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Wang Q, Yu G, Qiu J, Lu W. Application of Intravoxel Incoherent Motion in Clinical Liver Imaging: A Literature Review. J Magn Reson Imaging 2024; 60:417-440. [PMID: 37908165 DOI: 10.1002/jmri.29086] [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: 07/15/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023] Open
Abstract
Intravoxel incoherent motion (IVIM) modeling is a widely used double-exponential model for describing diffusion-weighted imaging (DWI) signal, with a slow component related to pure molecular diffusion and a fast component associated with microcirculatory perfusion, which compensates for the limitations of traditional DWI. IVIM is a noninvasive technique for obtaining liver pathological information and characterizing liver lesions, and has potential applications in the initial diagnosis and treatment monitoring of liver diseases. Recent studies have demonstrated that IVIM-derived parameters are useful for evaluating liver lesions, including nonalcoholic fatty liver disease (NAFLD), liver fibrosis and liver tumors. However, the results are not stable. Therefore, it is necessary to summarize the current applications of IVIM in liver disease research, identify existing shortcomings, and point out the future development direction. In this review, we searched for studies related to hepatic IVIM-DWI applications over the past two decades in the PubMed database. We first introduce the fundamental principles and influential factors of IVIM, and then discuss its application in NAFLD, liver fibrosis, and focal hepatic lesions. It has been found that IVIM is still unstable in ensuring the robustness and reproducibility of measurements in the assessment of liver fibrosis grade and liver tumors differentiation, due to inconsistent and substantial overlap in the range of IVIM-derived parameters for different fibrotic stages. In the end, the future direction of IVIM-DWI in the assessment of liver diseases is discussed, emphasizing the need for further research on the stability of IVIM-derived parameters, particularly perfusion-related parameters, in order to promote the clinical practice of IVIM-DWI. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Qi Wang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Guanghui Yu
- Department of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
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Yang Z, Liu C, Shi Z, Qin J. IDEAL-IQ combined with intravoxel incoherent motion diffusion-weighted imaging for quantitative diagnosis of osteoporosis. BMC Med Imaging 2024; 24:155. [PMID: 38902641 PMCID: PMC11188172 DOI: 10.1186/s12880-024-01326-0] [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: 10/13/2023] [Accepted: 06/07/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Osteoporosis (OP) is a common chronic metabolic bone disease characterized by decreased bone mineral content and microstructural damage, leading to increased fracture risk. Traditional methods for measuring bone density have limitations in accurately distinguishing vertebral bodies and are influenced by vertebral degeneration and surrounding tissues. Therefore, novel methods are needed to quantitatively assess changes in bone density and improve the accurate diagnosis of OP. METHODS This study aimed to explore the applicative value of the iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron (IDEAL-IQ) sequence combined with intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for the diagnosis of osteoporosis. Data from 135 patients undergoing dual-energy X-ray absorptiometry (DXA), IDEAL-IQ, and IVIM-DWI were prospectively collected and analyzed. Various parameters obtained from IVIM-DWI and IDEAL-IQ sequences were compared, and their diagnostic efficacy was evaluated. RESULTS Statistically significant differences were observed among the three groups for FF, R2*, f, D, DDC values, and BMD values. FF and f values exhibited negative correlations with BMD values, with r=-0.313 and - 0.274, respectively, while R2*, D, and DDC values showed positive correlations with BMD values, with r = 0.327, 0.532, and 0.390, respectively. Among these parameters, D demonstrated the highest diagnostic efficacy for osteoporosis (AUC = 0.826), followed by FF (AUC = 0.713). D* exhibited the lowest diagnostic performance for distinguishing the osteoporosis group from the other two groups. Only D showed a significant difference between genders. The AUCs for IDEAL-IQ, IVIM-DWI, and their combination were 0.74, 0.89, and 0.90, respectively. CONCLUSIONS IDEAL-IQ combined with IVIM-DWI provides valuable information for the diagnosis of osteoporosis and offers evidence for clinical decisions. The superior diagnostic performance of IVIM-DWI, particularly the D value, suggests its potential as a more sensitive and accurate method for diagnosing osteoporosis compared to IDEAL-IQ. These findings underscore the importance of integrating advanced imaging techniques into clinical practice for improved osteoporosis management and highlight the need for further research to explore the full clinical implications of these imaging modalities.
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Affiliation(s)
- Zhe Yang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Chenglong Liu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Zhaojuan Shi
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Jian Qin
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China.
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Wright AM, Wu YC, Feng L, Wen Q. Diffusion magnetic resonance imaging of cerebrospinal fluid dynamics: Current techniques and future advancements. NMR IN BIOMEDICINE 2024:e5162. [PMID: 38715420 DOI: 10.1002/nbm.5162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/20/2024] [Accepted: 03/30/2024] [Indexed: 05/22/2024]
Abstract
Cerebrospinal fluid (CSF) plays a critical role in metabolic waste clearance from the brain, requiring its circulation throughout various brain pathways, including the ventricular system, subarachnoid spaces, para-arterial spaces, interstitial spaces, and para-venous spaces. The complexity of CSF circulation has posed a challenge in obtaining noninvasive measurements of CSF dynamics. The assessment of CSF dynamics throughout its various circulatory pathways is possible using diffusion magnetic resonance imaging (MRI) with optimized sensitivity to incoherent water movement across the brain. This review presents an overview of both established and emerging diffusion MRI techniques designed to measure CSF dynamics and their potential clinical applications. The discussion offers insights into the optimization of diffusion MRI acquisition parameters to enhance the sensitivity and specificity of diffusion metrics on underlying CSF dynamics. Lastly, we emphasize the importance of cautious interpretations of diffusion-based imaging, especially when differentiating between tissue- and fluid-related changes or elucidating structural versus functional alterations.
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Affiliation(s)
- Adam M Wright
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Weldon School of Biomedical Engineering Department, Purdue University, West Lafayette, Indiana, USA
| | - Yu-Chien Wu
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Weldon School of Biomedical Engineering Department, Purdue University, West Lafayette, Indiana, USA
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Li Feng
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, New York, New York, USA
| | - Qiuting Wen
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Weldon School of Biomedical Engineering Department, Purdue University, West Lafayette, Indiana, USA
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Sample C, Wu J, Clark H. Image denoising and model-independent parameterization for IVIM MRI. Phys Med Biol 2024; 69:105001. [PMID: 38604177 DOI: 10.1088/1361-6560/ad3db8] [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] [Received: 12/20/2023] [Accepted: 04/11/2024] [Indexed: 04/13/2024]
Abstract
Objective. To improve intravoxel incoherent motion imaging (IVIM) magnetic resonance Imaging quality using a new image denoising technique and model-independent parameterization of the signal versusb-value curve.Approach. IVIM images were acquired for 13 head-and-neck patients prior to radiotherapy. Post-radiotherapy scans were also acquired for five of these patients. Images were denoised prior to parameter fitting using neural blind deconvolution, a method of solving the ill-posed mathematical problem of blind deconvolution using neural networks. The signal decay curve was then quantified in terms of several area under the curve (AUC) parameters. Improvements in image quality were assessed using blind image quality metrics, total variation (TV), and the correlations between parameter changes in parotid glands with radiotherapy dose levels. The validity of blur kernel predictions was assessed by the testing the method's ability to recover artificial 'pseudokernels'. AUC parameters were compared with monoexponential, biexponential, and triexponential model parameters in terms of their correlations with dose, contrast-to-noise (CNR) around parotid glands, and relative importance via principal component analysis.Main results. Image denoising improved blind image quality metrics, smoothed the signal versusb-value curve, and strengthened correlations between IVIM parameters and dose levels. Image TV was reduced and parameter CNRs generally increased following denoising.AUCparameters were more correlated with dose and had higher relative importance than exponential model parameters.Significance. IVIM parameters have high variability in the literature and perfusion-related parameters are difficult to interpret. Describing the signal versusb-value curve with model-independent parameters like theAUCand preprocessing images with denoising techniques could potentially benefit IVIM image parameterization in terms of reproducibility and functional utility.
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Affiliation(s)
- Caleb Sample
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, Vancouver, BC, CA, Canada
- Department of Medical Physics, BC Cancer, Surrey, BC, CA, Canada
| | - Jonn Wu
- Department of Radiation Oncology, BC Cancer, Vancouver, BC, CA, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, CA, Canada
| | - Haley Clark
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, Vancouver, BC, CA, Canada
- Department of Medical Physics, BC Cancer, Surrey, BC, CA, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, CA, Canada
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Huang J, Leporq B, Hervieu V, Dumortier J, Beuf O, Ratiney H. Diffusion-Weighted MRI of the Liver in Patients With Chronic Liver Disease: A Comparative Study Between Different Fitting Approaches and Diffusion Models. J Magn Reson Imaging 2024; 59:894-906. [PMID: 37243428 DOI: 10.1002/jmri.28826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) has been considered for chronic liver disease (CLD) characterization. Grading of liver fibrosis is important for disease management. PURPOSE To investigate the relationship between DWI's parameters and CLD-related features (particularly regarding fibrosis assessment). STUDY TYPE Retrospective. SUBJECTS Eighty-five patients with CLD (age: 47.9 ± 15.5, 42.4% females). FIELD STRENGTH/SEQUENCE 3-T, spin echo-echo planar imaging (SE-EPI) with 12 b-values (0-800 s/mm2 ). ASSESSMENT Several models statistical models, stretched exponential model, and intravoxel incoherent motion were simulated. The corresponding parameters (Ds , σ, DDC, α, f, D, D*) were estimated on simulation and in vivo data using the nonlinear least squares (NLS), segmented NLS, and Bayesian methods. The fitting accuracy was analyzed on simulated Rician noised DWI. In vivo, the parameters were averaged from five central slices entire liver to compare correlations with histological features (inflammation, fibrosis, and steatosis). Then, the differences between mild (F0-F2) or severe (F3-F6) groups were compared respecting to statistics and classification. A total of 75.3% of patients used to build various classifiers (stratified split strategy and 10-folders cross-validation) and the remaining for testing. STATISTICAL TESTS Mean squared error, mean average percentage error, spearman correlation, Mann-Whitney U-test, receiver operating characteristic (ROC) curve, area under ROC curve (AUC), sensitivity, specificity, accuracy, precision. A P-value <0.05 was considered statistically significant. RESULTS In simulation, the Bayesian method provided the most accurate parameters. In vivo, the highest negative significant correlation (Ds , steatosis: r = -0.46, D*, fibrosis: r = -0.24) and significant differences (Ds , σ, D*, f) were observed for Bayesian fitted parameters. Fibrosis classification was performed with an AUC of 0.92 (0.91 sensitivity and 0.70 specificity) with the aforementioned diffusion parameters based on the decision tree method. DATA CONCLUSION These results indicate that Bayesian fitted parameters may provide a noninvasive evaluation of fibrosis with decision tree. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Jiqing Huang
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
| | - Benjamin Leporq
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
| | - Valérie Hervieu
- Department of Anatomo-pathology, CHU Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jérôme Dumortier
- Department of Hepatology, CHU Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Olivier Beuf
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
| | - Hélène Ratiney
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
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Li J, Yan LL, Zhang HK, Wang Y, Xu SN, Chen XJ, Qu JR. Application of intravoxel incoherent motion diffusion-weighted imaging for preoperative knowledge of lymphovascular invasion in gastric cancer: a prospective study. Abdom Radiol (NY) 2023; 48:2207-2218. [PMID: 37085731 DOI: 10.1007/s00261-023-03920-2] [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] [Received: 02/24/2023] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE To investigate the potential of intravoxel incoherent motion diffusion-weighted imaging (IVIM) for preoperative prediction of lymphovascular invasion (LVI) in gastric cancer (GC). METHODS This study prospectively enrolled 90 patients (62 males, 28 females, 60.79 ± 9.99 years old) who received radical gastrostomy. Abdominal MRI examinations including IVIM were performed within 1 week before surgery. Patients were divided into LVI-positive and -negative group according to pathological diagnosis after surgery. The apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D*), and pseudodiffusion fraction (f), were compared between the two groups. The relationship between MRI parameters and LVI was studied by Spearman's correlation analysis. Multivariable logistic regression analysis was used to screen independent predictors of LVI. Receiver-operating characteristic curve analyses were applied to evaluate the efficacy. RESULTS The ADC, D in LVI-positive group were lower, whereas tumor thickness and f parameter in LVI-positive group were higher than those in LVI-negative group, and they were statistically correlated with LVI (p < 0.05). D, f and tumor thickness were independent risk factors of LVI. The area under the curve of ADC, D, f, thickness, and the combined parameter (D + f + thickness) were 0.667, 0.754, 0.695, 0.792, and 0.876, respectively. The combined parameter demonstrated higher efficacy than any other parameters (p < 0.05). CONCLUSION The ADC, D, and f can effectively distinguish LVI status of GC. The D, f and thickness were independent predictors. The combination of the three predictors further improved the efficacy.
