692 DOI: 10.1002/jmri.24755] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 07/15/2014] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To investigate in adults the associations between histologic features of nonalcoholic fatty liver disease (NAFLD) and quantitative measures derived from diffusion-weighted imaging (DWI). MATERIALS AND METHODS Eighty-nine adults undergoing standard-of-care liver biopsy for NAFLD were recruited for DWI. Biopsies were scored for histologic features of NAFLD. DWI was performed using b-values of 0, 100, and 500 s/mm(2) . Images were reconstructed using either conventional magnitude averaging (CMA) or a method to address bulk motion artifacts (Beta*LogNormal, BLN). The apparent diffusion coefficient (ADC) and the diffusivity (D) and perfusion fraction (F) of the intravoxel incoherent motion (IVIM) model were measured in the right hepatic lobe using both reconstructions. Associations between histologic features and DWI-derived measures were tested statistically with several methods including multiple linear regression. RESULTS Using CMA and BLN reconstructions, respectively, the means (and ranges) were 1.7 (1.1-3.5) and 1.4 (1.0-3.2) × 10(-3) mm(2) /s for ADC, 1.1 (0.84-1.4) and 0.84 (0.53-1.1) × 10(-3) mm(2) /s for D, and 17 and 18 (2.3-35)% for F. For both reconstruction methods, D decreased with steatosis and F decreased with fibrosis (P < 0.05). ADC was not independently associated with any histologic feature. CONCLUSION Steatosis and fibrosis have significant independent effects on D and F in adults undergoing biopsy for NAFLD.
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Affiliation(s)
- Paul Murphy
- Liver Imaging Group, Department of Radiology, University of California - San Diego, San Diego, California, USA
| | - Jonathan Hooker
- Liver Imaging Group, Department of Radiology, University of California - San Diego, San Diego, California, USA
| | - Brandon Ang
- NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California - San Diego, San Diego, California, USA
| | - Tanya Wolfson
- Computational and Applied Statistics Lab, San Diego Supercomputing Center, San Diego, California, USA
| | - Anthony Gamst
- Computational and Applied Statistics Lab, San Diego Supercomputing Center, San Diego, California, USA
| | - Mark Bydder
- Liver Imaging Group, Department of Radiology, University of California - San Diego, San Diego, California, USA
| | - Michael Middleton
- Liver Imaging Group, Department of Radiology, University of California - San Diego, San Diego, California, USA
| | | | | | - Rohit Loomba
- NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California - San Diego, San Diego, California, USA.,Division of Epidemiology, Department of Family and Preventative Medicine, University of California - San Diego, San Diego, California, USA
| | - Claude Sirlin
- Liver Imaging Group, Department of Radiology, University of California - San Diego, San Diego, California, USA
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107
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Normal hepatic parenchyma visibility and ADC quantification on diffusion-weighted MRI at 3 T: influence of age, gender, and iron content. Eur Radiol 2014; 24:3123-33. [DOI: 10.1007/s00330-014-3353-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 01/23/2023]
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108
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Jia QJ, Zhang SX, Chen WB, Liang L, Zhou ZG, Qiu QH, Liu ZY, Zeng QX, Liang CH. Initial experience of correlating parameters of intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging at 3.0 T in nasopharyngeal carcinoma. Eur Radiol 2014; 24:3076-87. [DOI: 10.1007/s00330-014-3343-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 06/04/2014] [Accepted: 07/11/2014] [Indexed: 02/07/2023]
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109
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Leporq B, Saint-Jalmes H, Rabrait C, Pilleul F, Guillaud O, Dumortier J, Scoazec JY, Beuf O. Optimization of intra-voxel incoherent motion imaging at 3.0 Tesla for fast liver examination. J Magn Reson Imaging 2014; 41:1209-17. [PMID: 25044653 DOI: 10.1002/jmri.24693] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 05/13/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Optimization of multi b-values MR protocol for fast intra-voxel incoherent motion imaging of the liver at 3.0 Tesla. METHODS A comparison of four different acquisition protocols were carried out based on estimated IVIM (DSlow , DFast , and f) and ADC-parameters in 25 healthy volunteers. The effects of respiratory gating compared with free breathing acquisition then diffusion gradient scheme (simultaneous or sequential) and finally use of weighted averaging for different b-values were assessed. An optimization study based on Cramer-Rao lower bound theory was then performed to minimize the number of b-values required for a suitable quantification. The duration-optimized protocol was evaluated on 12 patients with chronic liver diseases RESULTS No significant differences of IVIM parameters were observed between the assessed protocols. Only four b-values (0, 12, 82, and 1310 s.mm(-2) ) were found mandatory to perform a suitable quantification of IVIM parameters. DSlow and DFast significantly decreased between nonadvanced and advanced fibrosis (P < 0.05 and P < 0.01) whereas perfusion fraction and ADC variations were not found to be significant. CONCLUSION Results showed that IVIM could be performed in free breathing, with a weighted-averaging procedure, a simultaneous diffusion gradient scheme and only four optimized b-values (0, 10, 80, and 800) reducing scan duration by a factor of nine compared with a nonoptimized protocol. Preliminary results have shown that parameters such as DSlow and DFast based on optimized IVIM protocol can be relevant biomarkers to distinguish between nonadvanced and advanced fibrosis.
