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Liu X, Huang X, Han T, Li S, Xue C, Deng J, Zhou Q, Sun Q, Zhou J. Discrimination between microcystic meningioma and atypical meningioma using whole-lesion apparent diffusion coefficient histogram analysis. Clin Radiol 2022; 77:864-869. [PMID: 36030110 DOI: 10.1016/j.crad.2022.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 11/03/2022]
Abstract
AIM To explore the value of whole-lesion apparent diffusion coefficient (ADC) histogram analysis in discriminating microcystic meningioma (MCM) from atypical meningioma (AM). MATERIALS AND METHODS Clinical and preoperative MRI data of 20 patients with MCM and 26 patients with AM were analysed retrospectively. Whole-lesion apparent diffusion coefficient (ADC) histogram analysis was performed on each patient's lesion to obtain histogram parameters, including mean, variance, skewness, kurtosis, the 1st (ADCp1), 10th (ADCp10), 50th (ADCp50), 90th (ADCp90), and 99th (ADCp99) percentiles of ADC. The differences between the ADC histogram parameters of the two tumours were compared, and the receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of statistically significant parameters in distinguishing the two tumours. RESULTS The mean, ADCp1, ADCp10, ADCp50, and ADCp90 of MCM were greater than those of AM, and significant differences were observed in these parameters between MCM and AM (all p<0.05). ROC analysis showed that the mean had the highest area under the curve value (AUC) in distinguishing the two tumours (AUC = 0.852), when using 120.46 × 10-6 mm2/s as the optimal threshold, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for discriminating the two groups were 84.6%, 75%, 80.4%, 81.5%, and 78.9%, respectively. CONCLUSION Histogram analysis based on whole-lesion ADC maps was useful for discriminating between MCM from AM preoperatively, with the mean being the most promising potential parameter.
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Affiliation(s)
- X Liu
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - X Huang
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - T Han
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - S Li
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - C Xue
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - J Deng
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Q Zhou
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Q Sun
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - J Zhou
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China.
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Diffusion-weighted imaging and texture analysis: current role for diffuse liver disease. Abdom Radiol (NY) 2020; 45:3523-3531. [PMID: 33064169 DOI: 10.1007/s00261-020-02772-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/06/2020] [Accepted: 09/10/2020] [Indexed: 01/16/2023]
Abstract
Multiparametric MRI represents the primary imaging modality to assess diffuse liver disease, both in a qualitative and in a quantitative manner. Diffusion-weighted imaging (DWI) is among the imaging techniques that can be used to assess fibrosis due to its unique capability to assess microstructural changes at the tissue level. DWI is based on water mobility patterns and has the potential to become a non-invasive and non-destructive virtual biopsy to assess diffuse liver disease, overcoming sampling bias errors due to its three-dimensional imaging capabilities. Parallel to DWI, another quantitative method called texture analysis may be used to assess early and advanced diffused liver disease through quantifying spatial relationships in a global and local level, applying to any type of digital imaging technique like MRI or CT. Initial results using texture analysis hold great promise. In the current paper, we will review the role of DWI and texture analysis using MR images in assessing diffuse liver disease.