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Affiliation(s)
- Jing Li
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No. 127, Dongming Road, Zhengzhou, 450008, Henan, China
| | - Liang-Liang Yan
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No. 127, Dongming Road, Zhengzhou, 450008, Henan, China
| | - Hong-Kai Zhang
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No. 127, Dongming Road, Zhengzhou, 450008, Henan, China
| | - Yi Wang
- Department of Pathology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No.127, Dongming Road, Zhengzhou, 450008, Henan, China
| | - Shu-Ning Xu
- Department of Digestive Oncology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No.127, Dongming Road, Zhengzhou, 450008, Henan, China
| | - Xue-Jun Chen
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No. 127, Dongming Road, Zhengzhou, 450008, Henan, China
| | - Jin-Rong Qu
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No. 127, Dongming Road, Zhengzhou, 450008, Henan, China.
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Ma C, Tian S, Song Q, Chen L, Meng X, Wang N, Lin L, Wang J, Liu A, Song Q. Amide Proton Transfer-Weighted Imaging Combined With Intravoxel Incoherent Motion for Evaluating Microsatellite Instability in Endometrial Cancer. J Magn Reson Imaging 2023; 57:493-505. [PMID: 35735273 DOI: 10.1002/jmri.28287] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Microsatellite instability (MSI), caused by mismatch repair (MMR) protein defects that lead to uncorrectable mismatch bases, results in the accumulation of gene mutations and ultimately to tumors. Preoperative prediction of MSI can provide a basis for personalized and precise treatment of endometrial cancer (EC) patients. PURPOSE To investigate amide proton transfer weighting (APTw) imaging combined with intravoxel incoherent motion (IVIM) in the assessment of MSI in EC. STUDY TYPE Retrospective. POPULATION A total of 71 patients with EC (12 classified as the MSI group and 22 as the microsatellite stabilization [MSS] group after entering and leaving the group standard). FIELD STRENGTH/SEQUENCE A 3.0 T/IVIM, diffusion-weighted imaging (DWI) and APTw. ASSESSMENT Amide proton transfer (APT) value, apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f) were calculated and compared between MSI and MSS groups. STATISTICAL TESTS The Kendall's W test; Mann-Whitney U-test; Chi-square test or Fisher's exact test; logistic regression analysis; Area under the receiver operating characteristic (ROC) curve (AUC); The Delong test; Pearson or Spearman correlation coefficients. The significance threshold was set at P < 0.05. RESULTS APT and D* values of the MSI group were significantly higher than those of the MSS group. While ADC, D, and f values in the MSI group were significantly lower than those in the MSS group. The multivariate analysis revealed that only APT and D* values were independent predictors to evaluate the MSI status. And the ROC curves indicated that the combination of APT and D* values could distinguish the MSI status of EC with the highest diagnostic efficacy (AUC = 0.973), even without significant difference to those by APT (AUC = 0.894) or D* (AUC = 0.920) value separately (P = 0.149 and 0.078, respectively). CONCLUSION Combination of APTw and IVIM imaging may serve as an effective noninvasive method for clinical assessment of MSI in EC. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Changjun Ma
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Shifeng Tian
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Qingling Song
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Lihua Chen
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Xing Meng
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Women and Children's Medical Group, Dalian, Liaoning, China
| | - Nan Wang
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Liangjie Lin
- Clinical & Technical Support, Philips Healthcare, Beijing, China
| | - Jiazheng Wang
- Clinical & Technical Support, Philips Healthcare, Beijing, China
| | - Ailian Liu
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Qingwei Song
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
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Simchick G, Hernando D. Precision of region of interest-based tri-exponential intravoxel incoherent motion quantification and the role of the Intervoxel spatial distribution of flow velocities. Magn Reson Med 2022; 88:2662-2678. [PMID: 35968580 PMCID: PMC9529845 DOI: 10.1002/mrm.29406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/27/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022]
Abstract
PURPOSE The purpose of this work was to obtain precise tri-exponential intravoxel incoherent motion (IVIM) quantification in the liver using 2D (b-value and first-order motion moment [M1 ]) IVIM-DWI acquisitions and region of interest (ROI)-based fitting techniques. METHODS Diffusion MRI of the liver was performed in 10 healthy volunteers using three IVIM-DWI acquisitions: conventional monopolar, optimized monopolar, and optimized 2D (b-M1 ). For each acquisition, bi-exponential and tri-exponential full, segmented, and over-segmented ROI-based fitting and a newly proposed blood velocity SDdistribution (BVD) fitting technique were performed to obtain IVIM estimates in the right and left liver lobes. Fitting quality was evaluated using corrected Akaike information criterion. Precision metrics (test-retest repeatability, inter-reader reproducibility, and inter-lobar agreement) were evaluated using Bland-Altman analysis, repeatability/reproducibility coefficients (RPCs), and paired sample t-tests. Precision was compared across acquisitions and fitting methods. RESULTS High repeatability and reproducibility was observed in the estimations of the diffusion coefficient (Dtri = [1.03 ± 0.11] × 10-3 mm2 /s; RPCs ≤ 1.34 × 10-4 mm2 /s), perfusion fractions (F1 = 3.19 ± 1.89% and F2 = 16.4 ± 2.07%; RPCs ≤ 2.51%), and blood velocity SDs (Vb,1 = 1.44 ± 0.14 mm/s and Vb,2 = 3.62 ± 0.13 mm/s; RPCs ≤ 0.41 mm/s) in the right liver lobe using the 2D (b-M1 ) acquisition in conjunction with BVD fitting. Using these methods, significantly larger (p < 0.01) estimates of Dtri and F1 were observed in the left lobe in comparison to the right lobe, while estimates of Vb,1 and Vb,2 demonstrated high interlobar agreement (RPCs ≤ 0.45 mm/s). CONCLUSIONS The 2D (b-M1 ) IVIM-DWI data acquisition in conjunction with BVD fitting enables highly precise tri-exponential IVIM quantification in the right liver lobe.
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Affiliation(s)
- Gregory Simchick
- Radiology, University of Wisconsin-Madison, Madison, WI, United States
- Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Diego Hernando
- Radiology, University of Wisconsin-Madison, Madison, WI, United States
- Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
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Egnell L, Jerome NP, Andreassen MMS, Bathen TF, Goa PE. Effects of echo time on IVIM quantifications of locally advanced breast cancer in clinical diffusion-weighted MRI at 3 T. NMR IN BIOMEDICINE 2022; 35:e4654. [PMID: 34967468 DOI: 10.1002/nbm.4654] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 09/21/2021] [Accepted: 10/10/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to investigate the effects of echo time dependence in IVIM quantification of the pseudo-diffusion fraction in breast cancer and whether correcting for the echo time dependence offers added clinical value. MATERIALS AND METHODS Fifteen patients with biopsy-proven breast cancer underwent a 3 T MRI examination with an extended DWI protocol at two different echo times (TE = 53 ms, b = 0, 50 s/mm2 ; TE = 77 ms, b = 0, 50, 120, 200, 400, 700 s/mm2 ). Volumes of interest were delineated around the tumors. In addition, simulated MRI data were generated for different levels of signal-to-noise ratio and two values for the blood T2 relaxation time (T2p = 100 ms and 150 ms). The pseudo-diffusion signal fraction was estimated from the simulated and in vivo tumor data using both the standard IVIM model and an extended IVIM model that accounts for the echo time dependence arising from distinct transverse relaxation times. RESULTS Simulations showed that the standard IVIM model overestimated the pseudo-diffusion fraction by 25% (T2p = 100 ms) and 60 % (T2p = 150 ms) (p < 0.0001 at SNR = 50). In vivo, the estimated apparent T2 value at b = 50 s/mm2 was around 8% lower than at b = 0 s/mm2 (p = 0.01) demonstrating a removal of the signal contribution from blood with long T2 associated with pseudo-diffusion. Using two different fixed values for T2p = 100, 150 ms, the pseudo-diffusion fraction was 15% and 46% higher in the standard model compared with the echo-time-corrected model (p < 0.01). CONCLUSION The standard IVIM model was found to overestimate the pseudo-diffusion fraction by 15% to 46% compared with the echo-time-corrected model in breast tumor DWI data acquired at 3 T. Our results suggest that a corrected model may give more accurate results in terms of signal fractions, but may not justify the added time needed to acquire the additional data in terms of clinical value.
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Affiliation(s)
- Liv Egnell
- Department of Physics, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - Neil P Jerome
- Clinic of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Maren M S Andreassen
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Tone F Bathen
- Clinic of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Erik Goa
- Department of Physics, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway
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Zeng P, Ma L, Liu J, Song Z, Liu J, Yuan H. The diagnostic value of intravoxel incoherent motion diffusion-weighted imaging for distinguishing nonhypervascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas. Eur J Radiol 2022; 150:110261. [PMID: 35316674 DOI: 10.1016/j.ejrad.2022.110261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/19/2022] [Accepted: 03/14/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To primarily evaluate the diagnostic performance of the monoexponential and intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) models for differentiating between nonhypervascular pancreatic neuroendocrine tumors (PNETs) and pancreatic ductal adenocarcinomas (PDACs). METHODS 63 patients with PNETs (35 nonhypervascular PNETs and 28 hypervascular PNETs) and 164 patients with PDACs were retrospectively enrolled in the study and underwent multiple b-value DWI. Intraobserver and interobserver reliabilities of DWI parameters were assessed by using the intraclass correlation coefficient (ICC). The parameters of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) of nonhypervascular PNETs were compared with PDACs and hypervascular PNETs using the independent sample t test or the Mann-Whitney U test. The diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. RESULTS All DWI parameters values showed good to excellent intra- and interobserver agreements (ICC = 0.743-0.873). Nonhypervascular PNETs had significantly lower ADC and D, but significantly higher f than PDACs (P = 0.005, P < 0.001 and P < 0.001, respectively). ADC, D and f of nonhypervascular PNETs were lower than hypervascular PNETs (P = 0.001, <0.001 and 0.093, respectively). D* of nonhypervascular PNETs showed no statistically significant differences with PDACs and hypervascular PNETs (P = 0.809 and 0.420). D showed a higher area under the curve (AUC), followed by ADC and f (AUC = 0.885, 0.665 and 0.740, respectively) in differentiating nonhypervascular PNETs from PDACs. CONCLUSION Monoexponential and IVIM diffusion models are valuable to differentiate nonhypervascular PNETs from PDACs. D showed better performance than f and ADC.
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Affiliation(s)
- Piaoe Zeng
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Lu Ma
- Department of Radiology, Tsinghua University Hospital, 30 Shuangqing Road, Beijing 100084, Beijing, China
| | - Jianfang Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Zixiu Song
- Department of Pathology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Jianyu Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China.