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Affiliation(s)
- Benjamin Leporq
- Université de Lyon; CREATIS; CNRS UMR 5220; Inserm U1044; INSA-Lyon; Université Lyon 1, Villeurbanne, France
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Zhang SX, Jia QJ, Zhang ZP, Liang CH, Chen WB, Qiu QH, Li H. Intravoxel incoherent motion MRI: emerging applications for nasopharyngeal carcinoma at the primary site. Eur Radiol 2014; 24:1998-2004. [PMID: 24838795 PMCID: PMC4082649 DOI: 10.1007/s00330-014-3203-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/14/2014] [Accepted: 04/24/2014] [Indexed: 01/02/2023]
Abstract
Objectives We compared pure molecular diffusion (D), perfusion-related diffusion (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) based on intravoxel incoherent motion (IVIM) theory in patients with nasopharyngeal carcinoma (NPC). Methods Sixty-five consecutive patients (48 men) with suspected NPC were examined using a 3.0-T MR system. Diffusion-weighted imaging (DWI) was performed with 13 b values (range, 0–800 s/mm2). We regarded the result of endoscopy and biopsy as the gold standard for detection. D, D* and f were compared between patients with primary NPC and enlarged adenoids. Results IVIM DWI was successful in 37 of 40 NPC and 23 of 25 enlarged adenoids cases. D (P = 0.001) and f (P < 0.0001) were significantly lower in patients with NPC than in patients with enlarged adenoids, whereas D* was significantly higher (P < 0.0001). However, the ADC was not significantly different between the two groups (P > 0.05). The area under the ROC curve (AUC) for D was 0.849 and was significantly larger than that for ADC (P < 0.05). Conclusions IVIM DWI is a feasible technique for investigating primary NPC. D was significantly decreased in primary NPC, and increased D* reflected increased blood vessel generation and parenchymal perfusion in primary NPC. Key Points • Intravoxel incoherent motion (IVIM) analysis permits separate quantification of diffusion and perfusion. • IVIM DWI is a feasible technique for investigating primary NPC. • IVIM suggests that primary NPC tissue voxels exhibit both perfusion and diffusion.
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Affiliation(s)
- Shui-xing Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, No. 106 Zhongshan Er Road, 510080, Guangzhou, Guangdong Prov., People's Republic of China
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Wang LL, Lin J, Liu K, Chen CZ, Liu H, Lv P, Fu CX, Zeng MS. Intravoxel incoherent motion diffusion-weighted MR imaging in differentiation of lung cancer from obstructive lung consolidation: comparison and correlation with pharmacokinetic analysis from dynamic contrast-enhanced MR imaging. Eur Radiol 2014; 24:1914-22. [DOI: 10.1007/s00330-014-3176-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 03/24/2014] [Accepted: 04/03/2014] [Indexed: 12/28/2022]
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112
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Lee Y, Kim H. Assessment of diffusion tensor MR imaging (DTI) in liver fibrosis with minimal confounding effect of hepatic steatosis. Magn Reson Med 2014; 73:1602-8. [PMID: 24733754 DOI: 10.1002/mrm.25253] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/10/2014] [Accepted: 03/25/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE Given the potential confounding effect of fat on apparent diffusion coefficient (ADC) in the liver, we have assessed diffusion tensor imaging in liver fibrosis with minimal effect of fat on ADC and fractional anisotropy (FA). METHODS Thirty-six mice were used, among which 20 mice were CCl4 treated for fibrosis induction. Diffusion tensor imaging was performed at 9.4T using a spin-echo diffusion tensor imaging sequence with six gradient directions. Hepatic fat fraction obtained by MR spectroscopy was used as hepatic fat content. Fibrosis scores were obtained from histopathology. RESULTS The hepatic fat fractions of the two animal groups were below 5.5% and not different (5.3 ± 1.5 vs. 4.6 ± 1.1%; P = 0.115). Fibrosis scores were higher in CCl4 -treated mice (0.0 ± 0.0 vs. 2.1 ± 0.7; P < 0.001). Nonetheless, there was no difference in ADC between the two groups (0.711 ± 0.068 × 10(-3) vs. 0.718 ± 0.095 × 10(-3) mm(2) s(-1) ; P = 0.911). The treated group had a lower FA than control (0.552 ± 0.050 vs. 0.586 ± 0.013; P = 0.023). ADC was not correlated with hepatic fat fraction and fibrosis. FA was correlated with hepatic fat fraction (r = 0.418, P = 0.011) and fibrosis (r = -0.411, P = 0.012). CONCLUSION FA may be more sensitive to mild-to-moderate liver fibrosis than ADC. In addition to ADC, FA may also be sensitive to hepatic fat content, and therefore need careful interpretation in liver fibrosis with concomitant fatty liver.