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Baseline 3D-ADC outperforms 2D-ADC in predicting response to treatment in patients with colorectal liver metastases. Eur Radiol 2019; 30:291-300. [PMID: 31209620 DOI: 10.1007/s00330-019-06289-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 05/13/2019] [Accepted: 05/28/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To examine the value of baseline 3D-ADC and to predict short-term response to treatment in patients with hepatic colorectal metastases (CLMs). METHODS Liver MR images of 546 patients with CLMs (2008-2015) were reviewed retrospectively and 68 patients fulfilled inclusion criteria. Patients had received systemic chemotherapy (n = 17), hepatic trans-arterial chemoembolization or TACE (n = 34), and 90Y radioembolization (n = 17). Baseline (pre-treatment) 3D-ADC (volumetric) of metastatic lesions was calculated employing prototype software. RECIST 1.1 was used to assess short-term response to treatment. Prediction of response to treatment by baseline 3D-ADC and 2D-ADC (ROI-based) was also compared in all patients. RESULTS Partial response to treatment (minimum 30% decrease in tumor largest transverse diameter) was seen in 35.3% of patients; 41.2% with systemic chemotherapy, 32.4% with TACE, and 35.3% with 90Y radioembolization (p = 0.82). Median baseline 3D-ADC was significantly lower in responding than in nonresponding lesions. Area under the curve (AUC) of 3D-ADC was 0.90 in 90Y radioembolization patients, 0.88 in TACE patients, and 0.77 in systemic chemotherapy patients (p < 0.01). Optimal prediction was observed with the 10th percentile of ADC (1006 × 10-6 mm2/s), yielding sensitivity and specificity of 77.4% and 91.3%, respectively. 3D-ADC outperformed 2D-ADC in predicting response to treatment (AUC; 0.86 vs. 0.71; p < 0.001). CONCLUSION Baseline 3D-ADC is a highly specific biomarker in predicting partial short-term response to treatment in hepatic CLMs. KEY POINTS • Baseline 3D-ADC is a highly specific biomarker in predicting response to different treatments in hepatic CLMs. • The prediction level of baseline ADC is better for90Y radioembolization than for systemic chemotherapy/TACE in hepatic CLMs. • 3D-ADC outperforms 2D-ADC in predicting short-term response to treatment in hepatic CLMs.
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Considering tumour volume for motion corrected DWI of colorectal liver metastases increases sensitivity of ADC to detect treatment-induced changes. Sci Rep 2019; 9:3828. [PMID: 30846790 PMCID: PMC6405765 DOI: 10.1038/s41598-019-40565-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 02/12/2019] [Indexed: 01/20/2023] Open
Abstract
ADC is a potential post treatment imaging biomarker in colorectal liver metastasis however measurements are affected by respiratory motion. This is compounded by increased statistical uncertainty in ADC measurement with decreasing tumour volume. In this prospective study we applied a retrospective motion correction method to improve the image quality of 15 tumour data sets from 11 patients. We compared repeatability of ADC measurements corrected for motion artefact against non-motion corrected acquisition of the same data set. We then applied an error model that estimated the uncertainty in ADC repeatability measurements therefore taking into consideration tumour volume. Test-retest differences in ADC for each tumour, was scaled to their estimated measurement uncertainty, and 95% confidence limits were calculated, with a null hypothesis that there is no difference between the model distribution and the data. An early post treatment scan (within 7 days of starting treatment) was acquired for 12 tumours from 8 patients. When accounting for both motion artefact and statistical uncertainty due to tumour volumes, the threshold for detecting significant post treatment changes for an individual tumour in this data set, reduced from 30.3% to 1.7% (95% limits of agreement). Applying these constraints, a significant change in ADC (5th and 20th percentiles of the ADC histogram) was observed in 5 patients post treatment. For smaller studies, motion correcting data for small tumour volumes increased statistical efficiency to detect post treatment changes in ADC. Lower percentiles may be more sensitive than mean ADC for colorectal metastases.
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Sheng RF, Jin KP, Yang L, Wang HQ, Liu H, Ji Y, Fu CX, Zeng MS. Histogram Analysis of Diffusion Kurtosis Magnetic Resonance Imaging for Diagnosis of Hepatic Fibrosis. Korean J Radiol 2018; 19:916-922. [PMID: 30174481 PMCID: PMC6082766 DOI: 10.3348/kjr.2018.19.5.916] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 02/09/2018] [Indexed: 12/22/2022] Open
Abstract
Objective To investigate the diagnostic value of diffusion kurtosis imaging (DKI) histogram analysis in hepatic fibrosis staging. Materials and Methods Thirty-six rats were divided into carbon tetrachloride-induced fibrosis groups (6 rats per group for 2, 4, 6, and 8 weeks) and a control group (n = 12). MRI was performed using a 3T scanner. Histograms of DKI were obtained for corrected apparent diffusion (D), kurtosis (K) and apparent diffusion coefficient (ADC). Mean, median, skewness, kurtosis and 25th and 75th percentiles were generated and compared according to the fibrosis stage and inflammatory activity. Results A total of 35 rats were included, and 12, 5, 5, 6, and 7 rats were diagnosed as F0–F4. The mean, median, 25th and 75th percentiles, kurtosis of D map, median, 25th percentile, skewness of K map, and 75th percentile of ADC map demonstrated significant correlation with fibrosis stage (r = −0.767 to 0.339, p < 0.001 to p = 0.039). The fibrosis score was the independent variable associated with histogram parameters compared with inflammatory activity grade (p < 0.001 to p = 0.041), except the median of K map (p = 0.185). Areas under the receiver operating characteristic curve of D were larger than K and ADC maps in fibrosis staging, although no significant differences existed in pairwise comparisons (p = 0.0512 to p = 0.847). Conclusion Corrected apparent diffusion of DKI histogram analysis provides added value and better diagnostic performance to detect various liver fibrosis stages compared with ADC.