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Guo C, Zheng K, Ye Q, Lu Z, Xie Z, Li X, Zhao Y. Intravoxel Incoherent Motion Imaging on Sacroiliitis in Patients With Axial Spondyloarthritis: Correlation With Perfusion Characteristics Based on Dynamic Contrast-Enhanced Magnetic Resonance Imaging. Front Med (Lausanne) 2022; 8:798845. [PMID: 35155474 PMCID: PMC8826054 DOI: 10.3389/fmed.2021.798845] [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: 11/22/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To prospectively explore the relationship between intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) parameters of sacroiliitis in patients with axial spondyloarthritis (axSpA). METHODS Patients with initially diagnosed axSpA prospectively underwent on 3.0 T MRI of sacroiliac joint (SIJ). The IVIM parameters (D, f, D *) were calculated using biexponential analysis. K trans, K ep, V e, and V p from DCE-MRI were obtained in SIJ. The uni-variable and multi-variable linear regression analyses were used to evaluate the correlation between the parameters from these two imaging methods after controlling confounders, such as bone marrow edema (BME), age, agenda, scopes, and localization of lesions, and course of the disease. Then, their correlations were measured by calculating the Pearson's correlation coefficient (r). RESULTS The study eventually enrolled 234 patients (178 men, 56 women; mean age, 28.51 ± 9.50 years) with axSpA. With controlling confounders, D was independently related to K trans (regression coefficient [b] = 27.593, p < 0.001), K ep (b = -6.707, p = 0.021), and V e (b = 131.074, p = 0.003), whereas f and D * had no independent correlation with the parameters from DCE MRI. The correlations above were exhibited with Pearson's correlation coefficients (r) (r = 0.662, -0.408, and 0.396, respectively, all p < 0.001). CONCLUSION There were independent correlations between D derived from IVIM DWI and K trans, K ep, and V e derived from DCE-MRI. The factors which affect their correlations mainly included BME, gender, and scopes of lesions.
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Affiliation(s)
- Chang Guo
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Kai Zheng
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Qiang Ye
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Zixiao Lu
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Zhuoyao Xie
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Xin Li
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Yinghua Zhao
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
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Zhou X, Wang X, Liu E, Zhang L, Zhang H, Zhang X, Zhu Y, Kuai Z. An Unsupervised Deep Learning Approach for
Dynamic‐Exponential
Intravoxel Incoherent Motion
MRI
Modeling and Parameter Estimation in the Liver. J Magn Reson Imaging 2022; 56:848-859. [PMID: 35064945 DOI: 10.1002/jmri.28074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 12/18/2022] Open
Affiliation(s)
- Xin‐Xiang Zhou
- Imaging Center Harbin Medical University Cancer Hospital Harbin China
| | - Xin‐Yu Wang
- Imaging Center Harbin Medical University Cancer Hospital Harbin China
| | - En‐Hui Liu
- Imaging Center Harbin Medical University Cancer Hospital Harbin China
| | - Lan Zhang
- Imaging Center Harbin Medical University Cancer Hospital Harbin China
| | - Hong‐Xia Zhang
- Imaging Center Harbin Medical University Cancer Hospital Harbin China
| | - Xiu‐Shi Zhang
- Imaging Center Harbin Medical University Cancer Hospital Harbin China
| | - Yue‐Min Zhu
- CREATIS CNRS UMR 5220‐INSERM U1206‐University Lyon 1‐INSA Lyon‐University Jean Monnet Saint‐Etienne Lyon France
| | - Zi‐Xiang Kuai
- Imaging Center Harbin Medical University Cancer Hospital Harbin China
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Chaudhary N, Zhang G, Li S, Zhu W. Monoexponential, biexponential and stretched exponential models of diffusion weighted magnetic resonance imaging in glioma in relation to histopathologic grade and Ki-67 labeling index using high B values. Am J Transl Res 2021; 13:12480-12494. [PMID: 34956467 PMCID: PMC8661204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/12/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE To explore the performance of various parameters obtained from monoexponential (Gaussian), biexponential and stretched exponential (non-Gaussian) models of Diffusion Weighted Magnetic Resonance Imaging in differentiating gliomas with correlation to histopathology and Ki-67 labeling index (LI). MATERIALS AND METHODS This Institute Review Board approved retrospective study included 51 pathologically proven glioma patients (WHO Grade I, n = 1; Grade II, n = 19, Grade III, n = 12; Grade IV, n = 19), and immunohistochemistry for Ki-67 LI was obtained. The conventional Magnetic Resonance (MR) images and Diffusion Weighted (DW) images with 19 non-zero b values (0-4500 s/mm2) followed by contrast-enhanced MR images were obtained at 3T preoperatively. All images were processed with Advantage Workstation 4.5 (GE Medical Systems). Region of interest (ROI) in the solid part of the tumor was manually drawn along the border meticulously excluding areas of edema, cyst, hemorrhage, necrosis, and/or calcification, and the parameters: Apparent Diffusion Coefficient (ADC) of monoexponential; pure molecular diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast), and perfusion fraction (f) of biexponential; Distributed Diffusion Coefficient (DDC), and heterogeneity index (α) of stretched exponential models were obtained. ROI of 50 mm2 in the contralateral normal appearing white matter (NAWM) was drawn for the internal control either on centrum semiovale or white matter of the frontal lobe. Analysis of reliability by Intra-class Correlation Coefficient (ICC); correlation with Ki-67 LI by Spearman's rank correlation; comparison between high grade glioma (HGG) and low grade glioma (LGG) by either Mann Whitney U test or Independent t-Test; comparison among Grade II, III and IV gliomas by one-way ANOVA with Bonferroni; and diagnostic performance by analysis of Area Under Receiver Operating Characteristic (ROC) Curve (AUC) were conducted. RESULTS Highly significant differences were found between HGG and LGG for all the parameters (P < 0.001 for all). In differentiating HGG from LGG, AUC values were 0.955 for Ki-67 LI; 0.926 for α; 0.903 for Dslow; 0.897 for f; 0.863 for DDC; 0.852 for ADC; 0.820 for Dfast (P < 0.001 for all). The parameters ADC, Dslow, Dfast, f, DDC, and α showed moderate to good negative correlation with Ki-67 LI (P < 0.001 for all). The ICCs of all the parameters were found greater than 0.75 (P < 0.05 for all) suggesting good reliability of measurements. CONCLUSION In comparison to ADC derived from monoexponential model, the parameters α and Dslow derived from stretched exponential, and biexponential models respectively can efficiently differentiate HGG from LGG with high diagnostic accuracy. Additionally, f and DDC derived from biexponential, and stretched exponential models respectively are also more useful in differentiating HGG from LGG in comparison to ADC.
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Affiliation(s)
- Nabin Chaudhary
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
| | - Guiling Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
| | - Shihui Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology No. 1095 Jiefang Avenue, Wuhan 430030, Hubei, China
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Kaandorp MPT, Barbieri S, Klaassen R, van Laarhoven HWM, Crezee H, While PT, Nederveen AJ, Gurney‐Champion OJ. Improved unsupervised physics-informed deep learning for intravoxel incoherent motion modeling and evaluation in pancreatic cancer patients. Magn Reson Med 2021; 86:2250-2265. [PMID: 34105184 PMCID: PMC8362093 DOI: 10.1002/mrm.28852] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Earlier work showed that IVIM-NETorig , an unsupervised physics-informed deep neural network, was faster and more accurate than other state-of-the-art intravoxel-incoherent motion (IVIM) fitting approaches to diffusion-weighted imaging (DWI). This study presents a substantially improved version, IVIM-NEToptim , and characterizes its superior performance in pancreatic cancer patients. METHOD In simulations (signal-to-noise ratio [SNR] = 20), the accuracy, independence, and consistency of IVIM-NET were evaluated for combinations of hyperparameters (fit S0, constraints, network architecture, number of hidden layers, dropout, batch normalization, learning rate), by calculating the normalized root-mean-square error (NRMSE), Spearman's ρ, and the coefficient of variation (CVNET ), respectively. The best performing network, IVIM-NEToptim was compared to least squares (LS) and a Bayesian approach at different SNRs. IVIM-NEToptim 's performance was evaluated in an independent dataset of 23 patients with pancreatic ductal adenocarcinoma. Fourteen of the patients received no treatment between two repeated scan sessions and nine received chemoradiotherapy between the repeated sessions. Intersession within-subject standard deviations (wSD) and treatment-induced changes were assessed. RESULTS In simulations (SNR = 20), IVIM-NEToptim outperformed IVIM-NETorig in accuracy (NRMSE(D) = 0.177 vs 0.196; NMRSE(f) = 0.220 vs 0.267; NMRSE(D*) = 0.386 vs 0.393), independence (ρ(D*, f) = 0.22 vs 0.74), and consistency (CVNET (D) = 0.013 vs 0.104; CVNET (f) = 0.020 vs 0.054; CVNET (D*) = 0.036 vs 0.110). IVIM-NEToptim showed superior performance to the LS and Bayesian approaches at SNRs < 50. In vivo, IVIM-NEToptim showed significantly less noisy parameter maps with lower wSD for D and f than the alternatives. In the treated cohort, IVIM-NEToptim detected the most individual patients with significant parameter changes compared to day-to-day variations. CONCLUSION IVIM-NEToptim is recommended for accurate, informative, and consistent IVIM fitting to DWI data.
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Affiliation(s)
- Misha P. T. Kaandorp
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Department of Radiology and Nuclear MedicineSt. Olav’s University HospitalTrondheimNorway
- Department of Circulation and Medical ImagingNTNU – Norwegian University of Science and TechnologyTrondheimNorway
| | | | - Remy Klaassen
- Department of Medical OncologyCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical OncologyCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Hans Crezee
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Peter T. While
- Department of Radiology and Nuclear MedicineSt. Olav’s University HospitalTrondheimNorway
- Department of Circulation and Medical ImagingNTNU – Norwegian University of Science and TechnologyTrondheimNorway
| | - Aart J. Nederveen
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Oliver J. Gurney‐Champion
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
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Zhang XS, Liu EH, Wang XY, Zhou XX, Zhang HX, Zhu YM, Sang XQ, Kuai ZX. Short-Term Repeatability of in Vivo Cardiac Intravoxel Incoherent Motion Tensor Imaging in Healthy Human Volunteers. J Magn Reson Imaging 2021; 55:854-865. [PMID: 34296813 DOI: 10.1002/jmri.27847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Intravoxel incoherent motion (IVIM) tensor imaging is a promising technique for diagnosis and monitoring of cardiovascular diseases. Knowledge about measurement repeatability, however, remains limited. PURPOSE To evaluate short-term repeatability of IVIM tensor imaging in normal in vivo human hearts. STUDY TYPE Prospective. POPULATION Ten healthy subjects without history of heart diseases. FIELD STRENGTH/SEQUENCE Balanced steady-state free-precession cine sequence and single-shot spin-echo echo planar IVIM tensor imaging sequence (9 b-values, 0-400 seconds/mm2 and six diffusion-encoding directions) at 3.0 T. ASSESSMENT Subjects were scanned twice with an interval of 15 minutes, leaving the scanner between studies. The signal-to-noise ratio (SNR) was evaluated in anterior, lateral, septal, and inferior segments of the left ventricle wall. Fractional anisotropy (FA), mean diffusivity (MD), mean fraction (MF), and helix angle (HA) in the four segments were independently measured by five radiologists. STATISTICAL TESTS IVIM tensor indexes were compared between observers using a one-way analysis of variance or between scans using a paired t-test (normal data) or a Wilcoxon rank-sum test (non-normal data). Interobserver agreement and test-retest repeatability were assessed using the intraclass correlation coefficient (ICC), within-subject coefficient of variation (WCV), and Bland-Altman limits of agreements. RESULTS SNR of inferior segment was significantly lower than the other three segments, and inferior segment was therefore excluded from repeatability analysis. Interobserver repeatability was excellent for all IVIM tensor indexes (ICC: 0.886-0.972; WCV: 0.62%-4.22%). Test-retest repeatability was excellent for MD of the self-diffusion tensor (D) and MF of the perfusion fraction tensor (fp ) (ICC: 0.803-0.888; WCV: 1.42%-9.51%) and moderate for FA and MD of the pseudo-diffusion tensor (D* ) (ICC: 0.487-0.532; WCV: 6.98%-10.89%). FA of D and fp and HA of D presented good test-retest repeatability (ICC: 0.732-0.788; WCV: 3.28%-8.71%). DATA CONCLUSION The D and fp indexes exhibited satisfactory repeatability, but further efforts were needed to improve repeatability of D* indexes. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Xiu-Shi Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - En-Hui Liu
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xin-Yu Wang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xin-Xiang Zhou
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hong-Xia Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yue-Min Zhu
- CREATIS, CNRS UMR 5220-INSERM U1206-University Lyon 1-INSA Lyon-University Jean Monnet Saint-Etienne, Lyon, France
| | - Xi-Qiao Sang
- Division of Respiratory Disease, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Zi-Xiang Kuai
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
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Noninvasive DW-MRI metrics for staging hepatic fibrosis and grading inflammatory activity in patients with chronic hepatitis B. Abdom Radiol (NY) 2021; 46:1864-1875. [PMID: 33074424 DOI: 10.1007/s00261-020-02801-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/21/2020] [Accepted: 09/29/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To assess the value of various diffusion parameters obtained from monoexponential, biexponential, and stretched-exponential diffusion-weighted imaging (DWI) models for staging hepatic fibrosis (HF) and grading inflammatory activity in patients with chronic hepatitis B (CHB). METHODS 82 patients with CHB and 30 healthy volunteers underwent DWI with 13 b-values on a 3T MRI unit. The standard apparent diffusion coefficient (ADCst) was calculated using a monoexponential model. The true diffusion coefficient (Dt), pseudo-diffusion coefficient (Dp), and perfusion fraction (f) were calculated using a biexponential model. The distributed diffusion coefficient (DDC) and water-molecule diffusion heterogeneity index (α) were calculated using a stretched-exponential model. Receiver operating characteristic (ROC) curves were performed for diffusion parameters to compare the diagnosis performance. RESULTS The distributions of hepatic fibrosis stages and the inflammatory activity grades (METAVIR scoring system) were as follows: F0, n = 1; F1, n = 16; F2, n = 31; F3, n = 19; and F4, n = 15. A0, n = 1; A1, n = 14; A2, n = 46; and A3, n = 21. ADCst, Dt and DDC values showed negative correlation with the fibrosis stage (r = - 0.418, - 0.717 and - 0.630, all P < 0.001) and the inflammatory activity grade (r = - 0.514, - 0.626 and - 0.550, all P < 0.001). The area under the ROC curve (AUC) of Dt (AUC = 0.854, 0.881) and DDC (AUC = 0.794, 0.834) were significantly higher than that of ADCst (AUC = 0.637, 0.717) in discriminating significant fibrosis (≥ F2) and advanced fibrosis (≥ F3) (all P < 0.05). Although Dt (AUC = 0.867, 0.836) and DDC (AUC = 0.810, 0.808) showed higher AUCs than ADCst (AUC = 0.767, 0.803), there was no significant difference in their ability in detecting inflammatory activity grade ≥ A2/A3 (P > 0.05). CONCLUSIONS Dt and DDC are promising indicators and outperform ADCst for staging HF. While both Dt and DDC have similar diagnostic performance compared with ADCst for grading inflammatory activity.