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Affiliation(s)
- Yunjung Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
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113
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Evaluation of hepatic fibrosis using intravoxel incoherent motion in diffusion-weighted liver MRI. J Comput Assist Tomogr 2014; 38:110-6. [PMID: 24378888 DOI: 10.1097/rct.0b013e3182a589be] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine whether intravoxel incoherent motion (IVIM)-diffusion-weighted image (DWI)-derived parameters showed better diagnostic performance than the apparent diffusion coefficient (ADC(total)) for the evaluation of hepatic fibrosis (HF). METHODS This retrospective study was approved by institutional review board, and informed consent was waived. Fifty-five patients with chronic liver disease who had undergone IVIM-DWI using 8 b-values at 3 T were included. True diffusion coefficient (Dt), pseudo-diffusion coefficient (Dp), perfusion fraction (f), and ADC(total) were calculated. Receiver operating characteristic analysis was performed for all parameters for the HF staging. RESULTS All parameters showed a significant correlation with the HF stages (-0.31 to -0.72, P < 0.05). All parameters were significantly higher in F0 to F1 than in F4 (P < 0.05). The Dp showed better performance than the ADC(total) in differentiating significant HF (≥F2) from F0 to F1. CONCLUSIONS The IVIM-derived parameters and ADC(total) showed significant correlation with HF. The D p showed better diagnostic performance for differentiating significant HF than did ADC(total).
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114
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Van Beers BE. Science to Practice: can we diagnose nonalcoholic steatohepatitis with intravoxel incoherent motion diffusion-weighted MR imaging? Radiology 2014; 270:1-2. [PMID: 24354367 DOI: 10.1148/radiol.13132294] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
By showing that intravoxel incoherent motion parameters at diffusion-weighted magnetic resonance (MR) imaging may be indicators of the microcirculatory changes in patients with nonalcoholic steatohepatitis and fatty liver disease, Joo et al have taken a step forward in the validation of quantitative MR imaging parameters as biomarkers of nonalcoholic steatohepatitis and fatty liver disease. Further steps, including standardization, validation, and multiparametric imaging, must be taken before these parameters can be used as biomarkers in clinical practice.
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Affiliation(s)
- Bernard E Van Beers
- IPMA Laboratory, U773 INSERM University Paris Diderot, Sorbonne Paris Cité Department of Radiology Beaujon University Hospital Paris Nord 100 Boulevard du General Leclerc 92110 Clichy, France
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Dijkstra H, Handayani A, Kappert P, Oudkerk M, Sijens PE. Clinical implications of non-steatotic hepatic fat fractions on quantitative diffusion-weighted imaging of the liver. PLoS One 2014; 9:e87926. [PMID: 24505333 PMCID: PMC3913701 DOI: 10.1371/journal.pone.0087926] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 01/01/2014] [Indexed: 01/27/2023] Open
Abstract
Diffusion-weighted imaging (DWI) is an important diagnostic tool in the assessment of focal liver lesions and diffuse liver diseases such as cirrhosis and fibrosis. Quantitative DWI parameters such as molecular diffusion, microperfusion and their fractions, are known to be affected when hepatic fat fractions (HFF) are higher than 5.5% (steatosis). However, less is known about the effect on DWI for HFF in the normal non-steatotic range below 5.5%, which can be found in a large part of the population. The aim of this study was therefore to evaluate the diagnostic implications of non-steatotic HFF on quantitative DWI parameters in eight liver segments. For this purpose, eleven healthy volunteers (2 men, mean-age 31.0) were prospectively examined with DWI and three series of in-/out-of-phase dual-echo spoiled gradient-recalled MRI sequences to obtain the HFF and T2*. DWI data were analyzed using the intravoxel incoherent motion (IVIM) model. Four circular regions (ø22.3 mm) were drawn in each of eight liver segments and averaged. Measurements were divided in group 1 (HFF≤2.75%), group 2 (2.75< HFF ≤5.5%) and group 3 (HFF>5.5%). DWI parameters and T2* were compared between the three groups and between the segments. It was observed that the molecular diffusion (0.85, 0.72 and 0.49 ×10−3 mm2/s) and T2* (32.2, 27.2 and 21.0 ms) differed significantly between the three groups of increasing HFF (2.18, 3.50 and 19.91%). Microperfusion and its fraction remained similar for different HFF. Correlations with HFF were observed for the molecular diffusion (r = −0.514, p<0.001) and T2* (−0.714, p<0.001). Similar results were obtained for the majority of individual liver segments. It was concluded that fat significantly decreases molecular diffusion in the liver, also in absence of steatosis (HFF≤5.5%). Also, it was confirmed that fat influences T2*. Determination of HFF prior to quantitative DWI is therefore crucial.
