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Hu G, Ye C, Zhong M, Lei C, Qin J, Wang L. IVIM parameters mapping with artificial neural network based on mean deviation prior. Med Phys 2024. [PMID: 39241221 DOI: 10.1002/mp.17383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 07/29/2024] [Accepted: 08/12/2024] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND The diffusion and perfusion parameters derived from intravoxel incoherent motion (IVIM) imaging provide promising biomarkers for noninvasively quantifying and managing various diseases. Nevertheless, due to the distribution gap between simulated and real datasets, the out-of-distribution (OOD) problem occurred in supervised learning-based methods degrades their performance and hinders their real applications. PURPOSE To address the OOD problem in supervised methods and to further improve the accuracy and stability of IVIM parameter estimation, this work proposes a novel learning framework called IterANN, based on mean deviation prior (MDP) between training and estimated IVIM parameters on the test set. METHODS Specifically, MDP indicates that the mean of the estimated IVIM parameters always locates between the mean of IVIM parameters in the test and train sets. In IterANN, we adopt a very simple artificial neural network (ANN) architecture of two hidden layers with 12 neurons per hidden layer, an input layer containing the signals acquired at multiple b-values and an output layer composed of three IVIM parameters ( D $D$ , F $F$ andD S t a r $DStar$ ). Inspired by MDP, the distribution of IVIM parameters in the training set (simulated data) is iteratively updated so that their mean gradually approaches the predicted values of the real data. This aims to achieve a strong correlation between the simulated data and the real data. To validate the effectiveness of IterANN, we compare it with several methods on both simulation and real acquisition datasets, including 21 healthy and 3 tumor subjects, in terms of residual errors of IVIM parameters or DW signals, the coefficients of variation (CV) of IVIM parameters, and the parameter contrast-to-noise ratio (PCNR) between normal and tumor tissues. RESULTS On two simulation datasets, the proposed IterANN achieves the lowest residual error in IVIM parameters, especially in the case of low signal-to-noise ratio (SNR = 10), the residual error of D $D$ , F $F$ andD S t a r $DStar$ is decreased by15.82 % / 14.92 % , 81.19 % / 74.04 % , 50.77 % / 1.549 % $15.82\%/14.92\%, 81.19\%/74.04\%, 50.77\%/1.549\%$ (Gaussian distribution /realistic distribution) respectively comparing to the suboptimal method. On real dataset, the IterANN achieves the highest PCNR when comparing the normal and tumor regions. Additionally, the proposed IterANN demonstrated better stability, with its CV being significantly lower than that of other methods in the vast majority of cases (p < 0.01 $p<0.01$ , paired-sample Student's t-test). CONCLUSIONS The superior performance of IterANN demonstrates that updating the distribution of the train set based on MDP can effectively solve the OOD problem, which allows us not only to improve the accuracy and stability of the estimated IVIM parameters, but also to increase the potential of IVIM in disease diagnosis.
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Affiliation(s)
- Guodong Hu
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Chen Ye
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Ming Zhong
- Department of Radiology, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, NHC Key Laboratory of Pulmonary Immune-related Diseases, Guizhou Provincial People's Hospital, Guiyang, China
| | - Chao Lei
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Junpeng Qin
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Lihui Wang
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, China
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Loh M, Führes T, Stuprich C, Benkert T, Bickelhaupt S, Uder M, Laun FB. Effect of simultaneous multislice imaging, slice properties, and repetition time on the measured magnetic resonance biexponential intravoxel incoherent motion in the liver. PLoS One 2024; 19:e0306996. [PMID: 39121035 PMCID: PMC11315316 DOI: 10.1371/journal.pone.0306996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/26/2024] [Indexed: 08/11/2024] Open
Abstract
OBJECTIVES This study aims to investigate the previously reported dependency of intravoxel incoherent motion (IVIM) parameters on simultaneous multislice (SMS) acquisition and repetition time (TR). This includes the influence of slice thickness, slice gaps, and slice order on measured IVIM parameters. MATERIALS AND METHODS Diffusion-weighted imaging (DWI) of the liver was performed on 10 healthy volunteers (aged 20-30 years) at 3T with a slice thickness of 5 mm, a slice gap of 5 mm, and a linear slice order. Diffusion-weighted images were acquired with 19 b-values (0-800 s/mm2) using both conventional slice excitation with an acceleration factor of one (AF1) and SMS excitation with an acceleration factor of three (AF3). Each of these measurements were carried out with two repetition times (TRs)- 1,300 ms (prefix s) and 4,500 ms (prefix l)-resulting in four different combinations: sAF1, sAF3, lAF1, and lAF3. Five volunteers underwent additional measurements using a 10 mm slice thickness and with AF1. Median signal values in the liver were used to determine the biexponential IVIM parameters. Statistical significances were assessed using the Kruskal-Wallis test, Wilcoxon signed-rank test, and Student's t-test. In-silico investigations were also used to interpret the data. RESULTS There were no significant differences between the biexponential IVIM parameters acquired from sAF1, sAF3, lAF1, and lAF3. Median values of the perfusion fraction f were as follows: 29.9% (sAF1), 26.9% (sAF3), 28.1% (lAF1), and 27.5% (lAF3). In the 10 mm-thick slices, f decreased from 31.3% (lAF1) to 27.4% (sAF1) (p = 0.141). CONCLUSION The slice excitation mode did not appear to have any significant influence on the biexponential IVIM parameters. However, our simulations, as well as values reported from previous publications, show that slice thickness, slice gaps, and slice order are relevant and should thus be reported in IVIM studies.
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Affiliation(s)
- Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobit Führes
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Stuprich
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Sebastian Bickelhaupt
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Stuprich CM, Loh M, Nemerth JT, Nagel AM, Uder M, Laun FB. Velocity-compensated intravoxel incoherent motion of the human calf muscle. Magn Reson Med 2024; 92:543-555. [PMID: 38688865 DOI: 10.1002/mrm.30059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/15/2024] [Accepted: 02/03/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE To determine whether intravoxel incoherent motion (IVIM) describes the blood perfusion in muscles better, assuming pseudo diffusion (Bihan Model 1) or ballistic motion (Bihan Model 2). METHODS IVIM parameters were measured in 18 healthy subjects with three different diffusion gradient time profiles (bipolar with two diffusion times and one with velocity compensation) and 17 b-values (0-600 s/mm2) at rest and after muscle activation. The diffusion coefficient, perfusion fraction, and pseudo-diffusion coefficient were estimated with a segmented fit in the gastrocnemius medialis (GM) and tibialis anterior (TA) muscles. RESULTS Velocity-compensated gradients resulted in a decreased perfusion fraction (6.9% ± 1.4% vs. 4.4% ± 1.3% in the GM after activation) and pseudo-diffusion coefficient (0.069 ± 0.046 mm2/s vs. 0.014 ± 0.006 in the GM after activation) compared to the bipolar gradients with the longer diffusion encoding time. Increased diffusion coefficients, perfusion fractions, and pseudo-diffusion coefficients were observed in the GM after activation for all gradient profiles. However, the increase was significantly smaller for the velocity-compensated gradients. A diffusion time dependence was found for the pseudo-diffusion coefficient in the activated muscle. CONCLUSION Velocity-compensated diffusion gradients significantly suppress the IVIM effect in the calf muscle, indicating that the ballistic limit is mostly reached, which is supported by the time dependence of the pseudo-diffusion coefficient.
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Affiliation(s)
- Christoph M Stuprich
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Johannes T Nemerth
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik B Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Bäuchle TA, Stuprich CM, Loh M, Nagel AM, Uder M, Laun FB. Influence of Magnetic Field Strength on Intravoxel Incoherent Motion Parameters in Diffusion MRI of the Calf. Tomography 2024; 10:773-788. [PMID: 38787019 PMCID: PMC11126135 DOI: 10.3390/tomography10050059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/26/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Background: The purpose of this study was to investigate the dependence of Intravoxel Incoherent Motion (IVIM) parameters measured in the human calf on B0. Methods: Diffusion-weighted image data of eight healthy volunteers were acquired using five b-values (0-600 s/mm2) at rest and after muscle activation at 0.55 and 7 T. The musculus gastrocnemius mediale (GM, activated) was assessed. The perfusion fraction f and diffusion coefficient D were determined using segmented fits. The dependence on field strength was assessed using Student's t-test for paired samples and the Wilcoxon signed-rank test. A biophysical model built on the three non-exchanging compartments of muscle, venous blood, and arterial blood was used to interpret the data using literature relaxation times. Results: The measured perfusion fraction of the GM was significantly lower at 7 T, both for the baseline measurement and after muscle activation. For 0.55 and 7 T, the mean f values were 7.59% and 3.63% at rest, and 14.03% and 6.92% after activation, respectively. The biophysical model estimations for the mean proton-density-weighted perfusion fraction were 3.37% and 6.50% for the non-activated and activated states, respectively. Conclusions: B0 may have a significant effect on the measured IVIM parameters. The blood relaxation times suggest that 7 T IVIM may be arterial-weighted whereas 0.55 T IVIM may exhibit an approximately equal weighting of arterial and venous blood.
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Affiliation(s)
- Tamara Alice Bäuchle
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Christoph Martin Stuprich
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Armin Michael Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
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Li XM, Ma FZ, Quan XY, Zhang XC, Xiao BH, Wáng YXJ. Repeatability and reproducibility comparisons of liver IVIM imaging with free-breathing or respiratory-triggered sequences. NMR IN BIOMEDICINE 2024; 37:e5080. [PMID: 38113878 DOI: 10.1002/nbm.5080] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Abstract
For liver intravoxel incoherent motion (IVIM) data acquisition, respiratory-triggering (RT) MRI is commonly used, and there are strong motivations to shorten the scan duration. For the same scan duration, more b values or higher numbers of excitations can be allowed for free-breathing (FB) imaging than for RT. We studied whether FB can be used to replace RT when careful IVIM image acquisition and image processing are conducted. MRI data of 22 healthy participants were acquired using a 3.0 T scanner. Diffusion imaging was based on a single-shot spin-echo-type echo-planar sequence and 16 b values of 0, 2, 4, 7, 10, 15, 20, 30, 46, 60, 72, 100, 150, 200, 400, and 600 s/mm2 . Each subject attended two scan sessions with an interval of 10-20 days. For each scan session, a subject was scanned twice, first with RT and then with FB. The mean image acquisition time was 5.4 min for FB and 10.8 min for RT. IVIM parameters were calculated with bi-exponential model segmented fitting with a threshold b value of 60 s/mm2 , and fitting started from b = 2 s/mm2 . There was no statistically significant difference between IVIM parameters measured with FB imaging or RT imaging. Perfusion fraction ICC (intraclass correlation coefficient) for FB imaging and RT imaging in the same scan session was 0.824. For perfusion fraction, wSD (within-subject standard deviation), BA (Bland-Altman) difference, BA 95% limit, and ICC were 0.022, 0.0001, -0.0635~0.0637, and 0.687 for FB and 0.031, 0.0122, -0.0723~0.0967, and 0.611 for RT. For Dslow (×10-3 s/mm2 ), wSD, BA difference, BA 95% limit, and ICC were 0.057, 0.0268, -0.1258~0.1793, and 0.471 for FB and 0.073, -0.0078, -0.2170-0.2014, and <0.4 for RT. The Dfast coefficient of variation was 0.20 for FB imaging and 0.28 for RT imaging. All reproducibility indicators slightly favored FB imaging.
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Affiliation(s)
- Xin-Ming Li
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fu-Zhao Ma
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xian-Yue Quan
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xu-Chang Zhang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ben-Heng Xiao
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Bian W, Zhang J, Huang Q, Niu W, Li J, Song X, Cui S, Zheng Q, Niu J, Zhou XJ. Quantitative tumor burden imaging parameters of the spleen at MRI for predicting treatment response in patients with acute leukemia. Heliyon 2023; 9:e20348. [PMID: 37810872 PMCID: PMC10550618 DOI: 10.1016/j.heliyon.2023.e20348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives To study the value of standardized volume and intravoxel incoherent motion (IVIM) parameters of the spleen based on tumor burden for predicting treatment response in newly diagnosed acute leukemia (AL). Methods Patients with newly diagnosed AL were recruited and underwent abdominal IVIM diffusion-weighted imaging within one week before the first induction chemotherapy. Quantitative parameters of magnetic resonance imaging (MRI) included the standardized volume (representing volumetric tumor burden) and IVIM parameters (standard apparent diffusion coefficient [sADC]; pure diffusion coefficient [D]; pseudo-diffusion coefficient [D∗]; and pseudo-perfusion fraction [f], representing functional tumor burden) of the spleen. Clinical biomarkers of tumor burden were collected. Patients were divided into complete remission (CR) and non-CR groups according to the treatment response after the first standardized induction chemotherapy, and the MRI and clinical parameters were compared between the two groups. The correlations of MRI parameters with clinical biomarkers were analyzed. Multivariate logistic regression was performed to determine the independent predictors for treatment response. Receiver operating characteristic curves were used to analyze the predicted performance. Results 76 AL patients (CR: n = 43; non-CR: n = 33) were evaluated. Standardized spleen volume, sADC, D, f, white blood cell counts, and lactate dehydrogenase were significantly different between CR and non-CR groups (all p < 0.05). Standardized spleen volume, sADC, and D were correlated with white blood cell and lactate dehydrogenase, and f was correlated with lactate dehydrogenase (all p < 0.05). Standardized spleen volume (hazard ratio = 4.055, p = 0.042), D (hazard ratio = 0.991, p = 0.027), and f (hazard ratio = 1.142, p = 0.008) were independent predictors for treatment response, and the combination of standardized spleen volume, D, and f showed more favorable discrimination (area under the curve = 0.856) than individual predictors. Conclusion Standardized volume, D, and f of the spleen could be used to predict treatment response in newly diagnosed AL, and the combination of morphological and functional parameters would further improve the predicted performance. IVIM parameters of the spleen may be viable indicators for evaluating functional tumor burden in AL.