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Zhang L, Yang LQ, Wen L, Lv SQ, Hu JH, Li QR, Xu JP, Xu RF, Zhang D. Noninvasively Evaluating the Grading of Glioma by Multiparametric Magnetic Resonance Imaging. Acad Radiol 2021; 28:e137-e146. [PMID: 32417035 DOI: 10.1016/j.acra.2020.03.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVE To investigate the performance of multi-parametric magnetic resonance imaging (MRI) for glioma grading. MATERIALS AND METHODS Seventy consecutive patients with histopathologically confirmed glioma were retrospectively evaluated by conventional MRI, dynamic susceptibility-weighted contrast-enhanced, multiple diffusion-weighted imaging signal models including mono-exponential, bi-exponential, stretched exponential, and diffusion kurtosis imaging. One-way analysis of variance and independent-samples t test were used to compare the MR parameter values between low and high grades as well as among all grades of glioma. Receiver operating characteristic analysis, Spearman's correlation analysis, and binary logistic regression analysis were used to assess their diagnostic performance. RESULTS The diagnostic performance (the optimal thresholds, area under the receiver operating characteristic curve, sensitivity, and specificity) was achieved with normalized relative cerebral blood flow (rCBV) (2.240 ml/100 g, 0.844, 87.8%, and 75.9%, respectively), mean kurtosis (MK) (0.471, 0.873, 92.7%, and 79.3%), and water molecular diffusion heterogeneity index (α) (1.064, 0.847, 79.3% and 78.0%) for glioma grading. There were positive correlations between rCBV and MK and the tumor grades and negative correlations between α and the tumor grades (p < 0.01). The parameter of α yielded a diagnostic accuracy of 85.3%, the combination of MK and α yielded a diagnostic accuracy of 89.7%, while the combination of rCBV, MK, and α were more accurate (94.2%) in predicting tumor grade. CONCLUSION The most accurate parameters were rCBV, MK, and α in dynamic susceptibility-weighted contrast, diffusion kurtosis imaging, and Multi-b diffusion-weighted imaging for glioma grading, respectively. Multiparametric MRI can increase the accuracy of glioma grading.
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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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Riexinger A, Martin J, Wetscherek A, Kuder TA, Uder M, Hensel B, Laun FB. An optimized b-value distribution for triexponential intravoxel incoherent motion (IVIM) in the liver. Magn Reson Med 2020; 85:2095-2108. [PMID: 33201549 DOI: 10.1002/mrm.28582] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To find an optimized b-value distribution for reproducible triexponential intravoxel incoherent motion (IVIM) exams in the liver. METHODS A numeric optimization of b-value distributions was performed using the triexponential IVIM equation and 27 different IVIM parameter sets. Starting with an initially optimized distribution of 6 b-values, the number of b-values was increased stepwise. Each new b-value was chosen from a set of 64 predefined b-values based on the computed summed relative mean error of the fitted triexponential IVIM parameters. This process was repeated for up to 100 b-values. In simulations and in vivo measurements, optimized b-value distributions were compared to 4 representative distributions found in literature. RESULTS The first 16 optimized b-values were 0, 0.3, 0.3, 70, 200, 800, 70, 1, 3.5, 5, 70, 1.2, 6, 45, 1.5, and 60 in units of s/mm2 . Low b-values were much more frequent than high b-values. The optimized b-value distribution resulted in a higher fit stability compared to distributions used in literature in both, simulation and in vivo measurements. Using more than 6 b-values, ideally 16 or more, increased the fit stability considerably. CONCLUSION Using optimized b-values, the fit uncertainty in triexponential IVIM can be largely reduced. Ideally, 16 or more b-values should be acquired.
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Affiliation(s)
- Andreas Riexinger
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Jan Martin
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Andreas Wetscherek
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Tristan Anselm Kuder
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Bernhard Hensel
- Center for Medical Physics and Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Zhang XS, Sang XQ, Kuai ZX, Zhang HX, Lou J, Lu Q, Zhu YM. Investigation of intravoxel incoherent motion tensor imaging for the characterization of the in vivo human heart. Magn Reson Med 2020; 85:1414-1426. [PMID: 32989786 DOI: 10.1002/mrm.28523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate intravoxel incoherent motion (IVIM) tensor imaging of the in vivo human heart and elucidate whether the estimation of IVIM tensors is affected by the complexity of pseudo-diffusion components in myocardium. METHODS The cardiac IVIM data of 10 healthy subjects were acquired using a diffusion weighted spin-echo echo-planar imaging sequence along 6 gradient directions with 10 b values (0~400 s/mm2 ). The IVIM data of left ventricle myocardium were fitted to the IVIM tensor model. The complexity of myocardial pseudo-diffusion components was reduced through exclusion of low b values (0 and 5 s/mm2 ) from the IVIM curve-fitting analysis. The fractional anisotropy, mean fraction/mean diffusivity, and Westin measurements of pseudo-diffusion tensors (fp and D*) and self-diffusion tensor (D), as well as the angle between the main eigenvector of fp (or D*) and that of D, were computed and compared before and after excluding low b values. RESULTS The fractional anisotropy values of fp and D* without low b value participation were significantly higher (P < .001) than those with low b value participation, but an opposite trend was found for the mean fraction/diffusivity values. Besides, after removing low b values, the angle between the main eigenvector of fp (or D*) and that of D became small, and both fp and D* tensors presented significant decrease of spherical components and significant increase of linear components. CONCLUSION The presence of multiple pseudo-diffusion components in myocardium indeed influences the estimation of IVIM tensors. The IVIM tensor model needs to be further improved to account for the complexity of myocardial microcirculatory network and blood flow.
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Affiliation(s)
- Xiu-Shi Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Xi-Qiao Sang
- Division of Respiratory Disease, The Fourth Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Zi-Xiang Kuai
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Hong-Xia Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Jie Lou
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Qing Lu
- Department of Radiology, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yue-Min Zhu
- Univ Lyon, INSA Lyon, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Lyon, France
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Song T, Yao Q, Qu J, Zhang H, Zhao Y, Qin J, Feng W, Zhang S, Han X, Wang S, Yan X, Li H. The value of intravoxel incoherent motion diffusion-weighted imaging in predicting the pathologic response to neoadjuvant chemotherapy in locally advanced esophageal squamous cell carcinoma. Eur Radiol 2020; 31:1391-1400. [PMID: 32901300 DOI: 10.1007/s00330-020-07248-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/05/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for the prediction of pathologic response to neoadjuvant chemotherapy (NAC) in locally advanced esophageal squamous cell carcinoma (ESCC). MATERIAL AND METHODS Forty patients with locally advanced ESCC who were treated with NAC followed by radical resection were prospectively enrolled from September 2015 to May 2018. MRI and IVIM were performed within 1 week before and 2-3 weeks after NAC, prior to surgery. Parameters including apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), and pseudodiffusion fraction (f) before and after NAC were measured. Pathologic response was evaluated according to the AJCC tumor regression grade (TRG) system. The changes in IVIM values before and after therapy in different TRG groups were assessed. Receiver operating characteristic (ROC) curves analysis was used to determine the best cutoff value for predicting the pathologic response to NAC. RESULTS Twenty-two patients were identified as TRG 2 (responders), and eighteen as TRG 3 (non-responders) in pathologic evaluation. The ADC, D, and f values increased significantly after NAC. The post-NAC D and ΔD values of responders were significantly higher than those of non-responders. The area under the curve (AUC) was 0.722 for post-NAC D and 0.859 for ΔD in predicting pathologic response. The cutoff values of post-NAC D and ΔD were 1.685 × 10-3 mm2/s and 0.350 × 10-3 mm2/s, respectively. CONCLUSION IVIM-DWI may be used as an effective functional imaging technique to predict pathologic response to NAC in locally advanced ESCC. KEY POINTS • The optimal cutoff values of post-NAC D and ΔD for predicting pathologic response to NAC in locally advanced ESCC were 1.685 × 10-3 mm2/s and 0.350 × 10-3 mm2/s, respectively. • Pathologic response to NAC in locally advanced ESCC was favorable in patients with post-NAC D and ΔD values that were higher than the optimal cutoff values. • IVIM-DWI can potentially be used to preoperatively predict pathologic response to NAC in esophageal carcinoma. Accurate quantification of the D value derived from IVIM-DWI may eventually translate into an effective and non-invasive marker to predict therapeutic efficacy.
