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Oshima Y, Ogiso S, Imai H, Nakamura M, Wakama S, Tomofuji K, Ito T, Fukumitsu K, Ishii T, Matsuda T, Taura K. Fluid dynamics analyses of the intrahepatic portal vein tributaries using 7-T MRI. HPB (Oxford) 2021; 23:1692-1699. [PMID: 33958282 DOI: 10.1016/j.hpb.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/25/2020] [Accepted: 04/06/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Assessing portal vein (PV) hemodynamics is an essential part of liver disease management/liver surgery, yet the optimal methods of assessing intrahepatic PV flow have not yet been established. This study investigated the usefulness of 7-Tesla MRI with hemodynamic analysis for detecting small flow changes within narrow intrahepatic PV branches. METHODS Flow data in the main PV was obtained by two methods, two-dimensional cine phase contrast-MRI (2D cine PC-MRI) and three-dimensional non-cine phase contrast-MRI (3D PC-MRI). Hemodynamic parameters, such as flow volume rate, flow velocity, and wall shear stress in intrahepatic PV branches were calculated before and after a meal challenge using 3D PC-MRI and hemodynamic analysis. RESULTS The hemodynamic parameters obtained using 3D PC-MRI and 2D cine PC-MRI were similar. All intrahepatic PV branches were clearly depicted in eight planes, and significant changes in flow volume rate were seen in three planes. Average and maximum velocities, cross-sectional area, and wall shear stress were similar between before and after a meal challenge in all planes. CONCLUSION 7-Tesla 3D PC-MRI combined with hemodynamic analysis is a promising tool for assessing intrahepatic PV flow and enables future studies in small animals to investigate PV hemodynamics associated with liver disease/postoperative liver recovery.
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Affiliation(s)
- Yu Oshima
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Satoshi Ogiso
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Hirohiko Imai
- Department of Systems Science, Graduate School of Informatics, Kyoto University, Kyoto, 606-8501, Japan
| | - Masanori Nakamura
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Satoshi Wakama
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Katsuhiro Tomofuji
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takashi Ito
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ken Fukumitsu
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takamichi Ishii
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tetsuya Matsuda
- Department of Systems Science, Graduate School of Informatics, Kyoto University, Kyoto, 606-8501, Japan
| | - Kojiro Taura
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Kemėšienė J, Rühle A, Gomolka R, Wurnig MC, Rossi C, Boss A. Advanced diffusion imaging of abdominal organs in different hydration states of the human body: stability of biomarkers. Heliyon 2021; 7:e06072. [PMID: 33553749 PMCID: PMC7848648 DOI: 10.1016/j.heliyon.2021.e06072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/24/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND MR diffusion weighted imaging (DWI) may provide important information regarding the pathophysiology of parenchymal abdominal organs. The purpose of our study was to investigate the stability of imaging biomarkers of diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in abdominal parenchymal organs regarding two body hydration states. METHODS Ten healthy volunteers twice underwent DWI of abdominal organs using a double-refocused spin-echo echo-planar imaging sequences with 11 different b-values (ranging from 0 to 1,500 s/mm2): after 4 h of fluid deprivation; 45 min following 1000 ml of water intake. Four different diffusion models were evaluated and compared: standard DWI, DKI with mono-exponential fitting, multistep algorithm with variable b-value threshold for IVIM, combined IVIM-Kurtosis; in four abdominal organs: kidneys, liver, spleen and psoas muscle. RESULTS Diffusion parameters from all four models remained similar for the renal parenchyma before and after the water challenge. Significant differences were found for the liver, spleen, and psoas muscle. The largest effects were seen for: the liver parenchyma after the water challenge by means of IVIM model's true diffusion (p < 0.02); the spleen, for IVIM's perfusion fraction (p < 0.03), the psoas muscle for the ADC value (p < 0.02). CONCLUSIONS Herein, we showed that diffusion parameters of the kidney remain remarkably stable regarding the hydration status. This may be attributed to the kidney-specific compensatory mechanisms. For the liver, spleen and psoas muscle the diffusion parameters were sensitive to changes of the hydration. This phenomenon needs to be considered when evaluating diffusion data of these organs.