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Affiliation(s)
- Wenjin Bian
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
- Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Jianling Zhang
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Qianqian Huang
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Weiran Niu
- Department of Mental Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Jianting Li
- Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiaoli Song
- Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Sha Cui
- Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Qian Zheng
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
- Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Jinliang Niu
- Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiaohong Joe Zhou
- Center for MR Research and Departments of Radiology, Neurosurgery, And Biomedical Engineering, University of Illinois at Chicago, Chicago, 60612, Illinois, USA
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Loh M, Führes T, Stuprich C, Uder M, Saake M, Laun FB. Influence of saturation effects on biexponential liver intravoxel incoherent motion. Magn Reson Med 2023; 90:270-279. [PMID: 36861449 DOI: 10.1002/mrm.29622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/20/2023] [Accepted: 02/07/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE Studies on intravoxel incoherent motion (IVIM) imaging in the liver have been carried out with different acquisition protocols. The number of acquired slices and the distances between slices can influence IVIM measurements due to saturation effects, but these effects have often been disregarded. This study investigated differences in biexponential IVIM parameters between two slice settings. METHODS Fifteen healthy volunteers (21-30 years) were examined at a field strength of 3 T. Diffusion-weighted images of the abdomen were acquired with 16 b values (0-800 s/mm2 ), with four slices for the few slices setting and 24-27 slices for the many slices setting. Regions of interest were manually drawn in the liver. The data were fitted with a monoexponential signal curve and a biexponential IVIM curve, and biexponential IVIM parameters were determined. The dependence on the slice setting was assessed with Student's t test for paired samples (normally distributed IVIM parameters) and the Wilcoxon signed-rank test (non-normally distributed parameters). RESULTS None of the parameters were significantly different between the settings. For few slices and many slices, respectively, the mean values (SDs) for D $$ D $$ were 1.21 μm 2 / ms $$ 1.21{\upmu \mathrm{m}}^2/\mathrm{ms} $$ ( 0.19 μm 2 / ms $$ 0.19\kern0.3em {\upmu \mathrm{m}}^2/\mathrm{ms} $$ ) and 1.20 μm 2 / ms $$ 1.20{\upmu \mathrm{m}}^2/\mathrm{ms} $$ ( 0.11 μm 2 / ms $$ 0.11\kern0.3em {\upmu \mathrm{m}}^2/\mathrm{ms} $$ ); for f $$ f $$ they were 29.7% (6.2%) and 27.7% (3.6%); and for D * $$ {D}^{\ast } $$ they were 8.76 ⋅ 10 - 2 mm 2 / s $$ 8.76\cdot {10}^{-2}{\mathrm{mm}}^2/\mathrm{s} $$ ( 4.54 ⋅ 10 - 2 mm 2 / s $$ 4.54\cdot {10}^{-2}\kern0.3em {\mathrm{mm}}^2/\mathrm{s} $$ ) and 8.71 ⋅ 10 - 2 mm 2 / s $$ 8.71\cdot {10}^{-2}{\mathrm{mm}}^2/\mathrm{s} $$ ( 4.06 ⋅ 10 - 2 mm 2 / s $$ 4.06\cdot {10}^{-2}\kern0.3em {\mathrm{mm}}^2/\mathrm{s} $$ ). CONCLUSION Biexponential IVIM parameters in the liver are comparable among IVIM studies that use different slice settings, with mostly negligible saturation effects. However, this may not hold for studies that use much shorter TR.
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Affiliation(s)
- Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobit Führes
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Stuprich
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marc Saake
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Hu W, Chen L, Lin L, Wang J, Wang N, Liu A. Three-dimensional amide proton transfer-weighted and intravoxel incoherent motion imaging for predicting bone metastasis in patients with prostate cancer: A pilot study. Magn Reson Imaging 2023; 96:8-16. [PMID: 36375760 DOI: 10.1016/j.mri.2022.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/25/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To explore the value of 3-dimensional amide proton transfer-weighted (APTw) and intravoxel incoherent motion (IVIM) imaging in predicting bone metastasis (BM) of prostate cancer (PCa) in addition to routine diffusion-weighted imaging (DWI). METHODS The clinical and imaging data of 39 PCa patients who were pathologically confirmed in our hospital from March 2019 to February 2022 were retrospectively analyzed, and they were divided into BM-negative (27 patients) and BM-positive (12 patients) groups. MR examination included APTw, DWI and IVIM imaging. The IVIM data was fitted by single-exponential IVIM model (IVIMmono) and double-exponential IVIM model (IVIMbi), respectively. The APTw, ADC, IVIMmono (Dmono, D*mono, and fmono), and IVIMbi (Dbi, D*bi, and fbi) parameters were independently measured by two radiologists. The synthetic minority oversampling technique (SMOTE) was conducted to balance the minority group. Mann-Whitney U test or Student's t-test was used to compare above values between the BM-negative and BM-positive groups. The diagnostic performance was evaluated with receiver operating characteristic (ROC) analysis of each parameter and their combination. The Delong test was used for ROC curve comparison.The relationship between APTw and IVIM was explored through Spearman's rank correlation analysis. RESULTS The APTw and D*mono values were higher, and the ADC, fmono, and fbi values were lower in the BM-positive group than in the BM-negative group (all P < 0.05). Among the individual parameters, the AUC of fmono was the highest (AUC = 0.865), and AUC (fmono) was significantly higher than AUC (fbi), AUC (D*mono), and AUC (ADC) (all P < 0.05). The AUC (IVIMmono) was higher than the AUC (IVIMbi) (P = 0.0068). The combination of APTw and IVIMmono further improved diagnostic capability, and the AUC of APTw+IVIMmono was significantly higher than those of APTw and DWI (all P < 0.05). No correlation was found between IVIM-derived parameters and APTw value. CONCLUSION Both 3D APTw and IVIM imaging could predict BM of PCa. IVIM showed better performance than APTw and DWI, and the single-exponential IVIM model was superior to the double-exponential IVIM model. The combination of APTw and IVIM could further improve diagnostic performance.
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Affiliation(s)
- Wenjun Hu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China
| | - Lihua Chen
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China; Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, PR China
| | | | | | - Nan Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China; Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, PR China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China; Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, PR China.
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Xiang L, Yang H, Qin Y, Wen Y, Liu X, Zeng WB. Differential value of diffusion kurtosis imaging and intravoxel incoherent motion in benign and malignant solitary pulmonary lesions. Front Oncol 2023; 12:1075072. [PMID: 36713551 PMCID: PMC9878824 DOI: 10.3389/fonc.2022.1075072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Objective To investigate the diagnostic value of diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) whole-lesion histogram parameters in differentiating benign and malignant solitary pulmonary lesions (SPLs). Materials and Methods Patients with SPLs detected by chest CT examination and with further routine MRI, DKI and IVIM-DWI functional sequence scanning data were recruited. According to the pathological results, SPLs were divided into a benign group and a malignant group. Independent samples t tests (normal distribution) or Mann‒Whitney U tests (nonnormal distribution) were used to compare the differences in DKI (Dk, K), IVIM (D, D*, f) and ADC whole-lesion histogram parameters between the benign and malignant SPL groups. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of the histogram parameters and determine the optimal threshold. The area under the curve (AUC) of each histogram parameter was compared by the DeLong method. Spearman rank correlation was used to analyze the correlation between histogram parameters and malignant SPLs. Results Most of the histogram parameters for diffusion-related values (Dk, D, ADC) of malignant SPLs were significantly lower than those of benign SPLs, while most of the histogram parameters for the K value of malignant SPLs were significantly higher than those of benign SPLs. DKI (Dk, K), IVIM (D) and ADC were effective in differentiating benign and malignant SPLs and combined with multiple parameters of the whole-lesion histogram for the D value, had the highest diagnostic efficiency, with an AUC of 0.967, a sensitivity of 90.00% and a specificity of 94.03%. Most of the histogram parameters for the Dk, D and ADC values were negatively correlated with malignant SPLs, while most of the histogram parameters for the K value were positively correlated with malignant SPLs. Conclusions DKI (Dk, K) and IVIM (D) whole-lesion histogram parameters can noninvasively distinguish benign and malignant SPLs, and the diagnostic performance is better than that of DWI. Moreover, they can provide additional information on SPL microstructure, which has important significance for guiding clinical individualized precision diagnosis and treatment and has potential clinical application value.
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Affiliation(s)
- Lu Xiang
- Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing, China,College of Medical Imaging, North Sichuan Medical College, Sichuan, China
| | - Hong Yang
- Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing, China,Chongqing University School of Medicine, Chongqing, China
| | - Yu Qin
- Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing, China,College of Medical Imaging, North Sichuan Medical College, Sichuan, China
| | - Yun Wen
- Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Xue Liu
- PET-CT Center, Chongqing University Three Gorges Hospital, Chongqing, China,*Correspondence: Xue Liu, ; Wen-Bing Zeng,
| | - Wen-Bing Zeng
- Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing, China,*Correspondence: Xue Liu, ; Wen-Bing Zeng,
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10
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Mastropietro A, Procissi D, Scalco E, Rizzo G, Bertolino N. A supervised deep neural network approach with standardized targets for enhanced accuracy of IVIM parameter estimation from multi-SNR images. NMR IN BIOMEDICINE 2022; 35:e4774. [PMID: 35587618 PMCID: PMC9539583 DOI: 10.1002/nbm.4774] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
Extraction of intravoxel incoherent motion (IVIM) parameters from noisy diffusion-weighted (DW) images using a biexponential fitting model is computationally challenging, and the reliability of the estimated perfusion-related quantities represents a limitation of this technique. Artificial intelligence can overcome the current limitations and be a suitable solution to advance use of this technique in both preclinical and clinical settings. The purpose of this work was to develop a deep neural network (DNN) approach, trained on numerical simulated phantoms with different signal to noise ratios (SNRs), to improve IVIM parameter estimation. The proposed approach is based on a supervised fully connected DNN having 3 hidden layers, 18 inputs and 3 targets with standardized values. 14 × 103 simulated DW images, based on a Shepp-Logan phantom, were randomly generated with varying SNRs (ranging from 10 to 100). 7 × 103 images (1000 for each SNR) were used for training. Performance accuracy was assessed in simulated images and the proposed approach was compared with the state-of-the-art Bayesian approach and other DNN algorithms. The DNN approach was also evaluated in vivo on a high-field MRI preclinical scanner. Our DNN approach showed an overall improvement in accuracy when compared with the Bayesian approach and other DNN methods in most of the simulated conditions. The in vivo results demonstrated the feasibility of the proposed approach in real settings and generated quantitative results comparable to those obtained using the Bayesian and unsupervised approaches, especially for D and f, and with lower variability in homogeneous regions. The DNN architecture proposed in this work outlines two innovative features as compared with other studies: (1) the use of standardized targets to improve the estimation of parameters, and (2) the implementation of a single DNN to enhance the IVIM fitting at different SNRs, providing a valuable alternative tool to compute IVIM parameters in conditions of high background noise.