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Affiliation(s)
- Tao Song
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China
| | - Qi Yao
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China
| | - Jinrong Qu
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China.
| | - Hongkai Zhang
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China
| | - Yan Zhao
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China
| | - Jianjun Qin
- Department of Thoracic Surgery, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Wen Feng
- Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Shouning Zhang
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China
| | - Xianhua Han
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China
| | - Shaoyu Wang
- MR Scientific Marketing, Siemens Healthineers, XI'an, 710065, China
| | - Xu Yan
- MR Scientific Marketing, Siemens Healthineers, Shanghai, 201318, China
| | - Hailiang Li
- Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming road, Jinshui District, Zhengzhou city, Henan Province, China
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Quantified MRI and 25OH-VitD3 can be used as effective biomarkers for patients with neoadjuvant chemotherapy-induced liver injury in CRCLM? BMC Cancer 2020; 20:767. [PMID: 32799832 PMCID: PMC7429712 DOI: 10.1186/s12885-020-07282-6] [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: 06/01/2020] [Accepted: 08/09/2020] [Indexed: 12/26/2022] Open
Abstract
Background To evaluate proton-density fat-fraction (PDFF) and intravoxel incoherent motion (IVIM) techniques, and human 25-hydroxyvitamin D3 (25OH-VitD3) levels, as potential biomarkers in patients with colorectal cancer with liver metastasis (CRCLM). Changes were compared with those related to chemotherapy-associated steatohepatitis (CASH) and sinusoidal obstruction syndrome (SOS). Methods 63 patients with pathologically confirmed colorectal adenocarcinoma received 4–6 courses of NC before liver resection and underwent magnetic resonance imaging (MRI) with iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantification and IVIM sequences. Blood samples were analyzed using CTCAE. Pathological changes of liver tissues outside the metastases were assessed as the gold standard, and receiver operating characteristic (ROC) curves were analyzed. Results 16 cases had CASH liver injury, 14 cases had SOS changes, and 4 cases had CASH and SOS, and 7 showed no significant changes. Consistency between biochemical indices and pathological findings was poor (kappa = 0.246, p = 0.005). The areas under the ROC curve (AUCs) of ALT, AST, ALP, GGT, and TBIL were 0.571–0.691. AUCs of D, FF, and 25OH-VitD3 exceeded 0.8; when considering these markers together, sensitivity was 85.29% and specificity was 93.13%. ANOVA showed statistically significant differences among D, FF, and 25OH-VitD3 for different grades of liver injury (F = 4.64–26.5, p = 0.000–0.016). Conclusions D, FF, and 25OH-VitD3 are biomarkers for accurate prediction of NC-induced liver injury in patients with CRCLM, while FF and 25OH-VitD3 might be beneficial to distinguish liver injury grades. Trial registration Current Trials was retrospectively registered as ChiCTR1800015242 at Chinese Clinical Trial Registry on March 16, 2018.
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Tao YY, Zhou Y, Wang R, Gong XQ, Zheng J, Yang C, Yang L, Zhang XM. Progress of intravoxel incoherent motion diffusion-weighted imaging in liver diseases. World J Clin Cases 2020; 8:3164-3176. [PMID: 32874971 PMCID: PMC7441263 DOI: 10.12998/wjcc.v8.i15.3164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/11/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
Traditional magnetic resonance (MR) diffusion-weighted imaging (DWI) uses a single exponential model to obtain the apparent diffusion coefficient to quantitatively reflect the diffusion motion of water molecules in living tissues, but it is affected by blood perfusion. Intravoxel incoherent motion (IVIM)-DWI utilizes a double-exponential model to obtain information on pure water molecule diffusion and microcirculatory perfusion-related diffusion, which compensates for the insufficiency of traditional DWI. In recent years, research on the application of IVIM-DWI in the diagnosis and treatment of hepatic diseases has gradually increased and has achieved considerable progress. This study mainly reviews the basic principles of IVIM-DWI and related research progress in the diagnosis and treatment of hepatic diseases.
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Affiliation(s)
- Yun-Yun Tao
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Yi Zhou
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Ran Wang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xue-Qin Gong
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing Zheng
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Cui Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xiao-Ming Zhang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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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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Mi HL, Suo ST, Cheng JJ, Yin X, Zhu L, Dong SJ, Huang SS, Lin C, Xu JR, Lu Q. The invasion status of lymphovascular space and lymph nodes in cervical cancer assessed by mono-exponential and bi-exponential DWI-related parameters. Clin Radiol 2020; 75:763-771. [PMID: 32723502 DOI: 10.1016/j.crad.2020.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/06/2020] [Indexed: 12/27/2022]
Abstract
AIM To investigate whether mono-exponential and bi-exponential diffusion-weighted imaging (DWI)-related parameters of the primary tumour can evaluate the status of lymphovascular space invasion (LVSI) and lymph node metastasis (LNM) in patients with cervical carcinoma preoperatively. MATERIALS AND METHODS Eighty patients with cervical carcinoma were enrolled, who underwent preoperative multi b-value DWI and radical hysterectomy. They were classified into LVSI(+) versus LVSI(-) and LNM(+) versus LNM(-) according to postoperative pathology. The apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion coefficient (D∗), and perfusion fraction (f) were calculated from the whole tumour (_whole) and tumour margin (_margin). All parameters were compared between LVSI(+) and LVSI(-) and between LNM(+) and LNM(-). Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to evaluate the diagnostic performance of these parameters. RESULTS f_margin and D∗_whole showed significant differences in differentiating LVSI(+) from LVSI(-) tumours (p=0.002, 0.008, respectively), while LNM(+) tumours presented with significantly higher ADC_margin than that of LNM(-) tumours (p=0.009). The other parameters were not independent related factors with the status of LVSI or LNM according to logistic regression analysis (p>0.05). The area under the ROC curve of f_margin combined with D∗_whole in discriminating LVSI(+) from LVSI(-) was 0.826 (95% confidence interval [CI]: 0.691-0.961), while ADC_margin in differentiating LNM(+) from LNM(-) was 0.788 (95% CI: 0.648-0.928). CONCLUSIONS The parameters generated from mono-exponential and bi-exponential DWI of the primary cervical carcinoma could help discriminate its status regarding LVSI (f_margin and D∗_whole) and LNM (ADC_margin).
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Affiliation(s)
- H L Mi
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - S T Suo
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - J J Cheng
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - X Yin
- Department of Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - L Zhu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - S J Dong
- Department of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, 516 Jungong Rd, Shanghai, 20093, China
| | - S S Huang
- Department of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, 516 Jungong Rd, Shanghai, 20093, China
| | - C Lin
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - J R Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - Q Lu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China.
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Ye Z, Wei Y, Chen J, Yao S, Song B. Value of intravoxel incoherent motion in detecting and staging liver fibrosis: A meta-analysis. World J Gastroenterol 2020; 26:3304-3317. [PMID: 32684744 PMCID: PMC7336331 DOI: 10.3748/wjg.v26.i23.3304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/26/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver fibrosis (LF) is a common pathological feature of all chronic liver diseases. With the accumulation of extracellular matrix in the fibrotic liver, true molecular water diffusion and perfusion-related diffusion are restricted. Intravoxel incoherent motion (IVIM) can capture the information on tissue diffusivity and microcapillary perfusion separately and reflect the fibrotic severity with diffusion coefficients.
AIM To investigate the diagnostic performance of IVIM in detecting and staging LF with histology as a reference standard.
METHODS A comprehensive literature search was conducted to identify studies on the diagnostic accuracy of IVIM for assessment of histologically proven LF. The stages of LF were classified as F0 (no fibrosis), F1 (portal fibrosis without septa), F2 (periportal fibrosis with few septa), F3 (septal fibrosis), and F4 (cirrhosis) according to histopathological findings. Data were extracted to calculate the pooled sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio, as well as the area under the summary receiver operating characteristic curve (AUC) in each group.
RESULTS A total of 12 studies with 923 subjects were included in this meta-analysis with 5 studies (n = 465) for LF ≥ F1, 9 studies (n = 757) for LF ≥ F2, 4 studies (n = 413) for LF ≥ F3, and 6 studies (n = 562) for LF = F4. The pooled sensitivity and specificity were estimated to be 0.78 (95% confidence interval: 0.73-0.82) and 0.81 (0.74-0.86) for LF ≥ F1 detection with IVIM; 0.82 (0.79-0.86) and 0.80 (0.75-0.84) for staging F2 fibrosis; 0.85 (0.79-0.90) and 0.83 (0.77-0.87) for staging F3 fibrosis, and 0.90 (0.84-0.94) and 0.75 (0.70-0.79) for detecting F4 cirrhosis, respectively. The AUCs for LF ≥ F1, F2, F3, F4 detection were 0.862 (0.811-0.914), 0.883 (0.856-0.909), 0.886 (0.865-0.907), and 0.899 (0.866-0.932), respectively. Moderate to substantial heterogeneity was observed with inconsistency index (I2) ranging from 0% to 77.9%. No publication bias was detected.
CONCLUSION IVIM is a noninvasive tool with good diagnostic performance in detecting and staging LF. Optimized and standardized IVIM protocols are needed to further improve its diagnostic accuracy in clinical practice.
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Affiliation(s)
- Zheng Ye
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Wei
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jie Chen
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Shan Yao
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Peng J, Zheng J, Yang C, Wang R, Zhou Y, Tao YY, Gong XQ, Wang WC, Zhang XM, Yang L. Intravoxel incoherent motion diffusion-weighted imaging to differentiate hepatocellular carcinoma from intrahepatic cholangiocarcinoma. Sci Rep 2020. [DOI: doi.org/10.1038/s41598-020-64804-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
AbstractThe present study aimed to explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC). This study included 65 patients with malignant hepatic nodules (55 with HCC, 10 with ICC), and 17 control patients with normal livers. All patients underwent IVIM-DWI scans on a 3.0 T magnetic resonance imaging (MRI) scanner. The standard apparent diffusion coefficient (ADC), pure diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast), and perfusion fraction (f) were obtained. Differences in the parameters among the groups were analysed using one-way ANOVA, with p < 0.05 indicating statistical significance. Receiver operating characteristic (ROC) curve analysis was used to compare the efficacy of each parameter in differentiating HCC from ICC. ADC, Dslow, Dfast, f significantly differed among the three groups. ADC and Dslow were significantly lower in the HCC group than in the ICC group, while Dfast was significantly higher in the HCC group than in the ICC group; f did not significantly differ between the HCC and ICC groups. When the cut-off values of ADC, Dslow, and Dfast were 1.27 × 10−3 mm2/s, 0.81 × 10−3 mm2/s, and 26.04 × 10−3 mm2/s, respectively, their diagnostic sensitivities for differentiating HCC from ICC were 98.18%, 58.18%, and 94.55%, their diagnostic specificities were 50.00%, 80.00%, and 80.00%, and their areas under the ROC curve (AUCs) were 0.687, 0.721, and 0.896, respectively. Dfast displayed the largest AUC value. IVIM-DWI can be used to differentiate HCC from ICC.
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Intravoxel incoherent motion diffusion-weighted imaging to differentiate hepatocellular carcinoma from intrahepatic cholangiocarcinoma. Sci Rep 2020; 10:7717. [PMID: 32382050 PMCID: PMC7206040 DOI: 10.1038/s41598-020-64804-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/20/2020] [Indexed: 02/08/2023] Open
Abstract
The present study aimed to explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC). This study included 65 patients with malignant hepatic nodules (55 with HCC, 10 with ICC), and 17 control patients with normal livers. All patients underwent IVIM-DWI scans on a 3.0 T magnetic resonance imaging (MRI) scanner. The standard apparent diffusion coefficient (ADC), pure diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast), and perfusion fraction (f) were obtained. Differences in the parameters among the groups were analysed using one-way ANOVA, with p < 0.05 indicating statistical significance. Receiver operating characteristic (ROC) curve analysis was used to compare the efficacy of each parameter in differentiating HCC from ICC. ADC, Dslow, Dfast, f significantly differed among the three groups. ADC and Dslow were significantly lower in the HCC group than in the ICC group, while Dfast was significantly higher in the HCC group than in the ICC group; f did not significantly differ between the HCC and ICC groups. When the cut-off values of ADC, Dslow, and Dfast were 1.27 × 10−3 mm2/s, 0.81 × 10−3 mm2/s, and 26.04 × 10−3 mm2/s, respectively, their diagnostic sensitivities for differentiating HCC from ICC were 98.18%, 58.18%, and 94.55%, their diagnostic specificities were 50.00%, 80.00%, and 80.00%, and their areas under the ROC curve (AUCs) were 0.687, 0.721, and 0.896, respectively. Dfast displayed the largest AUC value. IVIM-DWI can be used to differentiate HCC from ICC.