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Affiliation(s)
- Ruo-Fan Sheng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Kai-Pu Jin
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Li Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - He-Qing Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Hao Liu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
| | - Yuan Ji
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Cai-Xia Fu
- MR Collaboration NEA, Siemens Ltd. China, Shanghai 201318, China
| | - Meng-Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
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Beckers RCJ, Beets-Tan RGH, Schnerr RS, Maas M, da Costa Andrade LA, Beets GL, Dejong CH, Houwers JB, Lambregts DMJ. Whole-volume vs. segmental CT texture analysis of the liver to assess metachronous colorectal liver metastases. Abdom Radiol (NY) 2017; 42:2639-2645. [PMID: 28555265 DOI: 10.1007/s00261-017-1190-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE It is unclear whether changes in liver texture in patients with colorectal cancer are caused by diffuse (e.g., perfusional) changes throughout the liver or rather based on focal changes (e.g., presence of occult metastases). The aim of this study is to compare a whole-liver approach to a segmental (Couinaud) approach for measuring the CT texture at the time of primary staging in patients who later develop metachronous metastases and evaluate whether assessing CT texture on a segmental level is of added benefit. METHODS 46 Patients were included: 27 patients without metastases (follow-up >2 years) and 19 patients who developed metachronous metastases within 24 months after diagnosis. Volumes of interest covering the whole liver were drawn on primary staging portal-phase CT. In addition, each liver segment was delineated separately. Mean gray-level intensity, entropy (E), and uniformity (U) were derived with different filters (σ0.5-2.5). Patients/segments without metastases and patients/segments that later developed metachronous metastases were compared using independent samples t tests. RESULTS Absolute differences in entropy and uniformity between the group without metastases and the group with metachronous metastases group were consistently smaller for the segmental approach compared to the whole-liver approach. No statistically significant differences were found in the texture measurements between both groups. CONCLUSIONS In this small patient cohort, we could not demonstrate a clear predictive value to identify patients at risk of developing metachronous metastases within 2 years. Segmental CT texture analysis of the liver probably has no additional benefit over whole-liver texture analysis.