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Affiliation(s)
- Hildebrand Dijkstra
- Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Astri Handayani
- Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Kappert
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Matthijs Oudkerk
- Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Paul E. Sijens
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Kakite S, Dyvorne H, Besa C, Cooper N, Facciuto M, Donnerhack C, Taouli B. Hepatocellular carcinoma: short-term reproducibility of apparent diffusion coefficient and intravoxel incoherent motion parameters at 3.0T. J Magn Reson Imaging 2014; 41:149-56. [PMID: 24415565 DOI: 10.1002/jmri.24538] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 11/05/2013] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate short-term test-retest and interobserver reproducibility of IVIM (intravoxel incoherent motion) diffusion parameters and ADC (apparent diffusion coefficient) of hepatocellular carcinoma (HCC) and liver parenchyma at 3.0T. MATERIALS AND METHODS In this prospective Institutional Review Board (IRB)-approved study, 11 patients were scanned twice using a free-breathing single-shot echo-planar-imaging, diffusion-weighted imaging (DWI) sequence using 4 b values (b = 0, 50, 500, 1000 s/mm(2)) and IVIM DWI using 16 b values (0-800 s/mm(2)) at 3.0T. IVIM parameters (D: true diffusion coefficient, D*: pseudodiffusion coefficient, PF: perfusion fraction) and ADC (using 4 b and 16 b) were calculated. Short-term test-retest and interobserver reproducibility of IVIM parameters and ADC were assessed by measuring correlation coefficient, coefficient of variation (CV), and Bland-Altman limits of agreements (BA-LA). RESULTS Fifteen HCCs were assessed in 10 patients. Reproducibility of IVIM metrics in HCC was poor for D* and PF (mean CV 60.6% and 37.3%, BA-LA: -161.6% to 135.3% and -66.2% to 101.0%, for D* and PF, respectively), good for D and ADC (CV 19.7% and <16%, BA-LA -57.4% to 36.3% and -38.2 to 34.1%, for D and ADC, respectively). Interobserver reproducibility was on the same order of test-retest reproducibility except for PF in HCC. Reproducibility of diffusion parameters was better in liver parenchyma compared to HCC. CONCLUSION Poor reproducibility of D*/PF and good reproducibility for D/ADC were observed in HCC and liver parenchyma. These findings may have implications for trials using DWI in HCC.
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Affiliation(s)
- Suguru Kakite
- Department of Radiology/Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Chen F, Keyzer FD, Feng YB, Cona MM, Yu J, Marchal G, Oyen R, Ni YC. Separate calculation of DW-MRI in assessing therapeutic effect in liver tumors in rats. World J Gastroenterol 2013; 19:9092-9103. [PMID: 24379636 PMCID: PMC3870564 DOI: 10.3748/wjg.v19.i47.9092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 09/07/2013] [Accepted: 11/05/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore whether the antitumor effect of a vascular disrupting agent (VDA) would be enhanced by combining with an antiangiogenic agent, and whether such synergistic effects can be effectively evaluated with separate calculation of diffusion weighted magnetic resonance imaging (DW-MRI).
METHODS: Thirty-seven rats with implanted liver tumors were randomized into the following three groups: (1) ZD6126, a kind of VDA; (2) ZDTHA, ZD6126 in combination with an antiangiogenic, thalidomide; and (3) control. Morphological DW-MRI were performed and quantified before, 4 h and 2 d after treatment. The apparent diffusion coefficient (ADC) values were calculated separately for low b values (ADClow), high b values (ADChigh) and all b values (ADCall). The tissue perfusion contribution, ADCperf, was calculated as ADClow-ADChigh. Imaging findings were finally verified by histopathology.
RESULTS: The combination therapy with ZDTHA significantly delayed tumor growth due to synergistic effects by inducing cumulative tumor necrosis. In addition to delaying tumor growth, ZDTHA caused tumor necrosis in an additive manner, which was verified by HE staining. Although both ADChigh and ADCall in the ZD6126 and ZDTHA groups were significantly higher compared to those in the control group on day 2, the entire tumor ADChigh of ZDTHA was even higher than that of ZD6126, but the significant difference was not observed for ADCall between ZDTHA and ZD6126. This indicated that the perfusion insensitive ADChigh values calculated from high b value images performed significantly better than ADCall for the monitoring of tumor necrosis on day 2. The perfusion sensitive ADCperf derived from ADClow by excluding high b value effects could better reflect the reduction of blood flow due to the vessel shutdown induced by ZD6126, compared to the ADClow at 4 h. The ADCperf could provide valuable perfusion information from DW-MRI data.
CONCLUSION: The separate calculation of ADC is more useful than conventional averaged ADC in evaluating the efficacy of combination therapy with ZD6126 and thalidomide for solid tumors.