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Doudou NR, Liu Y, Kampo S, Zhang K, Dai Y, Wang S. Optimization of intravoxel incoherent motion (IVIM): variability of parameters measurements using a reduced distribution of b values for breast tumors analysis. MAGMA (NEW YORK, N.Y.) 2020; 33:273-281. [PMID: 31571014 DOI: 10.1007/s10334-019-00779-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/13/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study aimed to examine the variability of intravoxel incoherent motion measurements acquired from reduced distributions of b values for breast tumors analysis. MATERIALS AND METHODS The investigations were carried out on twenty-four patients with diagnosed breast tumors. A conventional unenhanced MRI and various IVIM series preset with different distributions of b values (0-1000 s/mm2) were performed. We assessed the variability in Dslow, Dfast, and PF measurements for different distributions of 9 to 4 b values compared with the IVIM metrics for 10 b values using Wilcoxon-Signed rank test. The data was statistically significant at P < 0.05. RESULTS The results showed no significant variation in the estimations of IVIM parameters in patients. However, the measurements acquired with the combination of 5 b values Showed some variation in Dfast (P = 0.028) compared with 10 b values. The data showed high wCVs in the measurements acquired using the reduced set of 6 b values for Dslow and PF and with the combination of 7 b values for Dfast. There were inconsistencies noticed in the measurements acquired from malignant tumors using reduced distributions of b values (9 b values-4 b values). However, the set of 4 b values displayed the lowest wCVs for both benign and malignant datasets. We also observed unsystematic correlations among different combinations of b values in the categories of IVIM parameters. CONCLUSION There was no relevant variation in the parameters measurements irrespective of the number of b values used. Reduced distributions of b values may find use in estimations of IVIM parameters for breast lesions analysis.
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Affiliation(s)
- Natacha Raissa Doudou
- Department of Radiology, Dalian Medical University, Dalian, China
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yajie Liu
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Sylvanus Kampo
- Department of Anesthesiology, Dalian Medical University, Dalian, China
| | - Kai Zhang
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yue Dai
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shaowu Wang
- Department of Radiology, Dalian Medical University, Dalian, China.
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
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Hu YC, Yan LF, Han Y, Duan SJ, Sun Q, Li GF, Wang W, Wei XC, Zheng DD, Cui GB. Can the low and high b-value distribution influence the pseudodiffusion parameter derived from IVIM DWI in normal brain? BMC Med Imaging 2020; 20:14. [PMID: 32041549 PMCID: PMC7011602 DOI: 10.1186/s12880-020-0419-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/30/2020] [Indexed: 12/28/2022] Open
Abstract
Background Our study aims to reveal whether the low b-values distribution, high b-values upper limit, and the number of excitation (NEX) influence the accuracy of the intravoxel incoherent motion (IVIM) parameter derived from multi-b-value diffusion-weighted imaging (DWI) in the brain. Methods This prospective study was approved by the local Ethics Committee and informed consent was obtained from each participant. The five consecutive multi-b DWI with different b-value protocols (0–3500 s/mm2) were performed in 22 male healthy volunteers on a 3.0-T MRI system. The IVIM parameters from normal white matter (WM) and gray matter (GM) including slow diffusion coefficient (D), fast perfusion coefficient (D*) and perfusion fraction (f) were compared for differences among defined groups with different IVIM protocols by one-way ANOVA. Results The D* and f value of WM or GM in groups with less low b-values distribution (less than or equal to 5 b-values) were significantly lower than ones in any other group with more low b-values distribution (all P < 0.05), but no significant differences among groups with more low b-values distribution (P > 0.05). In addition, no significant differences in the D, D* and f value of WM or GM were found between group with one and more NEX of low b-values distribution (all P > 0.05). IVIM parameters in normal WM and GM strongly depended on the choice of the high b-value upper limit. Conclusions Metrics of IVIM parameters can be affected by low and high b value distribution. Eight low b-values distribution with high b-value upper limit of 800–1000 s/mm2 may be the relatively proper set when performing brain IVIM studies.
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Affiliation(s)
- Yu-Chuan Hu
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Lin-Feng Yan
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Yu Han
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Shi-Jun Duan
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Qian Sun
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Gang-Feng Li
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Wen Wang
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Xiao-Cheng Wei
- MR Research China, GE Healthcare China, Beijing, 100176, China
| | - Dan-Dan Zheng
- MR Research China, GE Healthcare China, Beijing, 100176, China
| | - Guang-Bin Cui
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China.
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Xiang SF, Zhang XQ, Yang SJ, Gao YY, Gao BL, Shi QL, Li S. Intravoxel Incoherent Motion Magnetic Resonance Imaging with Integrated Slice-specific Shimming for old myocardial infarction: A Pilot Study. Sci Rep 2019; 9:19766. [PMID: 31875029 PMCID: PMC6930276 DOI: 10.1038/s41598-019-56489-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/12/2019] [Indexed: 11/14/2022] Open
Abstract
Currently, little is known regarding the value of quantitative parameters derived from the intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) with integrated slice-specific shimming (iShim) sequence in detecting old myocardial infarction and myocardial fibrosis. This study was to investigate the value of IVIM-MRI with iShim sequence in diagnosing old myocardial infarction and fibrosis. Thirty-five patients with both old myocardial infarction and myocardial fibrosis and 12 healthy volunteers were prospectively enrolled to undergo cardiac diffusion-weighted imaging (DWI) using seven b-values (0, 20, 60, 80, 120, 200 and 600 s/mm2). The iShim sequence was used for IVIM data acquisition, and the diffusion parameters, D, D* and f values for IVIM, and conventional apparent diffusion coefficient (ADC) were evaluated on the anterior, posterior and lateral walls of the ventricular septum using the short axis of the heart. Significant differences were found in the D, D* and f values between healthy subjects and patients with old myocardial infarction and myocardial fibrosis (P = 0.000), with the median value of the D and f significantly smaller in the myocardial infarction and fibrosis than in the normal control but the median value of D* significantly greater in the myocardial infarction and fibrosis than in the normal control. In the receiver operating curve analysis, the areas under the curve were 0.939, 0.988 and 0.959 for the D, D* and f values, respectively. The sensitivities and specificities were 84.6% and 94.4% for D, 88.9% and 84.6% for D* and 100% and 93.1% for the f values, respectively. In conclusion, the IVIM-derived parameters (D, D* and f) obtained using the iShim DWI technique showed high capacity in diagnosing old myocardial infarction and myocardial fibrosis by providing diffusion and perfusion information, which may have great importance in future clinical practice.
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Affiliation(s)
- Shi-Feng Xiang
- Handan Central Hospital, 15 Southern Zhonghua Street, Handan City, Hebei Province, 056001, China
| | - Xue-Qiang Zhang
- Handan Central Hospital, 15 Southern Zhonghua Street, Handan City, Hebei Province, 056001, China.
| | - Su-Jun Yang
- Handan Central Hospital, 15 Southern Zhonghua Street, Handan City, Hebei Province, 056001, China
| | - Yun-Yun Gao
- Handan Central Hospital, 15 Southern Zhonghua Street, Handan City, Hebei Province, 056001, China
| | - Bu-Lang Gao
- Handan Central Hospital, 15 Southern Zhonghua Street, Handan City, Hebei Province, 056001, China
| | - Qing-Lei Shi
- Siemens medical system Co. Ltd., Beijing, 100176, China
| | - Shuai Li
- Siemens medical system Co. Ltd., Beijing, 100176, China
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Minutoli F, Pergolizzi S, Blandino A, Mormina E, Amato E, Gaeta M. Effect of granulocyte colony-stimulating factor on bone marrow: evaluation by intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging. Radiol Med 2019; 125:280-287. [PMID: 31823293 DOI: 10.1007/s11547-019-01115-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 11/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To report our experience with the use of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and dynamic contrast-enhanced (DCE)-MRI in bone marrow before and after administration of granulocyte colony-stimulating factor (GCSF). Moreover, a small series of patients with bone metastases from breast cancer have been evaluated by IVIM DW-MRI and DCE-MRI before and after GCSF administration. MATERIALS AND METHODS We studied with IVIM-MRI and DCE-MRI 14 patients with rectal or uterine cervix cancer studied before and 4-18 days after administration of GCSF; the second MR examination was obtained after three chemotherapy courses. IVIM perfusion fraction (f), pseudo-diffusion coefficient (D*), true diffusion coefficient (D) and apparent diffusion coefficient (ADC) as well area under the curve at 60 s (AUC60) were calculated for bone marrow before and after GCSF administration. Moreover, two different IVIM parametric maps (i.e., ADC and ADClow) were generated by selecting two different intervals of b values (0-1000 and 0-80, respectively). Furthermore, four patients affected by pelvic bone metastases from breast adenocarcinoma who received GCSF administration were also qualitatively evaluated for evidence of lesions on ADC maps, ADClow maps and DCE-MRI. RESULTS ADC, D, D*, f and AUC60 values were significantly higher in hyperplastic bone marrow than in untreated bone marrow (p values < 0.0001, < 0.0001, < 0.001, < 0.001, < 0.0001, respectively). All bone metastases were clearly differentiable from hyperplastic bone marrow on ADClow maps, but not on ADC maps and DCE-MRI. CONCLUSION MR functional imaging techniques, such as DW-, IVIM DW- and DCE-MRI are effective tools in assessing the response of bone marrow to the administration of growth factors. Although an overlap between signal of hyperplastic bone marrow and lytic bone metastases can occur on ADC maps and DCE-MRI, evaluation of ADClow maps by IVIM DW-MRI could permit to differentiate hyperplastic bone marrow from lytic bone metastases. Further studies are needed to confirm our data.
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Affiliation(s)
- Fabio Minutoli
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Stefano Pergolizzi
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Enricomaria Mormina
- Department of Clinical and Experimental Medicine, Policlinico Universitario "G. Martino", University of Messina, Via Consolare Valeria, 1, 98100, Messina, Italy.
| | - Ernesto Amato
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Michele Gaeta
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Messina, Italy
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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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Guo L, Liu X, Liu Z, Li X, Si Z, Qin J, Mei Y, Zhang Z, Xu Y, Wu Y. Differential detection of metastatic and inflammatory lymph nodes using intravoxel incoherent motion diffusion-weighted imaging. Magn Reson Imaging 2019; 65:62-66. [PMID: 31654737 DOI: 10.1016/j.mri.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/08/2019] [Accepted: 10/08/2019] [Indexed: 12/23/2022]
Abstract
PURPOSE This study sought to monitor the dynamic process of lymph node (LN) metastasis with intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), and to investigate the impact of disease course on the detection of metastatic LNs by IVIM-DWI. METHODS Twenty female New Zealand rabbits with 2.5-3.0 kg body weight were studied. VX2 cells and egg yolk emulsion were randomly inoculated into one thigh to induce metastatic and inflammatory popliteal LNs, respectively. Eight rabbits underwent IVIM-DWI (14 b values, 0-2000 s/mm2) 2 h prior to, and 14, 21, and 28 days after inoculation (D0, D14, D21, D28). The apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were measured and compared between the metastatic and the inflammatory groups at each time point. Three rabbits randomly chosen from the remaining twelve rabbits were sacrificed at each time point to perform hematoxylin and eosin staining and histologic evaluation. RESULTS The patterns of dynamic change of D*, ADC, and D were different between the metastatic and the inflammatory LNs. The metastatic group had a lower D* value at D14 (p = .003), and greater ADC and D values at both D21 (p = .001, p = .001) and D28 (p = .021, p = .001), compared to the inflammatory group. The f value of the metastatic group was greater than that of the inflammatory only at D28 (p = .001). CONCLUSIONS IVIM-DWI can reflect the dynamic process of LN metastasis, and disease course has a significant influence on the ability of IVIM-DWI to detect metastatic nodes.