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Affiliation(s)
- Jūratė Kemėšienė
- Department of Radiology, Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Lithuania
| | - Alexander Rühle
- Department of Molecular Radiation Oncology, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Ryszard Gomolka
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Moritz C. Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Cristina Rossi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
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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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Cox EF, Palaniyappan N, Aithal GP, Guha IN, Francis ST. Using MRI to study the alterations in liver blood flow, perfusion, and oxygenation in response to physiological stress challenges: Meal, hyperoxia, and hypercapnia. J Magn Reson Imaging 2018; 49:1577-1586. [PMID: 30353969 DOI: 10.1002/jmri.26341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/29/2018] [Accepted: 08/29/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Noninvasive assessment of dynamic changes in liver blood flow, perfusion, and oxygenation using MRI may allow detection of subtle hemodynamic alterations in cirrhosis. PURPOSE To assess the feasibility of measuring dynamic liver blood flow, perfusion, and T2 * alterations in response to meal, hypercapnia, and hyperoxia challenges. STUDY TYPE Prospective. SUBJECTS Ten healthy volunteers (HV) and 10 patients with compensated cirrhosis (CC). FIELD STRENGTH/SEQUENCE 3T; phase contrast, arterial spin labeling, and T 2 * mapping. ASSESSMENT Dynamic changes in portal vein and hepatic artery blood flow (using phase contrast MRI), liver perfusion (using arterial spin labeling), and blood oxygenation ( T 2 * mapping) following a meal challenge (660 kcal), hyperoxia (target PET O2 of 500 mmHg), and hypercapnia (target increase PET CO2 of ∼6 mmHg). STATISTICAL TESTS Tests between baseline and each challenge were performed using a paired two-tailed t-test (parametric) or Wilcoxon-signed-ranks test (nonparametric). Repeatability and reproducibility were determined by the coefficient of variation (CoV). RESULTS Portal vein velocity increased following the meal (70 ± 9%, P < 0.001) and hypercapnic (7 (5-11)%, P = 0.029) challenge, while hepatic artery flow decreased (-30 ± 18%, P = 0.005) following the meal challenge in HV. In CC patients, portal vein velocity increased (37 ± 13%, P = 0.012) without the decrease in hepatic artery flow following the meal. In both groups, the meal increased liver perfusion (HV: 82 ± 50%, P < 0.0001; CC: 27 (16-42)%, P = 0.011) with faster arrival time of blood (HV: -54 (-56-30)%, P = 0.074; CC: -42 ± 32%, P = 0.005). In HVs, T 2 * increased after the meal and in response to hyperoxia, with a decrease in hypercapnia (6 ± 8% P = 0.052; 3 ± 5%, P = 0.075; -5 ± 6%, P = 0.073, respectively), but no change in CC patients. Baseline between-session CoV <15% for blood flow and <10% for T 2 * measures. DATA CONCLUSION Dynamic changes in liver perfusion, blood flow, and oxygenation following a meal, hyperoxic, and hypercapnic challenges can be measured using noninvasive MRI and potentially be used to stratify patients with cirrhosis. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1577-1586.