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Joo I, Lee JM, Yoon JH, Jang JJ, Han JK, Choi BI. Nonalcoholic fatty liver disease: intravoxel incoherent motion diffusion-weighted MR imaging-an experimental study in a rabbit model. Radiology 2013; 270:131-40. [PMID: 24091358 DOI: 10.1148/radiol.13122506] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate the feasibility of using intravoxel incoherent motion (IVIM) diffusion-weighted imaging with multiple b values for the noninvasive diagnosis of nonalcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS This study was approved by the institutional animal care and use committee. Twenty-seven 8-week-old rabbits were fed a variety of diets (from a standard diet to a high-fat, high-cholesterol diet) before IVIM diffusion-weighted imaging was performed with seven b values by using a 3-T magnetic resonance (MR) imaging unit. At histologic analysis of the animals, livers were categorized by NAFLD severity as normal, NAFLD, borderline nonalcoholic steatohepatitis (NASH), or NASH. The apparent diffusion coefficient and IVIM-derived parameters including true diffusion coefficient, pseudodiffusion coefficient, and perfusion fraction of the liver parenchyma were measured. Each parameter was correlated with NAFLD severity, and optimal cutoff values were determined by means of receiver operating characteristics analysis. RESULTS Perfusion fraction was significantly lower in rabbits with NAFLD than in those with a normal liver, and it decreased further as severity of NAFLD increased, with medians of 22.2%, 14.8%, 11.3%, and 9.5% in the rabbits in the normal, NAFLD, borderline, and NASH groups, respectively (ρ = -0.83, P < .001). Apparent diffusion coefficient, true diffusion coefficient, and pseudodiffusion coefficient were not significantly different between the NAFLD severity groups. In terms of the diagnostic performance of perfusion fraction, area under the curve values were 0.984 (normal vs NAFLD or more severe disease), 0.959 (NAFLD or less severe vs borderline or more severe disease), and 0.903 (borderline or less severe vs NASH) with optimal cutoff values of 15.2%, 13.2%, and 11.0%, respectively. CONCLUSION Perfusion fractions extracted from IVIM diffusion-weighted imaging may help in the differentiation of early stage NASH from simple steatosis.
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Affiliation(s)
- Ijin Joo
- From the Department of Radiology (I.J., J.M.L., J.H.Y., J.K.H., B.I.C.), Institute of Radiation Medicine (J.M.L., J.K.H., B.I.C.), and Department of Pathology (J.J.J.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea
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Joo I, Lee JM, Yoon JH, Jang JJ, Han JK, Choi BI. Nonalcoholic Fatty Liver Disease: Intravoxel Incoherent Motion Diffusion-weighted MR Imaging-An Experimental Study in a Rabbit Model. Radiology 2013:122506. [PMID: 24475795 DOI: 10.1148/radiology.13122506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate the feasibility of using intravoxel incoherent motion (IVIM) diffusion-weighted imaging with multiple b values for the noninvasive diagnosis of nonalcoholic fatty liver disease (NAFLD). Materials and Methods This study was approved by the institutional animal care and use committee. Twenty-seven 8-week-old rabbits were fed a variety of diets (from a standard diet to a high-fat, high-cholesterol diet) before IVIM diffusion-weighted imaging was performed with seven b values by using a 3-T magnetic resonance (MR) imaging unit. At histologic analysis of the animals, livers were categorized by NAFLD severity as normal, NAFLD, borderline nonalcoholic steatohepatitis (NASH), or NASH. The apparent diffusion coefficient and IVIM-derived parameters including true diffusion coefficient, pseudodiffusion coefficient, and perfusion fraction of the liver parenchyma were measured. Each parameter was correlated with NAFLD severity, and optimal cutoff values were determined by means of receiver operating characteristics analysis. Results Perfusion fraction was significantly lower in rabbits with NAFLD than in those with a normal liver, and it decreased further as severity of NAFLD increased, with medians of 22.2%, 14.8%, 11.3%, and 9.5% in the rabbits in the normal, NAFLD, borderline, and NASH groups, respectively (ρ = -0.83, P < .001). Apparent diffusion coefficient, true diffusion coefficient, and pseudodiffusion coefficient were not significantly different between the NAFLD severity groups. In terms of the diagnostic performance of perfusion fraction, area under the curve values were 0.984 (normal vs NAFLD or more severe disease), 0.959 (NAFLD or less severe vs borderline or more severe disease), and 0.903 (borderline or less severe vs NASH) with optimal cutoff values of 15.2%, 13.2%, and 11.0%, respectively. Conclusion Perfusion fractions extracted from IVIM diffusion-weighted imaging may help in the differentiation of early stage NASH from simple steatosis. © RSNA, 2013.