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Affiliation(s)
- Liuji Guo
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xiaomin Liu
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Zhi Liu
- Department of Sonography, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xiaodan Li
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Zhiguang Si
- Department of Medical Imaging, People's Hospital of Dehong Prefecture, Dehong 678400, China
| | - Jie Qin
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yingjie Mei
- China International Center, Philips Healthcare, Guangzhou 510095, China
| | - Zhongping Zhang
- China International Center, Philips Healthcare, Guangzhou 510095, China
| | - Yikai Xu
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yuankui Wu
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou 510515, 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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Effect of combination and number of b values in IVIM analysis with post-processing methodology: simulation and clinical study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 32:519-527. [DOI: 10.1007/s10334-019-00764-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/10/2019] [Accepted: 06/04/2019] [Indexed: 01/24/2023]
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Wang J, Suo S, Zu J, Zhu W, Pan L, Song S, Li Y, Li L, Chen Z, Xu J. Detection of Crossed Cerebellar Diaschisis by Intravoxel Incoherent Motion MR Imaging in Subacute Ischemic Stroke. Cell Transplant 2019; 28:1062-1070. [PMID: 31198047 PMCID: PMC6728715 DOI: 10.1177/0963689719856290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Intravoxel incoherent motion has received extensive attention in brain studies for its
potential as a non-invasive magnetic resonance perfusion method. However, studies on
intravoxel incoherent motion imaging and crossed cerebellar diaschisis detection are
relatively scarce. The aim of our study was to evaluate the feasibility of using
intravoxel incoherent motion imaging in crossed cerebellar diaschisis diagnosis in
subacute ischemic stroke patients by comparing results from intravoxel incoherent motion
imaging, single-photon emission computed tomography, and arterial spin-labeling perfusion
methods. In total, 39 patients with subacute ischemic stroke who underwent intravoxel
incoherent motion, arterial spin-labeling, and single-photon emission computed tomography
scanning were enrolled. Intravoxel incoherent motion-derived perfusion-related parameters
including fast diffusion coefficient, vascular volume fraction, arterial
spin-labeling-derived cerebral blood flow as well as single-photon emission computed
tomography-derived cerebral blood flow of bilateral cerebellum were measured. A crossed
cerebellar diaschisis-positive result was considered present with an asymmetry index ≥10%
of single-photon emission computed tomography. In the crossed cerebellar
diaschisis-positive group, fast diffusion coefficient, arterial spin-labeling-derived
cerebral blood flow, and computed tomography-derived cerebral blood flow of the
contralateral cerebellum decreased compared with those of the ipsilesional cerebellum;
whereas vascular volume fraction significantly increased. The National Institutes of
Health Stroke Scale score and infarct volume in the crossed cerebellar diaschisis-positive
group were significantly higher than those in the crossed cerebellar diaschisis-negative
group. A positive correlation was detected between the fast diffusion coefficient-based
asymmetry index and the single-photon emission computed tomography-based asymmetry index,
fast diffusion coefficient-based asymmetry, and arterial spin-labeling based asymmetry
index; whereas the vascular volume fraction-based asymmetry index value
had a negative correlation with the single-photon emission computed tomography-based
asymmetry index and arterial spin-labeling based asymmetry index. Furthermore, the area
under the receiver operating characteristic curve value of the arterial
spin-labeling-based asymmetry index was 0.923. The fast diffusion coefficient derived from
the intravoxel incoherent motion could be valuable for the assessment of crossed
cerebellar diaschisis in supratentorial stroke patients.
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Affiliation(s)
- Juan Wang
- 1 Department of Radiology, Renji Hospital, China.,2 Department of Radiology, Renji Hospital South Campus, China
| | - Shiteng Suo
- 1 Department of Radiology, Renji Hospital, China
| | - Jinyan Zu
- 1 Department of Radiology, Renji Hospital, China.,2 Department of Radiology, Renji Hospital South Campus, China
| | - Wanqiu Zhu
- 1 Department of Radiology, Renji Hospital, China
| | - Lijun Pan
- 1 Department of Radiology, Renji Hospital, China
| | - Shaoli Song
- 3 Department of Nuclear Medicine, Renji Hospital South Campus, China
| | - Yang Li
- 2 Department of Radiology, Renji Hospital South Campus, China
| | - Lei Li
- 2 Department of Radiology, Renji Hospital South Campus, China
| | - Zengai Chen
- 1 Department of Radiology, Renji Hospital, China.,2 Department of Radiology, Renji Hospital South Campus, China
| | - Jianrong Xu
- 1 Department of Radiology, Renji Hospital, China
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Can IVIM help predict HCC recurrence after hepatectomy? Eur Radiol 2019; 29:5791-5803. [PMID: 30972544 DOI: 10.1007/s00330-019-06180-1] [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] [Received: 11/06/2018] [Revised: 01/30/2019] [Accepted: 02/08/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To determine the diagnostic performance of intravoxel incoherent motion (IVIM) parameters to predict tumor recurrence after hepatectomy in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). MATERIALS AND METHODS One hundred and fifty-seven patients (mean age 52.54 ± 11.32 years, 87% male) with surgically and pathologically confirmed HCC were included. Regions of interests were drawn including the tumors by two independent radiologists. ADC and IVIM-derived parameters (true diffusion coefficient [D]; pseudodiffusion coefficient [D*]; pseudodiffusion fraction [f]) were obtained preoperatively. The Cox proportional hazards model was used to analyze the predictors associated with tumor recurrence after hepatectomy. RESULTS Forty-seven of 157 (29.9%) patients experienced tumor recurrence. The multivariate Cox proportional hazards model revealed that a D value < 0.985 × 10-3 mm2/s (hazard ratio (HR), 0.190; p = 0.023) was a risk factor for tumor recurrence. Additional risk factors included younger age (HR, 0.328; p = 0.034) and higher serum alpha-fetoprotein (AFP) level (HR, 2.079; p = 0.013). Further, receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of the obtained Cox regression model improved from 0.68 for the combination of AFP and age alone to 0.724 for the combination of D value, AFP, and age. CONCLUSION The D value derived from the IVIM model is a potential biomarker for the preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence. KEY POINTS • The recurrence rate of HCC after hepatectomy was higher in patients with ADC, D, and f values that were lower than the optimal cutoff values. • The optimal cutoff values of ADC, D, D*, and f for predicting recurrence in HBV associated HCC were 0.858 × 10-3 mm2/s, 0.985 × 10-3 mm2/s, 12.5 × 10-3 mm2/s, and 23.4%, respectively. • The D value derived from IVIM diffusion-weighted imaging may be a useful biomarker for preoperative prediction of recurrence after hepatectomy in patients with HCC. When combined with age and AFP levels, D can improve the predictive performance for tumor recurrence.
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Sansone M, Fusco R, Petrillo A. D-optimal design of b-values for precise intra-voxel incoherent motion imaging. Biomed Phys Eng Express 2019; 5. [DOI: 10.1088/2057-1976/ab12bb] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/22/2019] [Indexed: 12/28/2022]
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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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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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Xiang SF, Zhang XQ, Yang SJ, Hou B, Wang YF, Huo S, Dong XL, Yang Z. STROBE-A preliminary investigation of IVIM-DWI in cardiac imaging. Medicine (Baltimore) 2018; 97:e11902. [PMID: 30200075 PMCID: PMC6133472 DOI: 10.1097/md.0000000000011902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
This study aims to explore the possibility to apply intravoxel incoherent motion-magnetic resonance imaging (IVIM-MRI) in cardiac imaging.Multi-b-value diffusion-weighted imaging (DWI) sequence scanning was performed on 12 healthy volunteers. A double exponential model was adopted, and the b-value sequence was 0, 20, 60, 80, 120, 200, and 600 second/mm. The D-value, D*-value, and f-value of the anterior posterior and lateral walls of the ventricular septum were respectively measured on the short axis section of the heart, the parameters of the myocardium in different blood supply areas in each segment were recorded, and the measured data of these different segments were compared using analysis of variance.Among these 12 healthy volunteers, the D-value, D*-value, and f-value of these 72 segments were not exactly equal, the D-values of the myocardium in the 5th and 11th segment were lower than those in the 2nd, 3rd, 8th, and 9th segments, and the pairwise differences were statistically significant (P < .001). Furthermore, the difference in D-value between the 5th and 11th segments was not statistically significant (P = 1.000). The D*-value and f-value of the myocardium in the 5th and 11th segment were higher than those in the 2nd, 3rd, 8th, and 9th segments, and the pairwise differences were statistically significant (P < .001). Furthermore, the differences in D*-value and f-value between the 5th and 11th segments was not statistically significant (P = .214, .787).The intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) technique can quantitatively reflect the diffusion and blood perfusion status of the myocardium.
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Affiliation(s)
| | | | | | | | | | - Shuang Huo
- Department of Scientific Research, Handan Central Hospital, Handan, China
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Rong D, Mao Y, Hu W, Xu S, Wang J, He H, Li S, Zhang R. Intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic and non-metastatic lymph nodes in pancreatic ductal adenocarcinoma. Eur Radiol 2018; 28:2781-2789. [PMID: 29404768 DOI: 10.1007/s00330-017-5259-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/14/2017] [Accepted: 12/20/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate the diagnostic potential of intravoxel incoherent motion (IVIM) DWI for differentiating metastatic and non-metastatic lymph node stations (LNS) in pancreatic ductal adenocarcinoma (PDAC). METHODS 59 LNS histologically diagnosed following surgical resection from 15 patients were included. IVIM DWI with 12 b values was added to the standard MRI protocol. Evaluation of parameters was performed pre-operatively and included the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). Diagnostic performance of ADC, D, D* and f for differentiating between metastatic and non-metastatic LNS was evaluated using ROC analysis. RESULTS Metastatic LNS had significantly lower D, D*, f and ADC values than the non-metastatic LNS (p< 0.01). The best diagnostic performance was found in D, with an area under the ROC curve of 0.979, while the area under the ROC curve values of D*, f and ADC were 0.867, 0.855 and 0.940, respectively. The optimal cut-off values for distinguishing metastatic and non-metastatic lymph nodes were D = 1.180 × 10-3 mm2/s; D* = 14.750 × 10-3 mm2/s, f = 20.65 %, and ADC = 1.390 × 10-3 mm2/s. CONCLUSION IVIM DWI is useful for differentiating between metastatic and non-metastatic LNS in PDAC. KEY POINTS • IVIM DWI is feasible for diagnosing LN metastasis in PDAC. • Metastatic LNS has lower D, D*, f, ADC values than non-metastatic LNS. • D-value from IVIM model has best diagnostic performance, followed by ADC value. • D* has the lowest AUC value.
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Affiliation(s)
- Dailin Rong
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Yize Mao
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Hepato-Biliary-Pancreatic Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Wanming Hu
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Pathology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Shuhang Xu
- Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong Province, People's Republic of China
| | - Jun Wang
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Hepato-Biliary-Pancreatic Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
- Department of Ultrasound, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Haoqiang He
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Shengping Li
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Department of Hepato-Biliary-Pancreatic Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
| | - Rong Zhang
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
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Measurement and scan reproducibility of parameters of intravoxel incoherent motion in renal tumor and normal renal parenchyma: a preliminary research at 3.0 T MR. Abdom Radiol (NY) 2018; 43:1739-1748. [PMID: 29071436 DOI: 10.1007/s00261-017-1361-7] [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: 12/18/2022]
Abstract
PURPOSE To prospectively estimate measurement and scan reproducibility of parameters of intravoxel incoherent motion (IVIM) in renal tumors, normal renal cortex, and medulla. METHODS Twenty-four consecutive patients (twelve males and twelve females; median age 56.7 years, range 32-71 years) with 25 renal tumors (20 renal cell carcinomas, one urothelium carcinoma, three angiomyolipomas, and one oncocytoma) were examined twice using IVIM1 and IVIM2 with 9 and 16 b values, respectively, at 3.0 T. All the patients were re-scanned in 24-48 h. Regions of interest (ROIs) were placed in solid part of tumor, normal cortex, and medulla to derive IVIM parameters D (true diffusion coefficient), D* (pseudodiffusion coefficient), and f (perfusion fraction of pseudodiffusion). Differences in parameters between two IVIM sets and intra-observer, inter-observer, and scan-rescan differences were assessed using paired t tests. Intra-observer, inter-observer, and scan-rescan reproducibility were assessed by measuring coefficient of variation and Bland-Altman limits of agreements. RESULTS Intra-observer reproducibility of renal tumors, normal renal cortex, and medulla was excellent for apparent diffusion coefficient (ADC; CV: 3.45%-5.34%, BA-LA: -14% to 18%) and D (CV: 3.65% to 6.04%, BA-LA: -18% to 19%), good for f (CV: 11.96%-16.08%, BA-LA: -76.4% to 92.1% except f of medulla with CV of 32.59% and BA-LA of -76.4% to 92.1% in IVIM1), and poor for D* (CV: 25.0% to 75.4%, BA-LA: -111% to 150%). The same order was in inter-observer reproducibility analysis. Scan-rescan reproducibility was the worst of the three parameters. Renal medulla showed worse reproducibility than renal tumors and the normal cortex. The metrics of IVIM2 had better reproducibility than IVIM1. CONCLUSION Excellent reproducibility evaluation for ADC and D, good for f, and poor for D* derived from IVIM was performed in renal tumors, normal renal cortex, and medulla. D* has limited reliability and scan-rescan reproducibility should be improved.