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Affiliation(s)
| | - Daniel Procissi
- Department of RadiologyNorthwestern UniversityChicagoIllinoisUSA
| | - Elisa Scalco
- Istituto di Tecnologie BiomedicheConsiglio Nazionale delle RicercheSegrateItaly
| | - Giovanna Rizzo
- Istituto di Tecnologie BiomedicheConsiglio Nazionale delle RicercheSegrateItaly
| | - Nicola Bertolino
- Department of RadiologyNorthwestern UniversityChicagoIllinoisUSA
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11
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Zheng CJ, Xiao BH, Huang H, Zhou N, Yan TY, Wáng YXJ. Bi-exponential fitting excluding b=0 data improves the scan-rescan stability of liver IVIM parameter measures and particularly so for the perfusion fraction. Quant Imaging Med Surg 2022; 12:3288-3299. [PMID: 35655827 PMCID: PMC9131351 DOI: 10.21037/qims-2022-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/11/2022] [Indexed: 08/30/2023]
Abstract
BACKGROUND A prerequisite to translating intravoxel incoherent motion (IVIM) imaging into meaningful clinical applications is sufficient scan-rescan reproducibility. This study aims to confirm the hypothesis that IVIM data fitting by not using b=0 images will improve the stability of liver IVIM measurement. METHODS Healthy volunteers' liver IVIM images were prospectively acquired using a 1.5-T magnet or a 3.0 T with 16 b-values. Repeatability study subjects were scanned twice during the same session, resulted in 35 paired scans for 35 subjects (11 men, mean age: 41.82 years, range: 32-60 years; 24 women, mean age: 42.67 years, range: 20-71 years). IVIM analysis was performed with full-fitting and segmented-fitting with a threshold b-value of 60 s/mm2, and fitting started from b=0 s/mm2 or from b=2 s/mm2. Reproducibility study subjects were scanned and then rescanned with an interval of 5-18 days, resulted in 20 paired scans for 11 subjects (4 men, mean age: 26.25 years, range: 25-27 years; 7 women, mean age: 25.57 years, range: 24-27 years). IVIM analysis was performed with segmented-fitting with a threshold b-value of 50 s/mm2, and fitting started from b=0 s/mm2 or from b=3 s/mm2. RESULTS Fitting without b=0 data generally improved the repeatability and reproducibility for both PF and Dslow, and particularly so for PF. For with b=0 data segmented fitting repeatability, PF had within-subject standard deviation of 0.019, bland-Atman 75% agreement limit of -31.52% to 28.35%, and ICC of 0.647, while these values were 0.009, -20.78% to 16.86%, and 0.837 for without b=0 analysis. Though the repeatability and reproducibility for Dfast generally also improved, they remained suboptimal. Measurement stability was better for repeatability than for reproducibility. CONCLUSIONS Scan-rescan repeatability and reproducibility of liver IVIM parameters can be improved by fitting without b=0 data, which is particularly so for PF.
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Affiliation(s)
- Cun-Jing Zheng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ben-Heng Xiao
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hua Huang
- Department of Radiology, The Third People’s Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, China
| | - Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Tai-Yu Yan
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yì Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Kong X, Zhang Q, Wu X, Zou T, Duan J, Song S, Nie J, Tao C, Tang M, Wang M, Zou J, Xie Y, Li Z, Li Z. Advances in Imaging in Evaluating the Efficacy of Neoadjuvant Chemotherapy for Breast Cancer. Front Oncol 2022; 12:816297. [PMID: 35669440 PMCID: PMC9163342 DOI: 10.3389/fonc.2022.816297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Neoadjuvant chemotherapy (NAC) is increasingly widely used in breast cancer treatment, and accurate evaluation of its response provides essential information for treatment and prognosis. Thus, the imaging tools used to quantify the disease response are critical in evaluating and managing patients treated with NAC. We discussed the recent progress, advantages, and disadvantages of common imaging methods in assessing the efficacy of NAC for breast cancer.
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Affiliation(s)
- Xianshu Kong
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Qian Zhang
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Xuemei Wu
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Tianning Zou
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jiajun Duan
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Shujie Song
- Department of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jianyun Nie
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Chu Tao
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Mi Tang
- Department of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Maohua Wang
- First Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Jieya Zou
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Yu Xie
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Zhenhui Li
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
| | - Zhen Li
- Third Department of the Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China
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13
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Perfusion-Diffusion Ratio: A New IVIM Approach in Differentiating Solid Benign and Malignant Primary Lesions of the Liver. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2957759. [PMID: 35075424 PMCID: PMC8783718 DOI: 10.1155/2022/2957759] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/02/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
Introduction In order to improve the efficacy of intravoxel incoherent motion (IVIM) parameters in characterising specific tissues, a new concept is introduced: the perfusion–diffusion ratio (PDR), which expresses the relationship between the signal S(b) decline rate as a result of IVIM and the rate of signal S(b) decline due to diffusion. The aim of this study was to investigate this novel approach in the differentiation of solid primary liver lesions. Material and Methods. Eighty-three patients referred for liver MRI between August 2017 and January 2020 with a suspected liver tumour were prospectively examined with the standard liver MRI protocol extended by DWI-IVIM sequence. Patients with no liver lesions, haemangiomas, or metastases were excluded. The final study population consisted of 34 patients with primary solid liver masses, 9 with FNH, 4 with regenerative nodules, 10 with HCC, and 11 with CCC. The PDR coefficient was introduced, defined as the ratio of the rate of signal S(b) decrease due to the IVIM effect to the rate of signal S(b) decrease due to the diffusion process, for b = 0. Results No significant differences were found between benign and malignant lesions in the case of IVIM parameters (f, D, or D∗) and ADC. Significant differences were observed only for PDR, with lower values for malignant lesions (p = 0.03). The ROC analysis yielded an AUC value for PDR equal to 0.74, with a cut-off value of 5.06, sensitivity of 81%, specificity of 77%, and accuracy of 79%. Conclusion PDR proved to be more effective than IVIM parameters and ADC in the differentiation of solid benign and malignant primary liver lesions.
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14
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Lee YJ, Kim SH, Kang BJ, Son YH, Grimm R. Associations between angiogenic factors and intravoxel incoherent motion-derived parameters in diffusion-weighted magnetic resonance imaging of breast cancer. Medicine (Baltimore) 2021; 100:e27495. [PMID: 34731130 PMCID: PMC8519258 DOI: 10.1097/md.0000000000027495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/23/2021] [Indexed: 01/05/2023] Open
Abstract
Intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) can be used to estimate perfusion-related parameters, but these parameters may differ, based on the curve-fitting algorithm used for IVIM. Microvessel density (MVD) and vascular endothelial growth factor (VEGF) status are used as angiogenic factors in breast cancer. We aimed to investigate the relationship between MVD, VEGF, and intravoxel incoherent motion (IVIM)-derived parameters, obtained by 4 curve-fitting algorithms, in patients with invasive breast cancers.This retrospective study investigated IVIM-derived parameters, D (ie, tissue diffusivity), D∗ (ie, pseudodiffusivity), and f (ie, perfusion fraction), of 55 breast cancers, using 10 b values (range, 0-800 s/mm2) and 4 curve-fitting algorithms: algorithm 1, linear fitting of D and f first, followed by D∗; algorithm 2, linear fitting of D and f and nonlinear fitting of D∗; algorithm 3, linear fitting of D and f, linear fitting of D∗, and ignoring D contribution for low b values; and algorithm 4, full nonlinear fitting of D, f, and D∗. We evaluated whole-tumor histograms of D, f, and D∗ for their association with MVD and VEGF.D∗10, D∗25, D∗50, D∗mean, D∗75, D∗90, f10, and f25, derived using algorithm 3, were associated with VEGF expression (P = .043, P = 0.012, P = .019, P = .024, P = .044, P = .041, P = .010, and P = .005, respectively). However, no correlation existed between MVD and IVIM-derived parameters.Perfusion-related IVIM parameters obtained by curve-fitting algorithm 3 may reflect VEGF expression.
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Affiliation(s)
- Youn Joo Lee
- Department of Radiology, Daejeon St. Mary's Hospital, Daejeon
| | - Sung Hun Kim
- Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Bong Joo Kang
- Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
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15
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Liu N, Yang X, Lei L, Pan K, Liu Q, Huang X. Intravoxel Incoherent Motion Model in Differentiating the Pathological Grades of Esophageal Carcinoma: Comparison of Mono-Exponential and Bi-Exponential Fit Model. Front Oncol 2021; 11:625891. [PMID: 33912449 PMCID: PMC8071935 DOI: 10.3389/fonc.2021.625891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/15/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To compare the diagnostic efficiency of the mono-exponential model and bi-exponential model deriving from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating the pathological grade of esophageal squamous cell carcinoma (ESCC). METHODS Fifty-four patients with ESCC were divided into three groups of poorly-differentiated (PD), moderately-differentiated (MD), and well-differentiated (WD), and underwent the IVIM-DWI scan. Mono-exponential (Dmono, D*mono, and fmono) and bi-exponential fit parameters (Dbi, D*bi, and fbi) were calculated using the IVIM data for the tumors. Mean parameter values of three groups were compared using a one-way ANOVA followed by post hoc tests. The receiver operating characteristic curve was drawn for differentiating pathological grade of ESCC. Correlations between pathological grades and IVIM parameters were analyzed. RESULTS There were significant differences in fmono and fbi among the PD, MD and WD ESCC groups (all p<0.05). The fmono were 0.32 ± 0.07, 0.23 ± 0.08, and 0.16 ± 0.05, respectively, and the fbi were 0.35 ± 0.08, 0.26 ± 0.10, and 0.18 ± 0.07, respectively. There was a significant difference in the Dmono between the WD and the PD group (1.48 ± 0.51* 10-3 mm2/s versus 1.05 ± 0.44*10-3 mm2/s, p<0.05), but there was no significant difference between the WD and MD groups, MD and PD groups (all p>0.05). The D*mono, Dbi, and D*bi showed no significant difference among the three groups (all p>0.05). The area under the curve (AUC) of Dmono, fmono and fbi in differentiating WD from PD ESCC were 0.764, 0.961 and 0.932, and the sensitivity and specificity were 92.9% and 60%, 92.9% and 90%, 85.7% and 100%, respectively. The AUC of fmono and fbi in differentiating MD from PD ESCC were 0.839 and 0.757, and the sensitivity and specificity were 78.6% and 80%, 85.7% and 70%, respectively. The AUC of fmono and fbi in differentiating MD from WD ESCC were 0.746 and 0.740, and the sensitivity and specificity were 65% and 85%, 80% and 60%, respectively. The pathologically differentiated grade was correlated with all IVIM parameters (all p<0.05). CONCLUSIONS The mono-exponential IVIM model is superior to the bi-exponential IVIM model in differentiating pathological grades of ESCC, which may be a promising imaging method to predict pathological grades of ESCC.
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Affiliation(s)
- Nian Liu
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiongxiong Yang
- Department of Radiology, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, China
| | - Lixing Lei
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ke Pan
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qianqian Liu
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiaohua Huang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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16
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Huang H, Zheng CJ, Wang LF, Che-Nordin N, Wáng YXJ. Age and gender dependence of liver diffusion parameters and the possibility that intravoxel incoherent motion modeling of the perfusion component is constrained by the diffusion component. NMR IN BIOMEDICINE 2021; 34:e4449. [PMID: 33354829 DOI: 10.1002/nbm.4449] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
The aim of this study was to establish reference values for middle-aged subjects and to investigate the age and gender dependence of liver diffusion MRI parameters. The IVIM type of liver diffusion scan was based on a single-shot spin-echo-type echo-planar sequence using a 1.5 T magnet with 16 b-values. Diffusion-derived vessel density (DDVD)(b0b2) or DDVD(b0b10) was the signal difference between b = 0 and b = 2 (or b = 10) s/mm2 images after removing visible vessels. IVIM analysis was performed with full fitting and segmented fitting, and with a threshold b-value of 60 or 200 s/mm2 , and fitting started from b = 2 s/mm2 . Thirty-one men (age range: 25-71 years) and 26 men (age: 22-69 years) had DDVD and IVIM analysis, respectively, while 37 women (age: 20-71 years) and 36 women (age: 20-71 years) had DDVD and IVIM analysis, respectively. DDVD results showed a significant age-related reduction for women. IVIM results for full fitting showed excellent agreement with those for segmented fitting using a threshold b of 60 s/mm2 , but this was less good for results with a threshold b of 200 s/mm2 . As age increased, female subjects' Dslow measure showed a significant reduction, while their PF and Dfast measures showed a significant increase. For the age group of 40-55 years, DDVD(b0b2), DDVD(b0b10), Dslow , PF and Dfast were 12.26 ± 3.90 au/pixel, 16.95 ± 5.45 au/pixel, 1.072 ± 0.067 (10-3 mm2 /s), 0.141 ± 0.025 and 61.0 ± 14.0 (10-3 mm2 /s) for men, and 13.35 ± 3.6 au/pixel, 17.20 ± 3.62 au/pixel, 1.069 ± 0.074 (10-3 mm2 /s), 0.119 ± 0.014 and 57.1 ± 13.2 (10-3 mm2 /s) for women, respectively. DDVD measure of this study suggest that aging is associated with a reduction in liver perfusion. There is a possibility that a lower Dslow measure is associated with artificially higher PF and Dfast measures, and that IVIM modeling of the perfusion component is constrained by the diffusion component.