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Affiliation(s)
- Ijin Joo
- From the Department of Radiology (I.J., J.M.L., J.H.Y., J.K.H., B.I.C.), Institute of Radiation Medicine (J.M.L., J.K.H., B.I.C.), and Department of Pathology (J.J.J.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea
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Hayashi T, Miyati T, Takahashi J, Tsuji Y, Suzuki H, Tagaya N, Hiramoto M, Fukuzawa K, Tano M, Saitoh S. Diffusion analysis with triexponential function in hepatic steatosis. Radiol Phys Technol 2013; 7:89-94. [PMID: 24092461 DOI: 10.1007/s12194-013-0235-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 09/05/2013] [Accepted: 09/08/2013] [Indexed: 02/06/2023]
Abstract
Our purpose was to assess the influence of liver steatosis on diffusion by triexponential analysis. Thirty-three patients underwent diffusion-weighted magnetic resonance imaging with multiple b values for perfusion-related diffusion, fast free diffusion, and slow restricted diffusion coefficients (D p, D f, D s) and fractions (F p, F f, F s). They also underwent dual-echo gradient-echo imaging for measurement of the hepatic fat fraction (HFF). Of these, 13 patients were included in the control group and 20 in the fatty liver group with HFF >5 %. The parameters of the two groups were compared by use of the Mann-Whitney U test. The relationships between diffusion coefficients and HFFs were assessed by use of the Pearson correlation. D p and D f were reduced significantly in the steatotic liver group compared with those in the control group (D p = 27.72 ± 6.61 × 10(-3) vs. 33.33 ± 6.47 × 10(-3) mm(2)/s, P = 0.0072; D f = 1.70 ± 0.53 × 10(-3) vs. 2.06 ± 0.40 × 10(-3) mm(2)/s, P = 0.0224). There were no significant differences in the other parameters between the two groups. Furthermore, D p and D f were correlated with HFF (P < 0.0001, r = -0.64 and P = 0.0008, r = -0.56, respectively). Decreased liver perfusion in steatosis caused the reduction in D p, and extracellular fat accumulation and intracellular fat droplets in steatosis led to the reduction in D f. Thus, the influence of hepatic steatosis should be taken into consideration when triexponential function analysis is used for assessment of diffuse liver disease.
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Affiliation(s)
- Tatsuya Hayashi
- Department of Radiological Technology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan,
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Onishi H, Theisen D, Dietrich O, Reiser MF, Zech CJ. Hepatic steatosis: effect on hepatocyte enhancement with gadoxetate disodium-enhanced liver MR imaging. J Magn Reson Imaging 2013; 39:42-50. [PMID: 24339365 DOI: 10.1002/jmri.24136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 02/26/2013] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To investigate the effect of hepatic steatosis on enhancement of liver parenchyma with gadoxetate disodium-enhanced MR imaging. MATERIALS AND METHODS Gadoxetate disodium-enhanced MR images of 166 patients were analyzed. Liver-spleen contrast and liver-spleen relative enhancement ratio on three-dimensional gradient echo T1-weighted images with fat suppression 20 minutes after injection of gadoxetate disodium were evaluated in correlation with fat signal fraction using the Pearson correlation coefficient and also compared between patients with normal liver parenchyma (n = 115) and with liver steatosis (n = 51) using the Student t-test. RESULTS The liver-spleen contrast at hepatobiliary phase showed inverse correlations with the fat signal fraction (r = -0.36; P < 0.01), while the liver-spleen relative enhancement ratio showed no statistical correlation with the fat signal fraction (P = 0.80). The liver-spleen contrast in the group with steatotic liver was significantly lower than that in the group with normal livers (P < 0.001). There was no significant difference in the relative enhancement ratio between the two groups (P = 0.85). CONCLUSION Our results may suggest that hepatic steatosis does not affect the uptake of gadoxetate disodium into hepatocytes and are considered crucial as background knowledge in extending the use of gadoxetate disodium-enhanced MR imaging to quantitate liver function.
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Affiliation(s)
- Hiromitsu Onishi
- Institute for Clinical Radiology, Ludwig Maximilians-University Hospital Munich, Germany; Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
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Federau C, O'Brien K, Meuli R, Hagmann P, Maeder P. Measuring brain perfusion with intravoxel incoherent motion (IVIM): Initial clinical experience. J Magn Reson Imaging 2013; 39:624-32. [DOI: 10.1002/jmri.24195] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 04/05/2013] [Indexed: 12/12/2022] Open
Affiliation(s)
- Christian Federau
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
| | | | - Reto Meuli
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
| | - Patric Hagmann
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
| | - Philippe Maeder
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
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Sumi M, Nakamura T. Head and neck tumours: combined MRI assessment based on IVIM and TIC analyses for the differentiation of tumors of different histological types. Eur Radiol 2013; 24:223-31. [PMID: 24013848 DOI: 10.1007/s00330-013-3002-z] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 08/09/2013] [Accepted: 08/11/2013] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We evaluated the combined use of intravoxel incoherent motion (IVIM) and time-signal intensity curve (TIC) analyses to diagnose head and neck tumours. METHODS We compared perfusion-related parameters (PP) and molecular diffusion values (D) determined from IVIM theory and TIC profiles among 92 tumours with different histologies. RESULTS IVIM parameters (f and D values) and TIC profiles in combination were distinct among the different types of head and neck tumours, including squamous cell carcinomas (SCCs), lymphomas, malignant salivary gland tumours, Warthin's tumours, pleomorphic adenomas and schwannomas. A multiparametric approach using both IVIM parameters and TIC profiles differentiated between benign and malignant tumours with 97 % accuracy and diagnosed different tumour types with 89 % accuracy. CONCLUSIONS Combined use of IVIM parameters and TIC profiles has high efficacy in diagnosing head and neck tumours. KEY POINTS • Head and neck tumours have wide MR perfusion/diffusion properties. • Dynamic contrast-enhanced (DCE) MR imaging can characterise tumour perfusion (TIC analysis). • Intravoxel incoherent motion (IVIM) imaging can provide diffusion and perfusion properties. • However, IVIM or DCE imaging alone is insufficient for diagnosing head/neck tumours. • Multiparametric approach using both IVIM and TIC profiles can facilitate the diagnosis.