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Affiliation(s)
- Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, School of Physics & Astronomy, University of Nottingham, Nottingham, UK
- NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Naaventhan Palaniyappan
- NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Guruprasad P Aithal
- NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - I Neil Guha
- NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, School of Physics & Astronomy, University of Nottingham, Nottingham, UK
- NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
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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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Cox EF, Palaniyappan N, Aithal GP, Guha IN, Francis ST. MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis. Eur Radiol Exp 2018. [PMCID: PMC6156698 DOI: 10.1186/s41747-018-0056-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Computed diffusion weighted imaging (cDWI) and voxelwise-computed diffusion weighted imaging (vcDWI) for oncologic liver imaging: A pilot study. Eur J Radiol Open 2018; 5:108-113. [PMID: 30101156 PMCID: PMC6084526 DOI: 10.1016/j.ejro.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/21/2018] [Accepted: 07/21/2018] [Indexed: 12/04/2022] Open
Abstract
Objective Aim of the study was to evaluate the influence of the selection of measured b-values on the precision of cDWI in the upper abdomen as well as on the lesion contrast of PET-positive liver metastases in cDWI and vcDWI. Methods We performed a retrospective analysis of 10 patients (4 m, 63.5 ± 12.9 y/o) with PET-positive liver metastases examined in 3 T-PET/MRI with b = 100,600,800,1000 and 1500s/mm2. cDWI (cb1000/cb1500) and vcDWI were computed based on following combinations: i) b = 100/600 s/mm2, ii) b = 100/800 s/mm2, iii) b = 100/1000s/mm2, iv) b = 100/600/1000s/mm2 v) all measured b-values. Mean signal intensity (SI) and standard deviation (SD) in the liver, spleen, kidney, bone marrow and in liver lesions were acquired. The coefficient of variation (CV = SD/SI), the differences of SI between measured and calculated high b-value images and the lesion contrast (SI lesion/liver) were computed. Results With increasing upper measured b-values, the CV in cDWI and vcDWI decreased (CV in the liver in cb1500: 0.42 with b100/600 s/mm2 and 0.28 with b100/b1000s/mm2) while the differences of measured and calculated b-value images decreased (in the liver in cb1500: 30.7% with b = 100/600 s/mm2, 19.7% with b100/b1000s/mm2). In diffusion-restricted lesions, lesion contrast was at least 1.6 in cb1000 and 1.4 in cb1500, respectively, with an upper measured b-value of b = 800 s/mm2 and 2.1 for vcDWI with an upper measured b-value of b = 1000s/mm2. Overall, the lesion contrast was superior in cb1500 and vcDWI compared to cb1000 (15% and 11%, respectively). Conclusion Measuring higher upper b-values seems to lead to more precise computed high b-value images and a decrease of CV. vcDWI provides a comparable lesion contrast to b = 1500s/mm2 and offers additionally the reduction of T2 shine-through effects. For vcDWI, measuring b = 1000s/mm2 as upper b-value seems to be necessary to guarantee good lesion visibility in the liver based on our preliminary results.
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Wurnig MC, Germann M, Boss A. Is there evidence for more than two diffusion components in abdominal organs? - A magnetic resonance imaging study in healthy volunteers. NMR IN BIOMEDICINE 2018; 31:e3852. [PMID: 29105178 DOI: 10.1002/nbm.3852] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 06/07/2023]
Abstract
The most commonly applied model for the description of diffusion-weighted imaging (DWI) data in perfused organs is bicompartmental intravoxel incoherent motion (IVIM) analysis. In this study, we assessed the ground truth of underlying diffusion components in healthy abdominal organs using an extensive DWI protocol and subsequent computation of apparent diffusion coefficient 'spectra', similar to the computation of previously described T2 relaxation spectra. Diffusion datasets of eight healthy subjects were acquired in a 3-T magnetic resonance scanner using 68 different b values during free breathing (equidistantly placed in the range 0-1005 s/mm2 ). Signal intensity curves as a function of the b value were analyzed in liver, spleen and kidneys using non-negative least-squares fitting to a distribution of decaying exponential functions with minimum amplitude energy regularization. In all assessed organs, the typical slow- and fast-diffusing components of the IVIM model were detected [liver: true diffusion D = (1.26 ± 0.01) × 10-3 mm2 /s, pseudodiffusion D* = (270 ± 44) × 10-3 mm2 /s; kidney cortex: D = (2.26 ± 0.07) × 10-3 mm2 /s, D* = (264 ± 78) × 10-3 mm2 /s; kidney medulla: D = (1.57 ± 0.28) × 10-3 mm2 /s, D* = (168 ± 18) × 10-3 mm2 /s; spleen: D = (0.91 ± 0.01) × 10-3 mm2 /s, D* = (69.8 ± 0.50) × 10-3 mm2 /s]. However, in the liver and kidney, a third component between D and D* was found [liver: D' = (43.8 ± 5.9) × 10-3 mm2 /s; kidney cortex: D' = (23.8 ± 11.5) × 10-3 mm2 /s; kidney medulla: D' = (5.23 ± 0.93) × 10-3 mm2 /s], whereas no third component was detected in the spleen. Fitting with a diffusion kurtosis model did not lead to a better fit of the resulting curves to the acquired data compared with apparent diffusion coefficient spectrum analysis. For a most accurate description of diffusion properties in the liver and the kidneys, a more sophisticated model seems to be required including three diffusion components.