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Affiliation(s)
- Hua Huang
- Department of Radiology, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong Province, China
| | - Cun-Jing Zheng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Li-Fei Wang
- Department of Radiology, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong Province, China
| | - Nazmi Che-Nordin
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Chevallier O, Wáng YXJ, Guillen K, Pellegrinelli J, Cercueil JP, Loffroy R. Evidence of Tri-Exponential Decay for Liver Intravoxel Incoherent Motion MRI: A Review of Published Results and Limitations. Diagnostics (Basel) 2021; 11:diagnostics11020379. [PMID: 33672277 PMCID: PMC7926368 DOI: 10.3390/diagnostics11020379] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/14/2021] [Accepted: 02/20/2021] [Indexed: 12/11/2022] Open
Abstract
Diffusion weighted imaging (DWI) and intravoxel incoherent motion (IVIM) have been explored to assess liver tumors and diffused liver diseases. IVIM reflects the microscopic translational motions that occur in voxels in magnetic resonance (MR) DWI. In biologic tissues, molecular diffusion of water and microcirculation of blood in the capillary network can be assessed using IVIM DWI. The most commonly applied model to describe the DWI signal is a bi-exponential model, with a slow compartment of diffusion linked to pure molecular diffusion (represented by the coefficient Dslow), and a fast compartment of diffusion, related to microperfusion (represented by the coefficient Dfast). However, high variance in Dfast estimates has been consistently shown in literature for liver IVIM, restricting its application in clinical practice. This variation could be explained by the presence of another very fast compartment of diffusion in the liver. Therefore, a tri-exponential model would be more suitable to describe the DWI signal. This article reviews the published evidence of the existence of this additional very fast diffusion compartment and discusses the performance and limitations of the tri-exponential model for liver IVIM in current clinical settings.
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Affiliation(s)
- Olivier Chevallier
- Image-Guided Therapy Center, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (J.P.); (J.-P.C.)
| | - Yì Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China;
| | - Kévin Guillen
- Image-Guided Therapy Center, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (J.P.); (J.-P.C.)
| | - Julie Pellegrinelli
- Image-Guided Therapy Center, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (J.P.); (J.-P.C.)
| | - Jean-Pierre Cercueil
- Image-Guided Therapy Center, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (J.P.); (J.-P.C.)
| | - Romaric Loffroy
- Image-Guided Therapy Center, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (K.G.); (J.P.); (J.-P.C.)
- Correspondence: ; Tel.: +33-380-293-677
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Jerome NP, Periquito JS. Analysis of Renal Diffusion-Weighted Imaging (DWI) Using Apparent Diffusion Coefficient (ADC) and Intravoxel Incoherent Motion (IVIM) Models. Methods Mol Biol 2021; 2216:611-635. [PMID: 33476027 DOI: 10.1007/978-1-0716-0978-1_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Analysis of renal diffusion-weighted imaging (DWI) data to derive markers of tissue properties requires careful consideration of the type, extent, and limitations of the acquired data. Alongside data quality and general suitability for quantitative analysis, choice of diffusion model, fitting algorithm, and processing steps can have consequences for the precision, accuracy, and reliability of derived diffusion parameters. Here we introduce and discuss important steps for diffusion-weighted image processing, and in particular give example analysis protocols and pseudo-code for analysis using the apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) models. Following an overview of general principles, we provide details of optional steps, and steps for validation of results. Illustrative examples are provided, together with extensive notes discussing wider context of individual steps, and notes on potential pitfalls.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This analysis protocol chapter is complemented by two separate chapters describing the basic concepts and experimental procedure.
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Affiliation(s)
- Neil Peter Jerome
- Institute for Circulation and Diagnostic Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway.
| | - João S Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
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19
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Intravoxel incoherent motion magnetic resonance imaging: basic principles and clinical applications. Pol J Radiol 2020; 85:e624-e635. [PMID: 33376564 PMCID: PMC7757509 DOI: 10.5114/pjr.2020.101476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 06/03/2020] [Indexed: 12/26/2022] Open
Abstract
The purpose of this article was to show basic principles, acquisition, advantages, disadvantages, and clinical applications of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI). IVIM MRI as a method was introduced in the late 1980s, but recently it started attracting more interest thanks to its applications in many fields, particularly in oncology and neuroradiology. This imaging technique has been developed with the objective of obtaining not only a functional analysis of different organs but also different types of lesions. Among many accessible tools in diagnostic imaging, IVIM MRI aroused the interest of many researchers in terms of studying its applicability in the evaluation of abdominal organs and diseases. The major conclusion of this article is that IVIM MRI seems to be a very auspicious method to investigate the human body, and that nowadays the most promising clinical application for IVIM perfusion MRI is oncology. However, due to lack of standardisation of image acquisition and analysis, further studies are needed to validate this method in clinical practice.
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20
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Ye C, Xu D, Qin Y, Wang L, Wang R, Li W, Kuai Z, Zhu Y. Accurate intravoxel incoherent motion parameter estimation using Bayesian fitting and reduced number of low b-values. Med Phys 2020; 47:4372-4385. [PMID: 32403175 DOI: 10.1002/mp.14233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/02/2020] [Accepted: 04/15/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Intravoxel incoherent motion (IVIM) magnetic resonance imaging is a potential noninvasive technique for the diagnosis of brain tumors. However, perfusion-related parameter mapping is a persistent problem. The purpose of this paper is to investigate the IVIM parameter mapping of brain tumors using Bayesian fitting and low b-values. METHODS Bayesian shrinkage prior (BSP) fitting method and different low b-value distributions were used to estimate IVIM parameters (diffusion D, pseudo-diffusion D*, and perfusion fraction F). The results were compared to those obtained by least squares (LSQ) on both simulated and in vivo brain data. Relative error (RE) and reproducibility were used to evaluate the results. The differences of IVIM parameters between brain tumor and normal regions were compared and used to assess the performance of Bayesian fitting in the IVIM application of brain tumor. RESULTS In tumor regions, the value of D* tended to be decreased when the number of low b-values was insufficient, especially with LSQ. BSP required less low b-values than LSQ for the correct estimation of perfusion parameters of brain tumors. The IVIM parameter maps of brain tumors yielded by BSP had smaller variability, lower RE, and higher reproducibility with respect to those obtained by LSQ. Obvious differences were observed between tumor and normal regions in parameters D (P < 0.05) and F (P < 0.001), especially F. BSP generated fewer outliers than LSQ, and distinguished better tumors from normal regions in parameter F. CONCLUSIONS Intravoxel incoherent motion parameters clearly allow brain tumors to be differentiated from normal regions. Bayesian fitting yields robust IVIM parameter mapping with fewer outliers and requires less low b-values than LSQ for the parameter estimation.
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Affiliation(s)
- Chen Ye
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Daoyun Xu
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Yongbin Qin
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Lihui Wang
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Rongpin Wang
- Department of Radiology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Wuchao Li
- Department of Radiology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Zixiang Kuai
- Harbin Medical University Cancer Hospital, Harbin, China
| | - Yuemin Zhu
- Univ Lyon, INSA Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, F-69621, France
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Lanzarone E, Mastropietro A, Scalco E, Vidiri A, Rizzo G. A novel bayesian approach with conditional autoregressive specification for intravoxel incoherent motion diffusion-weighted MRI. NMR IN BIOMEDICINE 2020; 33:e4201. [PMID: 31884712 DOI: 10.1002/nbm.4201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 08/28/2019] [Accepted: 09/13/2019] [Indexed: 06/10/2023]
Abstract
The Intra-Voxel Incoherent Motion (IVIM) model is largely adopted to estimate slow and fast diffusion coefficients of water molecules in biological tissues, which are used in cancer applications. The most reported fitting approach is a voxel-wise segmented non-linear least square, whereas Bayesian approaches with a direct fit, also considering spatial regularization, were proposed too. In this work a novel segmented Bayesian method was proposed, also in combination with a spatial regularization through a Conditional Autoregressive (CAR) prior specification. The two segmented Bayesian approaches, with and without CAR specification, were compared with two standard least-square and a direct Bayesian fitting methods. All approaches were tested on simulated images and real data of patients with head-and-neck and rectal cancer. Estimation accuracy and maps noisiness were quantified on simulated images, whereas the coefficient of variation and the goodness of fit were evaluated for real data. Both versions of the segmented Bayesian approach outperformed the standard methods on simulated images for pseudo-diffusion (D∗ ) and perfusion fraction (f), whilst the segmented least-square fitting remained the less biased for the diffusion coefficient (D). On real data, Bayesian approaches provided the less noisy maps, and the two Bayesian methods without CAR generally estimated lower values for f and D∗ coefficients with respect to the other approaches. The proposed segmented Bayesian approaches were superior, in terms of estimation accuracy and maps quality, to the direct Bayesian model and the least-square fittings. The CAR method improved the estimation accuracy, especially for D∗ .
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Affiliation(s)
- Ettore Lanzarone
- Institute for Applied Mathematics and Information Technologies (IMATI-CNR), Milan, Italy
| | - Alfonso Mastropietro
- Institute of Biomedical Technologies (ITB-CNR), Segrate (MI), Italy
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Segrate (MI), Italy
| | - Elisa Scalco
- Institute of Biomedical Technologies (ITB-CNR), Segrate (MI), Italy
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Segrate (MI), Italy
| | - Antonello Vidiri
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanna Rizzo
- Institute of Biomedical Technologies (ITB-CNR), Segrate (MI), Italy
- Institute of Molecular Bioimaging and Physiology (IBFM-CNR), Segrate (MI), Italy
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Gurney‐Champion OJ, Rauh SS, Harrington K, Oelfke U, Laun FB, Wetscherek A. Optimal acquisition scheme for flow-compensated intravoxel incoherent motion diffusion-weighted imaging in the abdomen: An accurate and precise clinically feasible protocol. Magn Reson Med 2020; 83:1003-1015. [PMID: 31566262 PMCID: PMC6899942 DOI: 10.1002/mrm.27990] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/14/2019] [Accepted: 08/17/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Flow-compensated (FC) diffusion-weighted MRI (DWI) for intravoxel-incoherent motion (IVIM) modeling allows for a more detailed description of tissue microvasculature than conventional IVIM. The long acquisition time of current FC-IVIM protocols, however, has prohibited clinical application. Therefore, we developed an optimized abdominal FC-IVIM acquisition with a clinically feasible scan time. METHODS Precision and accuracy of the FC-IVIM parameters were assessed by fitting the FC-IVIM model to signal decay curves, simulated for different acquisition schemes. Diffusion-weighted acquisitions were added subsequently to the protocol, where we chose the combination of b-value, diffusion time and gradient profile (FC or bipolar) that resulted in the largest improvement to its accuracy and precision. The resulting two optimized FC-IVIM protocols with 25 and 50 acquisitions (FC-IVIMopt25 and FC-IVIMopt50 ), together with a complementary acquisition consisting of 50 diffusion-weighting (FC-IVIMcomp ), were acquired in repeated abdominal free-breathing FC-IVIM imaging of seven healthy volunteers. Intersession and intrasession within-subject coefficient of variation of the FC-IVIM parameters were compared for the liver, spleen, and kidneys. RESULTS Simulations showed that the performance of FC-IVIM improved in tissue with larger perfusion fraction and signal-to-noise ratio. The scan time of the FC-IVIMopt25 and FC-IVIMopt50 protocols were 8 and 16 min. The best in vivo performance was seen in FC-IVIMopt50 . The intersession within-subject coefficients of variation of FC-IVIMopt50 were 11.6%, 16.3%, 65.5%, and 36.0% for FC-IVIM model parameters diffusivity, perfusion fraction, characteristic time and blood flow velocity, respectively. CONCLUSIONS We have optimized the FC-IVIM protocol, allowing for clinically feasible scan times (8-16 min).