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Affiliation(s)
- Misa Sumi
- Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
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Leitão HS, Paulino C, Rodrigues D, Gonçalves SI, Marques C, Carvalheiro M, Geraldes CF, Caseiro-Alves F. MR fat fraction mapping: a simple biomarker for liver steatosis quantification in nonalcoholic fatty liver disease patients. Acad Radiol 2013; 20:957-61. [PMID: 23830602 DOI: 10.1016/j.acra.2013.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 04/27/2013] [Accepted: 05/07/2013] [Indexed: 01/06/2023]
Abstract
RATIONALE AND OBJECTIVES To assess the performance, postprocessing time, and intra- and interobserver agreement of a simple magnetic resonance-based mapping technique to quantify liver fat. MATERIALS AND METHODS This prospective, single-center study included 26 patients who were overweight with type 2 diabetes and at risk for nonalcoholic fatty liver disease. Mapping of the liver was based on a triple echo gradient-echo sequence, and (1)H magnetic resonance spectroscopy was used as the reference standard. The nonparametric Spearman correlation coefficient and the Wilcoxon test were used for comparisons between mapping and spectroscopy. The mapping was assessed for its predictive performance using the area under the curve of a receiver operating characteristic curve. Intraclass correlation coefficients were used to calculate intra- and interobserver's agreement for mapping measurements. RESULTS Patients had a mean fat percentage of 11.7% (range, 2-35.4%). A strong correlation was seen between mapping and spectroscopy (r = 0.89, P < .0001). A cutoff of 6.9% for fat fraction mapping was found to diagnose steatosis with 93% sensitivity and 100% specificity with an area under the curve of 0.99. Mapping of the liver had shorter acquisition and post-processing times than spectroscopy (5 min vs. 38 min; P < .0001). Mapping measurements had an intra- and interobserver agreement of 0.98 and 0.99, respectively. CONCLUSIONS The magnetic resonance-based liver mapping can accurately quantify liver fat with a cutoff value of 6.9% and excellent intra- and interobserver agreement. This mapping technique, with its simple methodology and short postprocessing time, has the potential to be included in routine abdominal protocols.
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Soyer P, Kanematsu M, Taouli B, Koh DM, Manfredi R, Vilgrain V, Hoeffel C, Guiu B. ADC normalization: a promising research track for diffusion-weighted MR imaging of the abdomen. Diagn Interv Imaging 2013; 94:571-3. [PMID: 23731499 DOI: 10.1016/j.diii.2013.05.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Penner AH, Sprinkart AM, Kukuk GM, Gütgemann I, Gieseke J, Schild HH, Willinek WA, Mürtz P. Intravoxel incoherent motion model-based liver lesion characterisation from three b-value diffusion-weighted MRI. Eur Radiol 2013; 23:2773-83. [PMID: 23666233 DOI: 10.1007/s00330-013-2869-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/15/2013] [Accepted: 03/25/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate intravoxel incoherent motion (IVIM) model-based liver lesion characterisation from three b-value diffusion-weighted imaging (DWI). METHODS The 1.5-T DWI data from a respiratory gated spin-echo echo-planar magnetic resonance imaging sequence (b = 0, 50, 800 s/mm(2)) were retrospectively analysed in 38 patients with different liver lesions. Conventional apparent diffusion coefficient ADC = ADC(0,800) as well as IVIM-based parameters D' = ADC(50,800), ADC_low = ADC(0,50), and f' were calculated voxel-wise. Sixty-one regions of interest in hepatocellular carcinomas (HCCs, n = 24), haemangiomas (HEMs, n = 11), focal nodular hyperplasias (FNHs, n = 11), and healthy liver tissue (REFs, n = 15) were analysed. Group differences were investigated using Student's t-test and receiver-operating characteristic (ROC) analysis. RESULTS Mean values ± standard deviations of ADC, D', ADC_low (in 10(-5) mm(2)/s), and f' (in %) for REFs/FNHs/HEMs/HCCs were 130 ± 11/143 ± 27/168 ± 16/113 ± 25, 104 ± 12/123 ± 25/162 ± 18/102 ± 23, 518 ± 66/437 ± 97/268 ± 69/283 ± 120, and 18 ± 3/14 ± 4/6 ± 3/9 ± 5, respectively. Differences between lesions and REFs were more significant for IVIM-based parameters than for conventional ADC. ROC analysis showed the best discriminability between HCCs and FNHs for ADC_low and f' and between HEMs and FNHs or HCCs for D'. CONCLUSION Three instead of two b-value DWI enables a numerically stable and voxel-wise IVIM-based analysis for improved liver lesion characterisation with tolerable acquisition time. KEY POINTS • Quantitative analysis of diffusion-weighted MRI helps liver lesion characterisation. • Analysis of intravoxel incoherent motion is superior to apparent diffusion coefficient determination. • Only three b-values enable separation of diffusion and microcirculation effects. • The method presented is numerically stable, with voxel-wise results and short acquisition times.