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Affiliation(s)
- R C J Beckers
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R G H Beets-Tan
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R S Schnerr
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M Maas
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L A da Costa Andrade
- Medical Imaging Department and Faculty of Medicine, University Hospital of Coimbra, Coimbra, Portugal
| | - G L Beets
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C H Dejong
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Department of Surgery, RWTH Universitätsklinikum Aachen, Aachen, Germany
| | - J B Houwers
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - D M J Lambregts
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Sheng RF, Wang HQ, Jin KP, Yang L, Liu H, Ji Y, Fu CX, Zeng MS. Histogram analyses of diffusion kurtosis indices and apparent diffusion coefficient in assessing liver regeneration after ALPPS and a comparative study with portal vein ligation. J Magn Reson Imaging 2017. [PMID: 28640476 DOI: 10.1002/jmri.25793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ruo-fan Sheng
- Department of Radiology, Zhongshan Hospital; Fudan University; Shanghai Institute of Medical Imaging; Shanghai P.R. China
| | - He-qing Wang
- Department of Radiology, Zhongshan Hospital; Fudan University; Shanghai Institute of Medical Imaging; Shanghai P.R. China
| | - Kai-pu Jin
- Department of Radiology, Zhongshan Hospital; Fudan University; Shanghai Institute of Medical Imaging; Shanghai P.R. China
| | - Li Yang
- Department of Radiology, Zhongshan Hospital; Fudan University; Shanghai Institute of Medical Imaging; Shanghai P.R. China
| | - Hao Liu
- Department of Radiology, Zhongshan Hospital; Fudan University; Shanghai Institute of Medical Imaging; Shanghai P.R. China
| | - Yuan Ji
- Department of Pathology, Zhongshan Hospital; Fudan University; Shanghai P.R. China
| | | | - Meng-su Zeng
- Department of Radiology, Zhongshan Hospital; Fudan University; Shanghai Institute of Medical Imaging; Shanghai P.R. China
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Matos AP, Altun E, Ramalho M, Velloni F, AlObaidy M, Semelka RC. An overview of imaging techniques for liver metastases management. Expert Rev Gastroenterol Hepatol 2016; 9:1561-76. [PMID: 26414180 DOI: 10.1586/17474124.2015.1092873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Evaluation of liver metastases is one of the most common indications for liver imaging. Imaging plays a key role in the of assessment liver metastases. A variety of imaging techniques, including ultrasonography, computed tomography, MRI and PET combined with CT scan are available for diagnosis, planning treatment, and follow-up treatment response. In this paper, the authors present the role of imaging for the assessment of liver metastases and the contribution of each of the different imaging techniques for their evaluation and management. Following recent developments in the field of oncology, the authors also present the importance of imaging for the assessment of liver metastases response to therapy. Finally, future perspectives on imaging of liver metastases are presented.
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Affiliation(s)
- António P Matos
- a University of North Carolina, Department of Radiology, Chapel Hill, NC, USA
| | - Ersan Altun
- a University of North Carolina, Department of Radiology, Chapel Hill, NC, USA
| | - Miguel Ramalho
- a University of North Carolina, Department of Radiology, Chapel Hill, NC, USA
| | - Fernanda Velloni
- a University of North Carolina, Department of Radiology, Chapel Hill, NC, USA
| | - Mamdoh AlObaidy
- a University of North Carolina, Department of Radiology, Chapel Hill, NC, USA
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Ni P, Lin Y, Zhong Q, Chen Z, Sandrasegaran K, Lin C. Technical advancements and protocol optimization of diffusion-weighted imaging (DWI) in liver. Abdom Radiol (NY) 2016; 41:189-202. [PMID: 26830624 DOI: 10.1007/s00261-015-0602-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
An area of rapid advancement in abdominal MRI is diffusion-weighted imaging (DWI). By measuring diffusion properties of water molecules, DWI is capable of non-invasively probing tissue properties and physiology at cellular and macromolecular level. The integration of DWI as part of abdominal MRI exam allows better lesion characterization and therefore more accurate initial diagnosis and treatment monitoring. One of the most technical challenging, but also most useful abdominal DWI applications is in liver and therefore requires special attention and careful optimization. In this article, the latest technical developments of DWI and its liver applications are reviewed with the explanations of the technical principles, recommendations of the imaging parameters, and examples of clinical applications. More advanced DWI techniques, including Intra-Voxel Incoherent Motion (IVIM) diffusion imaging, anomalous diffusion imaging, and Diffusion Kurtosis Imaging (DKI) are discussed.
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Affiliation(s)
- Ping Ni
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Yuning Lin
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Qun Zhong
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Ziqian Chen
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Kumar Sandrasegaran
- Department of Radiology and Imaging Science, Indiana University School of Medicine, 950 West Walnut St. R2 E124, Indianapolis, IN, 46202, USA
| | - Chen Lin
- Department of Radiology and Imaging Science, Indiana University School of Medicine, 950 West Walnut St. R2 E124, Indianapolis, IN, 46202, USA.
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