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Affiliation(s)
- Oliver J. Gurney‐Champion
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
| | - Susanne S. Rauh
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
- Institute of RadiologyUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Kevin Harrington
- Targeted Therapy teamThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
| | - Uwe Oelfke
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
| | - Frederik B. Laun
- Institute of RadiologyUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Andreas Wetscherek
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
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Tosun M, Onal T, Uslu H, Alparslan B, Çetin Akhan S. Intravoxel incoherent motion imaging for diagnosing and staging the liver fibrosis and inflammation. Abdom Radiol (NY) 2020; 45:15-23. [PMID: 31705248 DOI: 10.1007/s00261-019-02300-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) model parameters for the diagnosis and staging of liver fibrosis and inflammation in patients with chronic hepatitis B. METHODS Fifty-four patients with chronic hepatitis B and 42 healthy volunteers were included in the study. All subjects were examined by 3 T magnetic resonance imaging. Diffusion-weighted imaging was undertaken with sixteen b values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histological evaluation of biopsy samples was considered the reference standard for the staging of liver fibrosis and inflammation. Differences in IVIM parameters between patient and control groups were analyzed. In the patient group, fibrosis stage and inflammation grade groups were analyzed with respect to IVIM parameters. The correlation was assessed between IVIM parameters and Ishak-modified scale of fibrosis stages and inflammation grades. RESULTS The D was significantly lower in the patient group than the control group, p = 0.038 with Cohen's d effect size of 0.452. D was significantly different between fibrosis stage levels. D values decreased in fibrosis stages from the minimal to moderate to marked fibrosis. Fibrosis grades significantly negatively correlated with D and D* values, p = 0.001, and 0.021, respectively. In addition, inflammation grades negatively correlated with f values, p = 0.047. CONCLUSION D values measured with IVIM imaging may help to diagnose liver fibrosis. IVIM imaging could be an alternative to liver biopsy for the staging of liver fibrosis.
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Affiliation(s)
- Mesude Tosun
- Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey.
| | | | - Hande Uslu
- Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Burcu Alparslan
- Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Sıla Çetin Akhan
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
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Chevallier O, Zhou N, Cercueil JP, He J, Loffroy R, Wáng YXJ. Comparison of tri-exponential decay versus bi-exponential decay and full fitting versus segmented fitting for modeling liver intravoxel incoherent motion diffusion MRI. NMR IN BIOMEDICINE 2019; 32:e4155. [PMID: 31361366 DOI: 10.1002/nbm.4155] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/15/2019] [Accepted: 06/23/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To determine whether bi- or tri-exponential models, and full or segmented fittings, better fit the intravoxel incoherent motion (IVIM) imaging signal of healthy livers. METHODS Diffusion-weighted images were acquired with a 3 T scanner using a respiratory-triggered echo-planar sequence and 16 b-values (0-800 s/mm2 ). Eighteen healthy volunteers had their livers scanned twice in the same session, and then once in another session. Liver parenchyma region-of-interest-based measurements were processed with bi-exponential and tri-exponential models, with both full fitting and segmented fitting (threshold b-value = 200 s/mm2 ). RESULTS With the signal of all scans averaged, bi-exponential model full fitting showed Dslow = 1.14 × 10-3 mm2 /s, Dfast = 193.6 × 10-3 mm2 /s, and perfusion fraction (PF) = 16.9%, and segmented fitting showed Dslow = 0.98 × 10-3 mm2 /s, Dfast = 42.2 × 10-3 mm2 /s, and PF = 23.3%. IVIM parameters derived from the tri-exponential model were similar for full fitting and segmented fitting, with slow (D'slow = 0.98 × 10-3 mm2 /s; F'slow = 76.4 or 76.6%), fast (D'fast = 15.1 or 15.4 × 10-3 mm2 /s; F'fast = 11.8 or 11.7%) and very fast (D'Vfast = 445.0 or 448.8 × 10-3 mm2 /s; F'Vfast = 11.8 or 11.7%) diffusion compartments. The tri-exponential model provided an overall better fit than the bi-exponential model. For the bi-exponential model, full fitting provided a better fit at very low and low b-values compared with segmented fitting, with the latter tending to underestimate Dfast ; however, the segmented method demonstrated lower error in signal prediction for high b-values. Compared with full fitting, tri-exponential segmented fitting offered better scan-rescan reproducibility. CONCLUSION For healthy liver, tri-exponential modeling is preferred to bi-exponential modeling. For the bi-exponential model, segmented fitting underestimates Dfast , but offers a more accurate estimation of Dslow .
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Affiliation(s)
- Olivier Chevallier
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon Cedex, France
| | - Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jean-Pierre Cercueil
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon Cedex, France
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon Cedex, France
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
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Xu X, Chen D, Cao L, Feng X, Tong R, Zheng S, Wu J. Spontaneous rupture of solid pseudopapillary tumor of pancreas: A case report and review of literature. Medicine (Baltimore) 2019; 98:e17554. [PMID: 31689759 PMCID: PMC6946308 DOI: 10.1097/md.0000000000017554] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Solid pseudopapillary tumors (SPT) account for 1% to 3% of all pancreatic tumors. They have low malignant potential with a favorable prognosis, and predominantly occur in young women. The pathogenesis and clinical behavior of SPT are still uncertain. In addition, most ruptures of SPT were associated with blunt abdominal trauma, while spontaneous ruptures seemed to be quite rare. Up to now, there have been only 3 spontaneous ruptured SPT cases reported worldwide. PATIENT CONCERNS Here, we reported a 22-year-old female patient with left lower abdominal pain. Computed tomography (CT) showed that a hemorrhagic complex solid cystic mass located in the lesser omentum sac. DIAGNOSIS According to pathological findings of tumor specimen, the diagnosis of solid pseudopapillary tumor (SPT) of the pancreas was made. INTERVENTIONS Distal pancreatectomy and splenectomy was carried out. OUTCOMES The patient recovered to normal status within 10 days after surgery. CONCLUSION Besides, we reviewed about 50 cases in literatures to find out the clinical characteristics and differential diagnostic strategies of SPT.
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Affiliation(s)
- Xiaofeng Xu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University,
| | - Diyu Chen
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University,
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health,
| | - Linping Cao
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University,
| | - Xiaode Feng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University,
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health,
| | - Rongliang Tong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University,
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health,
| | - Shusen Zheng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University,
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health,
- Collaborative Innovation Center for Diagnosis Treatment of Infectious Diseases, Hangzhou, Zhejiang, China
| | - Jian Wu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University,
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health,
- Collaborative Innovation Center for Diagnosis Treatment of Infectious Diseases, Hangzhou, Zhejiang, China
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Wáng YXJ, Wang X, Wu P, Wang Y, Chen W, Chen H, Li J. Topics on quantitative liver magnetic resonance imaging. Quant Imaging Med Surg 2019; 9:1840-1890. [PMID: 31867237 DOI: 10.21037/qims.2019.09.18] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Liver magnetic resonance imaging (MRI) is subject to continuous technical innovations through advances in hardware, sequence and novel contrast agent development. In order to utilize the abilities of liver MR to its full extent and perform high-quality efficient exams, it is mandatory to use the best imaging protocol, to minimize artifacts and to select the most adequate type of contrast agent. In this article, we review the routine clinical MR techniques applied currently and some latest developments of liver imaging techniques to help radiologists and technologists to better understand how to choose and optimize liver MRI protocols that can be used in clinical practice. This article covers topics on (I) fat signal suppression; (II) diffusion weighted imaging (DWI) and intravoxel incoherent motion (IVIM) analysis; (III) dynamic contrast-enhanced (DCE) MR imaging; (IV) liver fat quantification; (V) liver iron quantification; and (VI) scan speed acceleration.
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Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | | | - Peng Wu
- Philips Healthcare (Suzhou) Co., Ltd., Suzhou 215024, China
| | - Yajie Wang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Weibo Chen
- Philips Healthcare, Shanghai 200072, China.,Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai 200062, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai 200062, China
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Chabert S, Verdu J, Huerta G, Montalba C, Cox P, Riveros R, Uribe S, Salas R, Veloz A. Impact of b-Value Sampling Scheme on Brain IVIM Parameter Estimation in Healthy Subjects. Magn Reson Med Sci 2019; 19:216-226. [PMID: 31611542 PMCID: PMC7553810 DOI: 10.2463/mrms.mp.2019-0061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: Intravoxel incoherent motion (IVIM) analysis has attracted the interest of the clinical community due to its close relationship with microperfusion. Nevertheless, there is no clear reference protocol for its implementation; one of the questions being which b-value distribution to use. This study aimed to stress the importance of the sampling scheme and to show that an optimized b-value distribution decreases the variance associated with IVIM parameters in the brain with respect to a regular distribution in healthy volunteers. Methods: Ten volunteers were included in this study; images were acquired on a 1.5T MR scanner. Two distributions of 16 b-values were used: one considered ‘regular’ due to its close association with that used in other studies, and the other considered ‘optimized’ according to previous studies. IVIM parameters were adjusted according to the bi-exponential model, using two-step method. Analysis was undertaken in ROI defined using in the Automated Anatomical Labeling atlas, and parameters distributions were compared in a total of 832 ROI. Results: Maps with fewer speckles were obtained with the ‘optimized’ distribution. Coefficients of variation did not change significantly for the estimation of the diffusion coefficient D but decreased by approximately 39% for the pseudo-diffusion coefficient estimation and by 21% for the perfusion fraction. Distributions of adjusted parameters were found significantly different in 50% of the cases for the perfusion fraction, in 80% of the cases for the pseudo-diffusion coefficient and 17% of the cases for the diffusion coefficient. Observations across brain areas show that the range of average values for IVIM parameters is smaller in the ‘optimized’ case. Conclusion: Using an optimized distribution, data are sampled in a way that the IVIM signal decay is better described and less variance is obtained in the fitted parameters. The increased precision gained could help to detect small variations in IVIM parameters.
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Affiliation(s)
- Stéren Chabert
- CINGS Centro de Investigación y Desarrollo de Ingeniería para la Salud, Universidad de Valparaíso.,Escuela de Ingenieria Civil Biomedica, Universidad de Valparaíso.,Millennium Nucleus for Cardiovascular Magnetic Resonance
| | - Jorge Verdu
- Escuela de Ingenieria Civil Biomedica, Universidad de Valparaíso.,Universidad Politécnica de Valencia
| | - Gamaliel Huerta
- Escuela de Ingenieria Civil Biomedica, Universidad de Valparaíso
| | - Cristian Montalba
- Center for Biomedical Imaging, Pontificia Universidad Católica de Chile
| | - Pablo Cox
- Servicio de Imagenología, Hospital Carlos van Buren
| | - Rodrigo Riveros
- Servicio de Imagenología, Hospital Carlos van Buren.,Facultad de Medicina, Universidad de Valparaíso
| | - Sergio Uribe
- Millennium Nucleus for Cardiovascular Magnetic Resonance.,Center for Biomedical Imaging, Pontificia Universidad Católica de Chile.,Radiology Department, Pontificia Universidad Católica de Chile
| | - Rodrigo Salas
- CINGS Centro de Investigación y Desarrollo de Ingeniería para la Salud, Universidad de Valparaíso.,Escuela de Ingenieria Civil Biomedica, Universidad de Valparaíso
| | - Alejandro Veloz
- CINGS Centro de Investigación y Desarrollo de Ingeniería para la Salud, Universidad de Valparaíso.,Escuela de Ingenieria Civil Biomedica, Universidad de Valparaíso
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Fick RHJ, Wassermann D, Deriche R. The Dmipy Toolbox: Diffusion MRI Multi-Compartment Modeling and Microstructure Recovery Made Easy. Front Neuroinform 2019; 13:64. [PMID: 31680924 PMCID: PMC6803556 DOI: 10.3389/fninf.2019.00064] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/04/2019] [Indexed: 12/22/2022] Open
Abstract
Non-invasive estimation of brain microstructure features using diffusion MRI (dMRI)—known as Microstructure Imaging—has become an increasingly diverse and complicated field over the last decades. Multi-compartment (MC)-models, representing the measured diffusion signal as a linear combination of signal models of distinct tissue types, have been developed in many forms to estimate these features. However, a generalized implementation of MC-modeling as a whole, providing deeper insights in its capabilities, remains missing. To address this fact, we present Diffusion Microstructure Imaging in Python (Dmipy), an open-source toolbox implementing PGSE-based MC-modeling in its most general form. Dmipy allows on-the-fly implementation, signal modeling, and optimization of any user-defined MC-model, for any PGSE acquisition scheme. Dmipy follows a “building block”-based philosophy to Microstructure Imaging, meaning MC-models are modularly constructed to include any number and type of tissue models, allowing simultaneous representation of a tissue's diffusivity, orientation, volume fractions, axon orientation dispersion, and axon diameter distribution. In particular, Dmipy is geared toward facilitating reproducible, reliable MC-modeling pipelines, often allowing the whole process from model construction to parameter map recovery in fewer than 10 lines of code. To demonstrate Dmipy's ease of use and potential, we implement a wide range of well-known MC-models, including IVIM, AxCaliber, NODDI(x), Bingham-NODDI, the spherical mean-based SMT and MC-MDI, and spherical convolution-based single- and multi-tissue CSD. By allowing parameter cascading between MC-models, Dmipy also facilitates implementation of advanced approaches like CSD with voxel-varying kernels and single-shell 3-tissue CSD. By providing a well-tested, user-friendly toolbox that simplifies the interaction with the otherwise complicated field of dMRI-based Microstructure Imaging, Dmipy contributes to more reproducible, high-quality research.