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Affiliation(s)
- A-H Penner
- Department of Radiology, University of Bonn, Bonn, Germany
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Yoon JH, Lee JM, Yu MH, Kiefer B, Han JK, Choi BI. Evaluation of hepatic focal lesions using diffusion-weighted MR imaging: comparison of apparent diffusion coefficient and intravoxel incoherent motion-derived parameters. J Magn Reson Imaging 2013; 39:276-85. [PMID: 23633178 DOI: 10.1002/jmri.24158] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 03/06/2013] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To determine whether parameters obtained from intravoxel incoherent motion (IVIM)-diffusion-weighted imaging (DWI) using multiple b-values can improve characterization of common focal liver lesions (FLLs), compared with the apparent diffusion coefficient (ADCtotal ). MATERIALS AND METHODS Our Institutional Review Board approved this retrospective study and informed consent was waived. In all, 142 patients with 169 FLLs underwent liver magnetic resonance imaging (MRI) including IVIM-DWI with multiple b factors at 3.0T. ADCtotal and IVIM-DWI-derived parameters including true diffusion (Dt ), pseudodiffusion (Dp ), and perfusion fraction (f) were calculated for each lesion and compared using dedicated software. RESULTS Dt and ADCtotal were significantly lower in malignancies (0.95 ± 0.21, 1.14 ± 0.24, (×10(-3) mm(2) /sec)) than in benign FLLs (1.61 ± 0.34, 1.72 ± 0.37, (×10(-3) mm(2) /sec)). In the differential diagnosis of malignancies from benign lesions, Dt (Az value: 0.971) showed better diagnostic performance than ADCtotal (Az: 0.933) (P < 0.0005). Dt (Az: 0.961) also showed better diagnostic performance than ADCtotal (Az: 0.919) in differentiating hypervascular malignancies from benign hypervascular FLLs (P < 0.0005). In addition, Dp and f were significantly higher in hypervascular FLLs (35.74 ± 20.08 (×10(-3) mm(2) /sec), 28.14 ± 11.82 (%)) than hypovascular FLLs (21.87 ± 13.8 (×10(-3) mm(2) /sec), 12.2 ± 5.92 (%)) (P < 0.0001). CONCLUSION Dt provided better diagnostic performance than ADCtotal in differentiating benign from malignant lesions. Dp and f were significant parameters for diagnosing hypervascular FLLs.
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Affiliation(s)
- Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
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Quantitative liver ADC measurements using diffusion-weighted MRI at 3 Tesla: evaluation of reproducibility and perfusion dependence using different techniques for respiratory compensation. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2013; 26:431-42. [PMID: 23483359 DOI: 10.1007/s10334-013-0375-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 02/22/2013] [Accepted: 02/23/2013] [Indexed: 12/13/2022]
Abstract
OBJECT Diffusion weighted imaging (DWI) of the liver suffers from low signal to noise making 3 Tesla (3 T) an attractive option, but 3 T data is scarce. It was the aim to study the influence of different b values and respiratory compensation methods (RCM) on the apparent diffusion coefficient (ADC) level and on ADC reproducibility at 3 T. MATERIALS AND METHODS Ten healthy volunteers and 12 patients with malignant liver lesions underwent repeated (2-22 days) breathhold, free-breathing and respiratory triggered DWI at 3 T using b values between 0 and 1,000 s/mm(2). RESULTS The ADCs changed up to 150% in healthy livers and up to 48% in malignant lesions depending on b value combinations. Best ADC reproducibility in healthy livers were obtained with respiratory triggering (95% limits of agreement: ±0.12) and free-breathing (±0.14). In malignant lesions equivalent reproducibility was obtained with less RCM dependence. The use of a lower maximum b value (b = 500) decreased reproducibility (±0.14 to ±0.32) in both normal liver and malignant lesions. CONCLUSION Large differences in absolute ADC values and reproducibility caused by varying combinations of clinically realistic b values were demonstrated. Different RCMs caused smaller differences. Lowering maximum b value to 500 increased limits of agreement up to a factor of two. Serial ADC changes larger than approximately 15% can be detected confidently on an individual basis in both malignant lesions and normal liver parenchyma at 3 T using appropriate b values and respiratory compensation.
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