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Intravoxel Incoherent Motion: Model-Free Determination of Tissue Type in Abdominal Organs Using Machine Learning. Invest Radiol 2018; 52:747-757. [PMID: 28742733 DOI: 10.1097/rli.0000000000000400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE For diffusion data sets including low and high b-values, the intravoxel incoherent motion model is commonly applied to characterize tissue. The aim of the present study was to show that machine learning allows a model-free approach to determine tissue type without a priori assumptions on the underlying physiology. MATERIALS AND METHODS In 8 healthy volunteers, diffusion data sets were acquired using an echo-planar imaging sequence with 16 b-values in the range between 0 and 1000 s/mm. Using the k-nearest neighbors technique, the machine learning algorithm was trained to distinguish abdominal organs (liver, kidney, spleen, muscle) using the signal intensities at different b-values as training features. For systematic variation of model complexity (number of neighbors), performance was assessed by calculation of the accuracy and the kappa coefficient (κ). Most important b-values for tissue discrimination were determined by principal component analysis. RESULTS The optimal trade-off between model complexity and overfitting was found in the range between K = 11 to 13. On "real-world" data not previously applied to optimize the algorithm, the k-nearest neighbors algorithm was capable to accurately distinguish tissue types with best accuracy of 94.5% and κ = 0.92 reached for intermediate model complexity (K = 11). The principal component analysis showed that most important b-values are (with decreasing importance): b = 1000 s/mm, b = 970 s/mm, b = 750 s/mm, b = 20 s/mm, b = 620 s/mm, and b = 40 s/mm. Applying a reduced set of 6 most important b-values, still a similar accuracy was achieved on the real-world data set with an average accuracy of 93.7% and a κ coefficient of 0.91. CONCLUSIONS Machine learning allows for a model-free determination of tissue type using intra voxel incoherent motion signal decay curves as features. The technique may be useful for segmentation of abdominal organs or distinction between healthy and pathological tissues.
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Li H, Zhang J, Zheng Z, Guo Y, Chen M, Xie C, Zhang Z, Mei Y, Feng Y, Xu Y. Preoperative histogram analysis of intravoxel incoherent motion (IVIM) for predicting microvascular invasion in patients with single hepatocellular carcinoma. Eur J Radiol 2018; 105:65-71. [PMID: 30017300 DOI: 10.1016/j.ejrad.2018.05.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 02/09/2023]
Abstract
PURPOSE To evaluate the value of intravoxel incoherent motion (IVIM) histogram analysis based on whole tumor volume in predicting microvascular invasion (MVI) of single hepatocellular carcinoma (HCC). MATERIALS AND METHODS The study enrolled 41 patients with pathologically proven HCCs who underwent IVIM diffusion-weighted imaging with nine b values and contrast-enhanced magnetic resonance imaging (MRI). Histogram parameters including mean; skewness; kurtosis; and percentiles (5th, 10th, 25th, 50th, 75th, 90th, 95th) were derived from apparent diffusion coefficient (ADC), perfusion fraction (f), true diffusion coefficient (D), and pseudo diffusion coefficient (D*). Quantitative histogram parameters and clinical data were compared between HCCs with and without MVI. For significant parameters, receiver operating characteristic (ROC) curves were further plotted to compare the diagnosis performance for identifying MVI. RESULTS The mean, 5th, 10th, 25th, 50th, and 75th percentiles of D, and the 5th, 10th, and 25th percentiles of ADC between HCCs with and without MVI were statistically significant (all P<0.05). The histogram parameters of D* and f showed no statistically significant differences between HCCs with and without MVI (all P>0.05). The areas under the ROC curves (AUCs) were 0.707-0.874 for D and 0.668-0.720 for ADC. The largest AUC of D (5th percentile) showed significantly higher accuracy than that of ADC or tumor size (P = 0.009-0.046). With a cut-off of 0.403 × 10-3 mm²/s, the 5th percentile of D value provided a sensitivity of 81% and a specificity of 85% in the prediction of MVI. CONCLUSIONS Histogram analysis of IVIM based on whole tumor volume can be useful for predicting MVI. The 5th percentile of D was most useful value to predict MVI of HCC.
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Affiliation(s)
- Hongxiang Li
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Jing Zhang
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Zeyu Zheng
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Yihao Guo
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Maodong Chen
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Caiqin Xie
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | | | - Yingjie Mei
- Philips Intergrated Solution Center, Guangzhou, PR China.
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
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Mürtz P, Sprinkart AM, Reick M, Pieper CC, Schievelkamp AH, König R, Schild HH, Willinek WA, Kukuk GM. Accurate IVIM model-based liver lesion characterisation can be achieved with only three b-value DWI. Eur Radiol 2018; 28:4418-4428. [PMID: 29671057 DOI: 10.1007/s00330-018-5401-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/19/2018] [Accepted: 02/21/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate a simplified intravoxel incoherent motion (IVIM) approach of diffusion-weighted imaging (DWI) with four b-values for liver lesion characterisation at 1.5 T. METHODS DWI data from a respiratory-gated MRI sequence with b = 0, 50, 250, 800 s/mm2 were retrospectively analysed in 173 lesions and 40 healthy livers. The apparent diffusion coefficient ADC = ADC(0,800) and IVIM-based parameters D1' = ADC(50,800), D2' =ADC(250,800), f1', f2', D*', ADClow = ADC(0,50), and ADCdiff=ADClow-D2' were calculated voxel-wise without fitting procedures. Differences between lesion groups were investigated. RESULTS Focal nodular hyperplasias were best discriminated from all other lesions by f1' with an area under the curve (AUC) of 0.989. Haemangiomas were best discriminated by D1' (AUC of 0.994). For discrimination between malignant and benign lesions, ADC(0,800) and D1' were best suited (AUC of 0.915 and 0.858, respectively). Discriminatory power was further increased by using a combination of D1' and f1'. CONCLUSION IVIM parameters D and f approximated from three b-values provided more discriminatory power between liver lesions than ADC determined from two b-values. The use of b = 0, 50, 800 s/mm2 was superior to that of b = 0, 250, 800 s/mm2. The acquisition of four instead of three b-values has no further benefit for lesion characterisation. KEY POINTS • Diffusion and perfusion characteristics are assessable with only three b-values. • Association of b = 0, 50, 800 s/mm2is superior to b = 0, 250, 800 s/mm2. • A fourth acquired b-value has no benefit for differential diagnosis. • For liver lesion characterisation, simplified IVIM analysis is superior to ADC determination. • Simplified IVIM approach guarantees numerically stable, voxel-wise results and short acquisition times.
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Affiliation(s)
- P Mürtz
- Department of Radiology, University of Bonn, Bonn, Germany.
- Radiologische Klinik der Universität Bonn, Sigmund-Freud-Straße 25, 53105, Bonn, Germany.
| | - A M Sprinkart
- Department of Radiology, University of Bonn, Bonn, Germany
| | - M Reick
- Department of Radiology, University of Bonn, Bonn, Germany
| | - C C Pieper
- Department of Radiology, University of Bonn, Bonn, Germany
| | | | - R König
- Department of Radiology, University of Bonn, Bonn, Germany
| | - H H Schild
- Department of Radiology, University of Bonn, Bonn, Germany
| | - W A Willinek
- Department of Radiology, University of Bonn, Bonn, Germany
| | - G M Kukuk
- Department of Radiology, University of Bonn, Bonn, Germany
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Becker AS, Boss A, Klarhoefer M, Finkenstaedt T, Wurnig MC, Rossi C. Investigation of the pulsatility of cerebrospinal fluid using cardiac-gated Intravoxel Incoherent Motion imaging. Neuroimage 2018; 169:126-133. [DOI: 10.1016/j.neuroimage.2017.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 02/09/2023] Open
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Luo M, Zhang L, Jiang XH, Zhang WD. Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia. Diagn Interv Radiol 2018; 23:263-271. [PMID: 28703102 DOI: 10.5152/dir.2017.16595] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE We aimed to explore whether intravoxel incoherent motion (IVIM)-related parameters of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) demonstrate differences that could be used to differentiate and improve diagnostic efficiency. METHODS A total of 27 patients, including 22 with HCC and 5 with FNH, underwent liver 3.0 T magnetic resonance imaging for routine sequences. They were concurrently examined by IVIM diffusion-weighted imaging (DWI) scanning with 11 different b values (0-800 s/mm2). IVIM-derived parameters, such as pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADCtotal), were quantified automatically by post-processing software and compared between HCC and FNH groups. A receiver operating characteristic (ROC) curve was then created to predict their diagnostic value. RESULTS D* was weak in terms of reproducibility among the other parameters. ADCtotal, D, and D* were significantly lower in the HCC group than in the FNH group, while f did not show a significant difference. ADCtotal and D had the largest area under the curve values (AUC; 0.915 and 0.897, respectively) and similarly high efficacy to differentiate the two conditions. CONCLUSION IVIM provides a new modality to differentiate the HCC and FNH. ADCtotal and D demonstrated outstanding and comparable diagnosing utility.
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Affiliation(s)
- Ma Luo
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
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Bertleff M, Domsch S, Weingärtner S, Zapp J, O'Brien K, Barth M, Schad LR. Diffusion parameter mapping with the combined intravoxel incoherent motion and kurtosis model using artificial neural networks at 3 T. NMR IN BIOMEDICINE 2017; 30:e3833. [PMID: 28960549 DOI: 10.1002/nbm.3833] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
Artificial neural networks (ANNs) were used for voxel-wise parameter estimation with the combined intravoxel incoherent motion (IVIM) and kurtosis model facilitating robust diffusion parameter mapping in the human brain. The proposed ANN approach was compared with conventional least-squares regression (LSR) and state-of-the-art multi-step fitting (LSR-MS) in Monte-Carlo simulations and in vivo in terms of estimation accuracy and precision, number of outliers and sensitivity in the distinction between grey (GM) and white (WM) matter. Both the proposed ANN approach and LSR-MS yielded visually increased parameter map quality. Estimations of all parameters (perfusion fraction f, diffusion coefficient D, pseudo-diffusion coefficient D*, kurtosis K) were in good agreement with the literature using ANN, whereas LSR-MS resulted in D* overestimation and LSR yielded increased values for f and D*, as well as decreased values for K. Using ANN, outliers were reduced for the parameters f (ANN, 1%; LSR-MS, 19%; LSR, 8%), D* (ANN, 21%; LSR-MS, 25%; LSR, 23%) and K (ANN, 0%; LSR-MS, 0%; LSR, 15%). Moreover, ANN enabled significant distinction between GM and WM based on all parameters, whereas LSR facilitated this distinction only based on D and LSR-MS on f, D and K. Overall, the proposed ANN approach was found to be superior to conventional LSR, posing a powerful alternative to the state-of-the-art method LSR-MS with several advantages in the estimation of IVIM-kurtosis parameters, which might facilitate increased applicability of enhanced diffusion models at clinical scan times.
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Affiliation(s)
- Marco Bertleff
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Domsch
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Weingärtner
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, USA
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Jascha Zapp
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Kieran O'Brien
- Center for Advanced Imaging, University of Queensland, St Lucia, QLD, Australia
| | - Markus Barth
- Center for Advanced Imaging, University of Queensland, St Lucia, QLD, Australia
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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