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Affiliation(s)
- Rutger H J Fick
- TheraPanacea, Paris, France.,Inria Sophia Antipolis-Méditerranée, Université Côte d'Azur, Sophia Antipolis, France
| | | | - Rachid Deriche
- Inria Sophia Antipolis-Méditerranée, Université Côte d'Azur, Sophia Antipolis, France
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Chouhan MD, Firmin L, Read S, Amin Z, Taylor SA. Quantitative pancreatic MRI: a pathology-based review. Br J Radiol 2019; 92:20180941. [PMID: 30982337 DOI: 10.1259/bjr.20180941] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
MRI plays an important role in the clinical management of pancreatic disorders and interpretation is reliant on qualitative assessment of anatomy. Conventional sequences capturing pancreatic structure can however be adapted to yield quantitative measures which provide more diagnostic information, with a view to increasing diagnostic accuracy, improving patient stratification, providing robust non-invasive outcome measures for therapeutic trials and ultimately personalizing patient care. In this review, we evaluate the use of established techniques such as secretin-enhanced MR cholangiopancreatography, diffusion-weighted imaging, T 1, T 2* and fat fraction mapping, but also more experimental methods such as MR elastography and arterial spin labelling, and their application to the assessment of diffuse pancreatic disease (including chronic, acute and autoimmune pancreatitis/IgG4 disease, metabolic disease and iron deposition disorders) and cystic/solid focal pancreatic masses. Finally, we explore some of the broader challenges to their implementation and future directions in this promising area.
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Affiliation(s)
- Manil D Chouhan
- 1 University College London (UCL) Centre for Medical Imaging, Division of Medicine, UCL , London , UK.,2 Department of Imaging, University College London Hospitals (UCLH) NHS Foundation Trust , London , UK
| | - Louisa Firmin
- 2 Department of Imaging, University College London Hospitals (UCLH) NHS Foundation Trust , London , UK
| | - Samantha Read
- 2 Department of Imaging, University College London Hospitals (UCLH) NHS Foundation Trust , London , UK
| | - Zahir Amin
- 2 Department of Imaging, University College London Hospitals (UCLH) NHS Foundation Trust , London , UK
| | - Stuart A Taylor
- 1 University College London (UCL) Centre for Medical Imaging, Division of Medicine, UCL , London , UK.,2 Department of Imaging, University College London Hospitals (UCLH) NHS Foundation Trust , London , UK
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Jalnefjord O, Montelius M, Starck G, Ljungberg M. Optimization of b-value schemes for estimation of the diffusion coefficient and the perfusion fraction with segmented intravoxel incoherent motion model fitting. Magn Reson Med 2019; 82:1541-1552. [PMID: 31148264 PMCID: PMC6772171 DOI: 10.1002/mrm.27826] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 05/03/2019] [Accepted: 05/05/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE Intravoxel incoherent motion (IVIM) modeling for estimation of the diffusion coefficient (D) and perfusion fraction (f) is increasingly popular, but no consensus on standard protocols exists. This study provides a framework for optimization of b-value schemes for reduced estimation uncertainty of D and f from segmented model fitting. THEORY Analytical expressions for uncertainties of D and f from segmented model fitting were derived as Cramer-Rao lower bounds (CRLBs). METHODS Optimized b-value schemes were obtained for 3 to 12 acquisitions and in the limit of infinitely many acquisitions through constrained minimization of the CRLBs, with b-values constrained to be 0 or 200 to 800 s/mm2 . The optimized b-value scheme with eight acquisitions was compared with b-values linearly distributed in the allowed range using simulations and in vivo liver data from seven healthy volunteers. RESULTS All optimized b-value schemes contained exactly three unique b-values regardless of the total number of acquisitions (0, 200, and 800 s/mm2 ) with repeated acquisitions distributed approximately as 1:2:2. Compared with linearly distributed b-values, the variability of estimates of D and f was reduced by approximately 30% as seen both in simulations and in repeated in vivo measurements. CONCLUSION The uncertainty of IVIM D and f estimates can be reduced by the use of optimized b-value schemes.
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Affiliation(s)
- Oscar Jalnefjord
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mikael Montelius
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Göran Starck
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Ljungberg
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
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31
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Vidić I, Jerome NP, Bathen TF, Goa PE, While PT. Accuracy of breast cancer lesion classification using intravoxel incoherent motion diffusion‐weighted imaging is improved by the inclusion of global or local prior knowledge with bayesian methods. J Magn Reson Imaging 2019; 50:1478-1488. [DOI: 10.1002/jmri.26772] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022] Open
Affiliation(s)
- Igor Vidić
- Department of PhysicsNTNU, Norwegian University of Science and Technology Trondheim Norway
| | - Neil P. Jerome
- Department of Circulation and Medical ImagingNTNU, Norwegian University of Science and Technology Trondheim Norway
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
| | - Tone F. Bathen
- Department of Circulation and Medical ImagingNTNU, Norwegian University of Science and Technology Trondheim Norway
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
| | - Pål E. Goa
- Department of PhysicsNTNU, Norwegian University of Science and Technology Trondheim Norway
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
| | - Peter T. While
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
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Meyer HJ, Hamerla G, Leifels L, Höhn AK, Surov A. Whole-lesion ADC histogram analysis is not able to reflect microvessel density in HNSCC. Medicine (Baltimore) 2019; 98:e15520. [PMID: 31124932 PMCID: PMC6571415 DOI: 10.1097/md.0000000000015520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Diffusion-weighted imaging (DWI) is a functional imaging technique sensitive to microstructure in tissues. It is widely acknowledged to reflect cellularity in tumors. A small part of DWI is also sensitive to perfusion-related information and might therefore be also be able to reflect microvessel density in tumor tissues. Aim of the present study was to elucidate possible correlations between microvessel density and apparent diffusion coefficient (ADC) values in head and neck squamous cell carcinoma (HNSCC).Thirty-four patients with histologically proven primary HNSCC were included in the study. DWI was performed with a 3 T magnetic resonance imaging (MRI) (b-values 0 and 800 s/mm) and histogram analysis was calculated with a whole lesion measurement. In every case, microvessel density was estimated with CD105-stained specimens.There were no statistically significant correlations between ADC histogram parameters and microvessel density. The calculated correlation coefficients ranged from r = -0.27, P = .13 for entropy and vessel area to r = 0.16, P = .40 for ADCmin and vessel count.Whole-lesion histogram analysis of ADC values cannot reflect microvessel density in HNSCC.
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Affiliation(s)
| | | | | | | | - Alexey Surov
- Department of Diagnostic and Interventional Radiology
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Li T, Che-Nordin N, Wáng YXJ, Rong PF, Qiu SW, Zhang SW, Zhang P, Jiang YF, Chevallier O, Zhao F, Xiao XY, Wang W. Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced liver fibrosis. Quant Imaging Med Surg 2019; 9:371-385. [PMID: 31032185 PMCID: PMC6462566 DOI: 10.21037/qims.2019.02.11] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent two studies reported that intravoxel incoherent motion (IVIM) analysis can separate healthy livers and viral hepatitis B (VHB) induced liver fibrosis. However, in these two studies the starting b value for bi-exponential decay analysis was b =10 and 15 s/mm2 respectively. The current study has two primary aims. The first is to further confirm the diagnostic value of IVIM in detecting liver fibrosis. The second is to test whether by sampling very low b value densely, then b =0 s/mm2 image could be included to improve IVIM's diagnostic performance. METHODS This was a prospective study with data acquired at the Third Xiangya Hospital of Central South University, Changsha, China. Healthy volunteers and patients suspected of VHB induced liver fibrosis with liver biopsy performed, as well as hepatocellular carcinoma patients scheduled for surgery, were recruited. All the hepatocellular carcinoma patients had liver fibrosis. After exclusions based on pre-defined criteria for image data quality, for IVIM analysis this study included 20 healthy volunteers; 4 chronic VHB patients with biopsy showing no liver fibrosis; 11 stage-1 liver fibrosis patients, 10 stage-2 liver fibrosis patients, 2 stage-3 liver fibrosis patients, and 5 stage-4 liver fibrosis patients. In the liver fibrosis patients, 1, 19, and 8 cases had inflammation grade-0, grade-1, and grade-2 respectively. The reference IVIM bi-exponential decay curve fitting analysis was segmented fitting performed with b =2 s/mm2 image as the starting point and a threshold-b of 60 s/mm2. This reference fitting method was compared with threshold-b of 40 s/mm2, full fitting, fitting starting from b =0, 5, and 10 s/mm2 respectively. The potential correlation between IVIM readouts and liver function was assessed for the liver fibrosis patients. RESULTS Based on the smaller coefficient of variation (CoV) for the volunteer group and the smaller patient/volunteer ratios [= (mean measurement for patient groups)/(mean measurement for healthy volunteers)], the comparison of fitting methods favored the reference approach starting from b =2 s/mm2 with a threshold-b of 60 s/mm2. The IVIM measures of four patients without liver fibrosis resembled those of healthy subjects. PF offered the best diagnostic value for separating healthy livers and fibrotic livers, and a threshold of PF =0.1406 separated all fibrotic livers and healthy livers with an exception of one hepatocellular carcinoma patient (fibrosis grade-2/inflammation grade-2). The correlation between fibrosis grading and inflammation grading was weakly positive; while compared with fibrotic livers with inflammation grade-1, fibrotic livers with inflammation grade-2 showed a trend of higher Dfast. A weak correlation is shown with lower PF and lower Dfast associated with lower total protein, lower albumin; higher alanine transaminase, higher aspartate transaminase; higher total bilirubin, and higher direct bilirubin. CONCLUSIONS Segmented-fitting with threshold-b =60 s/mm2 and starting from non-zero very low b value outperforms other methods. IVIM has high sensitivity in detecting liver fibrosis, and PF and Dfast have potential correlation with serum liver function biomarkers. IVIM measures and liver fibrosis grading are not in a linear relationship.
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Affiliation(s)
- Ting Li
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Nazmi Che-Nordin
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Yì Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Peng-Fei Rong
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Shi-Wen Qiu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Sheng-Wang Zhang
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Pan Zhang
- Department of Infectious Diseases, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Yong-Fang Jiang
- Liver Diseases Research Center, The Second Xiangya Hospital, Central South University, Changsha 410013, China
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, Université de Bourgogne, Dijon, France
| | - Feng Zhao
- Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Xiao-Yi Xiao
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Wei Wang
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
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Ye C, Xu D, Qin Y, Wang L, Wang R, Li W, Kuai Z, Zhu Y. Estimation of intravoxel incoherent motion parameters using low b-values. PLoS One 2019; 14:e0211911. [PMID: 30726298 PMCID: PMC6364995 DOI: 10.1371/journal.pone.0211911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/22/2019] [Indexed: 02/06/2023] Open
Abstract
Intravoxel incoherent motion (IVIM) imaging is a magnetic resonance imaging (MRI) technique widely used in clinical applications for various organs. However, IVIM imaging at low b-values is a persistent problem. This paper aims to investigate in a systematic and detailed manner how the number of low b-values influences the estimation of IVIM parameters. To this end, diffusion-weighted (DW) data with different low b-values were simulated to get insight into the distributions of subsequent IVIM parameters. Then, in vivo DW data with different numbers of low b-values and different number of excitations (NEX) were acquired. Finally, least-squares (LSQ) and Bayesian shrinkage prior (BSP) fitting methods were implemented to estimate IVIM parameters. The influence of the number of low b-values on IVIM parameters was analyzed in terms of relative error (RE) and structural similarity (SSIM). The results showed that the influence of the number of low b-values on IVIM parameters is variable. LSQ is more dependent on the number of low b-values than BSP, but the latter is more sensitive to noise.
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Affiliation(s)
- Chen Ye
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Daoyun Xu
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
- * E-mail:
| | - Yongbin Qin
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Lihui Wang
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Rongpin Wang
- Department of Radiology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Wuchao Li
- Department of Radiology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Zixiang Kuai
- Harbin Medical University Cancer Hospital, Harbin, China
| | - Yuemin Zhu
- Univ Lyon, INSA Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, France
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Wáng YXJ, Li YT, Chevallier O, Huang H, Leung JCS, Chen W, Lu PX. Dependence of intravoxel incoherent motion diffusion MR threshold b-value selection for separating perfusion and diffusion compartments and liver fibrosis diagnostic performance. Acta Radiol 2019; 60:3-12. [PMID: 29742916 DOI: 10.1177/0284185118774913] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Intravoxel incoherent motion (IVIM) tissue parameters depend on the threshold b-value. PURPOSE To explore how threshold b-value impacts PF ( f), Dslow ( D), and Dfast ( D*) values and their performance for liver fibrosis detection. MATERIAL AND METHODS Fifteen healthy volunteers and 33 hepatitis B patients were included. With a 1.5-T magnetic resonance (MR) scanner and respiration gating, IVIM data were acquired with ten b-values of 10, 20, 40, 60, 80, 100, 150, 200, 400, and 800 s/mm2. Signal measurement was performed on the right liver. Segmented-unconstrained analysis was used to compute IVIM parameters and six threshold b-values in the range of 40-200 s/mm2 were compared. PF, Dslow, and Dfast values were placed along the x-axis, y-axis, and z-axis, and a plane was defined to separate volunteers from patients. RESULTS Higher threshold b-values were associated with higher PF measurement; while lower threshold b-values led to higher Dslow and Dfast measurements. The dependence of PF, Dslow, and Dfast on threshold b-value differed between healthy livers and fibrotic livers; with the healthy livers showing a higher dependence. Threshold b-value = 60 s/mm2 showed the largest mean distance between healthy liver datapoints vs. fibrotic liver datapoints, and a classification and regression tree showed that a combination of PF (PF < 9.5%), Dslow (Dslow < 1.239 × 10-3 mm2/s), and Dfast (Dfast < 20.85 × 10-3 mm2/s) differentiated healthy individuals and all individual fibrotic livers with an area under the curve of logistic regression (AUC) of 1. CONCLUSION For segmented-unconstrained analysis, the selection of threshold b-value = 60 s/mm2 improves IVIM differentiation between healthy livers and fibrotic livers.
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Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
| | - Yáo T Li
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
| | - Olivier Chevallier
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
- Department of Vascular and Interventional Radiology, University of Bourgogne/Franche-Comté, François-Mitterrand Teaching Hospital, Dijon Cedex, France
| | - Hua Huang
- Department of Radiology, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, PR China
| | - Jason Chi Shun Leung
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
| | - Pu-Xuan Lu
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong Province, PR China
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Chevallier O, Zhou N, He J, Loffroy R, Wáng YXJ. Removal of evidential motion-contaminated and poorly fitted image data improves IVIM diffusion MRI parameter scan-rescan reproducibility. Acta Radiol 2018; 59:1157-1167. [PMID: 29430937 DOI: 10.1177/0284185118756949] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background It has been reported that intravoxel incoherent motion (IVIM) diffusion magnetic resonance imaging (MRI) scan-rescan reproducibility is unsatisfactory. Purpose To study IVIM MRI parameter reproducibility for liver parenchyma after the removal of motion-contaminated and/or poorly fitted image data. Material and Methods Eighteen healthy volunteers had liver scans twice in the same session to assess scan-rescan repeatability, and again in another session after an average interval of 13 days to assess reproducibility. Diffusion-weighted images were acquired with a 3-T scanner using respiratory-triggered echo-planar sequence and 16 b-values (0-800 s/mm2). Measurement was performed on the right liver with segment-unconstrained least square fitting. Image series with evidential anatomical mismatch, apparent artifacts, and poorly fitted signal intensity vs. b-value curve were excluded. A minimum of three slices was deemed necessary for IVIM parameter estimation. Results With a total 54 examinations, six did not satisfy inclusion criteria, leading to a success rate of 89%, and 14 volunteers were finally included for the repeatability/reproducibility study. A total of 3-10 slices per examination (mean = 5.3 slices, median = 5 slices) were utilized for analysis. Using threshold b-value = 80 s/mm2, the coefficient of variation and within-subject coefficient of variation for repeatability were 2.86% and 3.36% for Dslow, 3.81% and 4.24% for perfusion fraction (PF), 18.16% and 24.88% for Dfast; and those for reproducibility were 2.48% and 3.24% for Dslow, 4.91% and 5.38% for PF, and 21.18% and 30.89% for Dfast. Conclusion Removal of motion-contaminated and/or poorly fitted image data improves IVIM parameter reproducibility.
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Affiliation(s)
- Olivier Chevallier
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
- Department of Vascular and Interventional Radiology, University of Bourgogne/Franche-Comté, François-Mitterrand Teaching Hospital, Dijon Cedex, France
| | - Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, University of Bourgogne/Franche-Comté, François-Mitterrand Teaching Hospital, Dijon Cedex, France
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
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Comparison of methods for estimation of the intravoxel incoherent motion (IVIM) diffusion coefficient (D) and perfusion fraction (f). MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2018; 31:715-723. [DOI: 10.1007/s10334-018-0697-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/03/2018] [Accepted: 07/25/2018] [Indexed: 12/11/2022]
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Klaassen R, Gurney-Champion OJ, Engelbrecht MRW, Stoker J, Wilmink JW, Besselink MG, Bel A, van Tienhoven G, van Laarhoven HWM, Nederveen AJ. Evaluation of Six Diffusion-weighted MRI Models for Assessing Effects of Neoadjuvant Chemoradiation in Pancreatic Cancer Patients. Int J Radiat Oncol Biol Phys 2018; 102:1052-1062. [PMID: 29891208 DOI: 10.1016/j.ijrobp.2018.04.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/03/2018] [Accepted: 04/23/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare 6 diffusion-weighted imaging (DWI) MRI models for response evaluation in patients with pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS DWI images were acquired at 3T for b = 0-600 s/mm2 in fourteen patients with advanced PDAC during 2 separate pretreatment sessions and 9 patients with (borderline) resectable PDAC pre and post neoadjuvant chemoradiation. Data was fitted with a mono-exponential (ADC), double mono-exponential to b = 0 and 100 s/mm2 (ADCfast), and b = 100 and 600 s/mm2 (ADCslow), IVIM model with D* free (D, f, D*) and fixed (D, f), tri-exponent (D, f1, f2), and stretched exponent model (DDC, α). Goodness of fit (adjusted R2), tumor to normal tissue contrast, repeatability (coefficient of variation), and parameter correlations (Spearman's rho) were assessed for the repeated measures. Treatment induced changes were assessed and compared to the repeatability. RESULTS The mono-exponential model had the lowest goodness of fit in both tumor (R2 = 0.94) and normal-appearing pancreas (R2 = 0.88). Tumour to normal tissue contrast was higher for the 'non-diffusion' parameters (ADCfast, f, D*, f1, f2, α), with better repeatability for the diffusion parameters (ADC, ADCslow, D, DDC). Diffusion parameters were strongly correlated between the models (rho ≥0.81) and showed a general treatment associated increase. All models were able to identify individual treatment effects, showing a change greater than the repeatability in 5 out of 9 patients for at least one of the parameters. CONCLUSIONS Individual treatment evaluation is possible with all investigated DWI models, with treatment associated changes exceeding the repeatability. The double monoexponential fit with ADCfast and ADCslow is able to discriminate between non-diffusion and diffusion related effects, is measured fast and can be performed on most commercial scanners, making it an attractive alternative for the more advanced multiparametric models in radiotherapy treatment evaluation.
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Affiliation(s)
- Remy Klaassen
- Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands; Cancer Center Amsterdam, LEXOR (Laboratory for Experimental Oncology and Radiobiology), Academic Medical Center, Amsterdam, The Netherlands.
| | - Oliver J Gurney-Champion
- Department of Radiology & Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Marc R W Engelbrecht
- Department of Radiology & Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Jaap Stoker
- Department of Radiology & Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Johanna W Wilmink
- Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Arjan Bel
- Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology & Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
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Quantification of hepatic perfusion and hepatocyte function with dynamic gadoxetic acid-enhanced MRI in patients with chronic liver disease. Clin Sci (Lond) 2018; 132:813-824. [PMID: 29440620 DOI: 10.1042/cs20171131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 02/05/2018] [Accepted: 02/09/2018] [Indexed: 02/06/2023]
Abstract
The purpose of the present study was to develop and perform initial validation of dynamic MRI enhanced with gadoxetic acid as hepatobiliary contrast agent to quantify hepatic perfusion and hepatocyte function in patients with chronic liver disease. Free-breathing, dynamic gadoxetic acid-enhanced MRI was performed at 3.0 T using a 3D time-resolved angiography sequence with stochastic trajectories during 38 min. A dual-input three-compartment model was developed to derive hepatic perfusion and hepatocyte function parameters. Method feasibility was assessed in 23 patients with biopsy-proven chronic liver disease. Parameter analysis could be performed in 21 patients (91%). The hepatocyte function parameters were more discriminant than the perfusion parameters to differentiate between patients with minimal fibrosis (METAVIR F0-F1), intermediate fibrosis (F2-F3) and cirrhosis (F4). The areas under the receiver operating characteristic curves (ROCs) to diagnose significant fibrosis (METAVIR F ≥ 2) were: 0.95 (95% CI: 0.87-1; P<0.001) for biliary efflux, 0.88 (95% CI: 0.73-1; P<0.01) for sinusoidal backflux, 0.81 (95% CI: 0.61-1; P<0.05) for hepatocyte uptake fraction and 0.75 (95% CI: 0.54-1; P<0.05) for hepatic perfusion index (HPI), respectively. These initial results in patients with chronic liver diseases show that simultaneous quantification of hepatic perfusion and hepatocyte function is feasible with free breathing dynamic gadoxetic acid-enhanced MRI. Hepatocyte function parameters may be relevant to assess liver fibrosis severity.
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Li GF, Duan SJ, Yan LF, Wang W, Jing Y, Yan WQ, Sun Q, Wang SM, Nan HY, Xu TY, Zheng DD, Hu YC, Cui GB. Intravoxel incoherent motion diffusion-weighted MR imaging parameters predict pathological classification in thymic epithelial tumors. Oncotarget 2018; 8:44579-44592. [PMID: 28574817 PMCID: PMC5546503 DOI: 10.18632/oncotarget.17857] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/12/2017] [Indexed: 12/20/2022] Open
Abstract
We evaluated the performance of intravoxel incoherent motion (IVIM) parameters for preoperatively predicting the subtype and Masaoka stage of thymic epithelial tumors (TETs). Seventy-seven patients with pathologically confirmed TETs underwent a diffusion weighted imaging (DWI) sequence with 9 b values. Differences in the slow diffusion coefficient (D), fast perfusion coefficient (D), and perfusion fraction (f) IVIM parameters, as well as the multi b-value fitted apparent diffusion coefficient (ADCmb), were compared among patients with low-risk (LRT) and high-risk thymomas (HRT) and thymic carcinomas (TC), and between early stage (stages I and II) and advanced stage (stages III and IV) TET patients. ADCmb, D, and D values were higher in the LRT group than in the HRT or TC group, but did not differ between the HRT and TC groups. The mean ADCmb, D, and D values were higher in the early stage TETs group than the advanced stage TETs group. The f values did not differ among the groups. These results suggest that IVIM DWI could be used to preoperatively predict subtype and Masaoka stage in TET patients.
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Affiliation(s)
- Gang-Feng Li
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Shi-Jun Duan
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Lin-Feng Yan
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wen Wang
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yong Jing
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei-Qiang Yan
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Qian Sun
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Shu-Mei Wang
- Department of Pathology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Hai-Yan Nan
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Tian-Yong Xu
- MR Research China, GE Healthcare China, Beijing, China
| | - Dan-Dan Zheng
- MR Research China, GE Healthcare China, Beijing, China
| | - Yu-Chuan Hu
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Guang-Bin Cui
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
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Comparison of six fit algorithms for the intra-voxel incoherent motion model of diffusion-weighted magnetic resonance imaging data of pancreatic cancer patients. PLoS One 2018; 13:e0194590. [PMID: 29617445 PMCID: PMC5884505 DOI: 10.1371/journal.pone.0194590] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 03/06/2018] [Indexed: 01/22/2023] Open
Abstract
The intravoxel incoherent motion (IVIM) model for diffusion-weighted imaging (DWI) MRI data bears much promise as a tool for visualizing tumours and monitoring treatment response. To improve the currently poor precision of IVIM, several fit algorithms have been suggested. In this work, we compared the performance of two Bayesian IVIM fit algorithms and four other IVIM fit algorithms for pancreatic cancer imaging. DWI data were acquired in 14 pancreatic cancer patients during two MRI examinations. Three different measures of performance of the fitting algorithms were assessed: (i) uniqueness of fit parameters (Spearman’s rho); (ii) precision (within-subject coefficient of variation, wCV); and (iii) contrast between tumour and normal-appearing pancreatic tissue. For the diffusivity D and perfusion fraction f, a Bayesian fit (IVIM-Bayesian-lin) offered the best trade-off between tumour contrast and precision. With the exception for IVIM-Bayesian-lin, all algorithms resulted in a very poor precision of the pseudo-diffusion coefficient D* with a wCV of more than 50%. The pseudo-diffusion coefficient D* of the Bayesian approaches were, however, significantly correlated with D and f. Therefore, the added value of fitting D* was considered limited in pancreatic cancer patients. The easier implemented least squares fit with fixed D* (IVIM-fixed) performed similar to IVIM-Bayesian-lin for f and D. In conclusion, the best performing IVIM fit algorithm was IVM-Bayesian-lin, but an easier to implement least squares fit with fixed D* performs similarly in pancreatic cancer patients.
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Jakab A, Tuura R, Kottke R, Kellenberger CJ, Scheer I. Intra-voxel incoherent motion MRI of the living human foetus: technique and test-retest repeatability. Eur Radiol Exp 2017; 1:26. [PMID: 29708192 PMCID: PMC5909359 DOI: 10.1186/s41747-017-0031-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/03/2017] [Indexed: 01/05/2023] Open
Abstract
Background Our purpose was to test the within-subject (test–retest) reproducibility of the perfusion fraction, diffusion coefficient, and pseudo-diffusion coefficient measurements in various foetus organs and in the placenta based on the intra-voxel incoherent motion (IVIM) principle. Methods In utero diffusion-weighted IVIM magnetic resonance imaging (MRI) was performed in 15 pregnant women (pregnancy age 21–36 weeks) on 1.5-T and 3.0-T clinical scanners with b-factors in the range of 0–900 s/mm2 in 16 steps. A bi-exponential model was fitted on the volume-averaged diffusion values. Perfusion fraction (f), diffusion coefficient (d), and pseudo-diffusion coefficient (D*) were calculated. Within-subject reproducibility was evaluated as test–retest variability (VAR %) of the IVIM parameters in the foetal frontal cortex, frontal white matter, cerebellum, lungs, kidneys, liver, and in the placenta. Results For the foetal lungs, liver and the placenta, test–retest variability was in the range of 14–20% for f, 12–14% for d, and 17–25% for D*. The diffusion coefficients of the investigated brain regions were moderately to highly reproducible (VAR 5–15%). However, f and D* showed inferior reproducibility compared to corresponding measures for the lungs, liver, and placenta. The IVIM parameters of the foetal kidney were revealed to be highly variable across scans. Conclusions IVIM MRI potentially provides a novel method for examining microvascular perfusion and diffusion in the developing human foetus. However, reproducibility of perfusion and diffusion parameters depends greatly upon data quality, foetal and maternal movements, and foetal-specific image post-processing.
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Affiliation(s)
- András Jakab
- 1Center for MR-Research, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.,2Computational Imaging Research Lab (CIR), Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria
| | - Ruth Tuura
- 1Center for MR-Research, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Raimund Kottke
- 3Department of Diagnostic Imaging, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Christian J Kellenberger
- 3Department of Diagnostic Imaging, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Ianina Scheer
- 3Department of Diagnostic Imaging, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland
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Hu F, Yang R, Huang Z, Wang M, Zhang H, Yan X, Song B. Liver fibrosis: in vivo evaluation using intravoxel incoherent motion-derived histogram metrics with histopathologic findings at 3.0 T. Abdom Radiol (NY) 2017. [PMID: 28624925 DOI: 10.1007/s00261-017-1208-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To retrospectively determine the feasibility of intravoxel incoherent motion (IVIM) imaging based on histogram analysis for the staging of liver fibrosis (LF) using histopathologic findings as the reference standard. METHODS 56 consecutive patients (14 men, 42 women; age range, 15-76, years) with chronic liver diseases (CLDs) were studied using IVIM-DWI with 9 b-values (0, 25, 50, 75, 100, 150, 200, 500, 800 s/mm2) at 3.0 T. Fibrosis stage was evaluated using the METAVIR scoring system. Histogram metrics including mean, standard deviation (Std), skewness, kurtosis, minimum (Min), maximum (Max), range, interquartile (Iq) range, and percentiles (10, 25, 50, 75, 90th) were extracted from apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) maps. All histogram metrics among different fibrosis groups were compared using one-way analysis of variance or nonparametric Kruskal-Wallis test. For significant parameters, receivers operating characteristic curve (ROC) analyses were further performed for the staging of LF. RESULTS Based on their METAVIR stage, the 56 patients were reclassified into three groups as follows: F0-1 group (n = 25), F2-3 group (n = 21), and F4 group (n = 10). The mean, Iq range, percentiles (50, 75, and 90th) of D* maps between the groups were significant differences (all P < 0.05). Area under the ROC curve (AUC) of the mean, Iq range, 50, 75, and 90th percentile of D* maps for identifying significant LF (≥F2 stage) was 0.901, 0.859, 0.876, 0.943, and 0.886 (all P < 0.0001), respectively; for diagnosing severe fibrosis or cirrhosis (F4), AUC was 0.917, 0.922, 0.943, 0.985, and 0.939 (all P < 0.0001), respectively. The histogram metrics of ADC, D, and f maps demonstrated no significant difference among the groups (all P > 0.05). CONCLUSION Histogram analysis of D* map derived from IVIM can be used to stage liver fibrosis in patients with CLDs and provide more quantitative information beyond the mean value.
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Affiliation(s)
- Fubi Hu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, Sichuan, China
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, 278# Baoguang Road, Xindu District, Chengdu, Sichuan, China
| | - Ru Yang
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, 278# Baoguang Road, Xindu District, Chengdu, Sichuan, China
| | - Zixing Huang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, Sichuan, China
| | - Min Wang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, Sichuan, China
| | - Hanmei Zhang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, Sichuan, China
| | - Xu Yan
- Siemens Healthcare, MR Collaborations NE Asia, Shanghai, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, Sichuan, China.
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Meeus EM, Zarinabad N, Manias KA, Novak J, Rose HEL, Dehghani H, Foster K, Morland B, Peet AC. Diffusion-weighted MRI and intravoxel incoherent motion model for diagnosis of pediatric solid abdominal tumors. J Magn Reson Imaging 2017; 47:1475-1486. [PMID: 29159937 PMCID: PMC6001424 DOI: 10.1002/jmri.25901] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/06/2017] [Indexed: 12/24/2022] Open
Abstract
Background Pediatric retroperitoneal tumors in the renal bed are often large and heterogeneous, and their diagnosis based on conventional imaging alone is not possible. More advanced imaging methods, such as diffusion‐weighted (DW) MRI and the use of intravoxel incoherent motion (IVIM), have the potential to provide additional biomarkers that could facilitate their noninvasive diagnosis. Purpose To assess the use of an IVIM model for diagnosis of childhood malignant abdominal tumors and discrimination of benign from malignant lesions. Study Type Retrospective. Population Forty‐two pediatric patients with abdominal lesions (n = 32 malignant, n = 10 benign), verified by histopathology. Field Strength/Sequence 1.5T MRI system and a DW‐MRI sequence with six b‐values (0, 50, 100, 150, 600, 1000 s/mm2). Assessment Parameter maps of apparent diffusion coefficient (ADC), and IVIM maps of slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion fraction (f) were computed using a segmented fitting model. Histograms were constructed for whole‐tumor regions of each parameter. Statistical Tests Comparison of histogram parameters of and their diagnostic performance was determined using Kruskal–Wallis, Mann–Whitney U, and receiver‐operating characteristic (ROC) analysis. Results IVIM parameters D* and f were significantly higher in neuroblastoma compared to Wilms' tumors (P < 0.05). The ROC analysis showed that the best diagnostic performance was achieved with D* 90th percentile (area under the curve [AUC] = 0.935; P = 0.002; cutoff value = 32,376 × 10−6 mm2/s) and f mean values (AUC = 1.00; P < 0.001; cutoff value = 14.7) in discriminating between neuroblastoma (n = 11) and Wilms' tumors (n = 8). Discrimination between tumor types was not possible with IVIM D or ADC parameters. Malignant tumors revealed significantly lower ADC, D, and higher D* values than in benign lesions (all P < 0.05). Data Conclusion IVIM perfusion parameters could distinguish between malignant childhood tumor types, providing potential imaging biomarkers for their diagnosis. Level of Evidence: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1475–1486.
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Affiliation(s)
- Emma M Meeus
- Physical Sciences of Imaging in Biomedical Sciences (PSIBS) Doctoral Training Centre, University of Birmingham, UK.,Institute of Cancer and Genomic Sciences, University of Birmingham, UK.,Department of Oncology, Birmingham Children's Hospital, Birmingham, UK
| | - Niloufar Zarinabad
- Institute of Cancer and Genomic Sciences, University of Birmingham, UK.,Department of Oncology, Birmingham Children's Hospital, Birmingham, UK
| | - Karen A Manias
- Institute of Cancer and Genomic Sciences, University of Birmingham, UK.,Department of Oncology, Birmingham Children's Hospital, Birmingham, UK
| | - Jan Novak
- Institute of Cancer and Genomic Sciences, University of Birmingham, UK.,Department of Oncology, Birmingham Children's Hospital, Birmingham, UK
| | - Heather E L Rose
- Institute of Cancer and Genomic Sciences, University of Birmingham, UK.,Department of Oncology, Birmingham Children's Hospital, Birmingham, UK
| | - Hamid Dehghani
- Physical Sciences of Imaging in Biomedical Sciences (PSIBS) Doctoral Training Centre, University of Birmingham, UK.,School of Computer Science, University of Birmingham, UK
| | - Katharine Foster
- Department of Radiology, Birmingham Children's Hospital, Birmingham, UK
| | - Bruce Morland
- Department of Oncology, Birmingham Children's Hospital, Birmingham, UK
| | - Andrew C Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, UK.,Department of Oncology, Birmingham Children's Hospital, Birmingham, UK
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Meeus EM, Novak J, Dehghani H, Peet AC. Rapid measurement of intravoxel incoherent motion (IVIM) derived perfusion fraction for clinical magnetic resonance imaging. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:269-283. [PMID: 29075909 PMCID: PMC5871652 DOI: 10.1007/s10334-017-0656-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to investigate the reliability of intravoxel incoherent motion (IVIM) model derived parameters D and f and their dependence on b value distributions with a rapid three b value acquisition protocol. MATERIALS AND METHODS Diffusion models for brain, kidney, and liver were assessed for bias, error, and reproducibility for the estimated IVIM parameters using b values 0 and 1000, and a b value between 200 and 900, at signal-to-noise ratios (SNR) 40, 55, and 80. Relative errors were used to estimate optimal b value distributions for each tissue scenario. Sixteen volunteers underwent brain DW-MRI, for which bias and coefficient of variation were determined in the grey matter. RESULTS Bias had a large influence in the estimation of D and f for the low-perfused brain model, particularly at lower b values, with the same trends being confirmed by in vivo imaging. Significant differences were demonstrated in vivo for estimation of D (P = 0.029) and f (P < 0.001) with [300,1000] and [500,1000] distributions. The effect of bias was considerably lower for the high-perfused models. The optimal b value distributions were estimated to be brain500,1000, kidney300,1000, and liver200,1000. CONCLUSION IVIM parameters can be estimated using a rapid DW-MRI protocol, where the optimal b value distribution depends on tissue characteristics and compromise between bias and variability.
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Affiliation(s)
- Emma M Meeus
- Physical Sciences of Imaging in Biomedical Sciences (PSIBS) Doctoral Training Centre, University of Birmingham, Birmingham, B15 2TT, UK.,Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.,Department of Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Jan Novak
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.,Department of Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Hamid Dehghani
- Physical Sciences of Imaging in Biomedical Sciences (PSIBS) Doctoral Training Centre, University of Birmingham, Birmingham, B15 2TT, UK.,School of Computer Science, University of Birmingham, Birmingham, B15 2TT, UK
| | - Andrew C Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK. .,Department of Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
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Gustafsson O, Montelius M, Starck G, Ljungberg M. Impact of prior distributions and central tendency measures on Bayesian intravoxel incoherent motion model fitting. Magn Reson Med 2017. [PMID: 28626964 DOI: 10.1002/mrm.26783] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Bayesian model fitting has been proposed as a robust alternative for intravoxel incoherent motion (IVIM) model-fitting parameter estimation. However, consensus regarding choice of prior distribution and posterior distribution central tendency measure is needed. The aim of this study was to compare the quality of IVIM parameter estimates produced by different prior distributions and central tendency measures, and to gain knowledge about the effect of these choices. METHODS Three prior distributions (uniform, reciprocal, and lognormal) and two measures of central tendency (mean and mode) found in the literature were studied using simulations and in vivo data from a tumor mouse model. RESULTS Simulations showed that the uniform and lognormal priors were superior to the reciprocal prior, especially for the parameters D and f and clinically relevant SNR levels. The choice of central tendency measure had less effect on the results, but had some effects on estimation bias. Results based on simulations and in vivo data agreed well, indicating high validity of the simulations. CONCLUSIONS Choice of prior distribution and central tendency measure affects the results of Bayesian IVIM parameter estimates. This must be considered when comparing results from different studies. The best overall quality of IVIM parameter estimates was obtained using the lognormal prior. Magn Reson Med 79:1674-1683, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Oscar Gustafsson
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mikael Montelius
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Göran Starck
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Ljungberg
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
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