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Affiliation(s)
- Moritz C Wurnig
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Manon Germann
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Andreas Boss
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
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The IVIM signal in the healthy cerebral gray matter: A play of spherical and non-spherical components. Neuroimage 2017; 152:340-347. [DOI: 10.1016/j.neuroimage.2017.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/27/2017] [Accepted: 03/02/2017] [Indexed: 12/12/2022] Open
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Boss A, Barth B, Filli L, Kenkel D, Wurnig MC, Piccirelli M, Reiner CS. Simultaneous multi-slice echo planar diffusion weighted imaging of the liver and the pancreas: Optimization of signal-to-noise ratio and acquisition time and application to intravoxel incoherent motion analysis. Eur J Radiol 2016; 85:1948-1955. [PMID: 27776645 DOI: 10.1016/j.ejrad.2016.09.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 09/02/2016] [Accepted: 09/05/2016] [Indexed: 01/02/2023]
Abstract
PURPOSE To optimize and test a diffusion-weighted imaging (DWI) echo-planar imaging (EPI) sequence with simultaneous multi-slice (SMS) excitation in the liver and pancreas regarding acquisition time (TA), number of slices, signal-to-noise ratio (SNR), image quality (IQ), apparent diffusion coefficient (ADC) quantitation accuracy, and feasibility of intravoxel incoherent motion (IVIM) analysis. MATERIALS AND METHODS Ten healthy volunteers underwent DWI of the upper abdomen at 3T. A SMS DWI sequence with CAIPIRINHA unaliasing technique (acceleration factors 2/3, denoted AF2/3) was compared to standard DWI-EPI (AF1). Four schemes were evaluated: (i) reducing TA, (ii) keeping TA identical with increasing number of averages, (iii) increasing number of slices with identical TA (iv) increasing number of b-values for IVIM. Acquisition schemes i-iii were evaluated qualitatively (reader score) and quantitatively (ADC values, SNR). RESULTS In scheme (i) no differences in SNR were observed (p=0.321-0.038) with reduced TA (AF2 increase in SNR/time 75.6%, AF3 increase SNR/time 102.4%). No SNR improvement was obtained in scheme (ii). Increased SNR/time could be invested in acquisition of more and thinner slices or higher number of b-values. Image quality scores were stable for AF2 but decreased for AF3. Only for AF3, liver ADC values were systematically lower. CONCLUSION SMS-DWI of the liver and pancreas provides substantially higher SNR/time, which either may be used for shorter scan time, higher slice resolution or IVIM measurements.
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Affiliation(s)
- Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland.
| | - Borna Barth
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Lukas Filli
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - David Kenkel
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Moritz C Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Marco Piccirelli
- Institute of Neuroradiology, University Hospital of Zurich, Switzerland
| | - Caecilia S Reiner
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
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Stieb S, Boss A, Wurnig MC, Özbay PS, Weiss T, Guckenberger M, Riesterer O, Rossi C. Non-parametric intravoxel incoherent motion analysis in patients with intracranial lesions: Test-retest reliability and correlation with arterial spin labeling. NEUROIMAGE-CLINICAL 2016; 11:780-788. [PMID: 27354956 PMCID: PMC4910187 DOI: 10.1016/j.nicl.2016.05.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 12/26/2022]
Abstract
Intravoxel incoherent motion (IVIM) analysis of diffusion imaging data provides biomarkers of true passive water diffusion and perfusion properties. A new IVIM algorithm with variable adjustment of the b-value threshold separating diffusion and perfusion effects was applied for cerebral tissue characterization in healthy volunteers, computation of test-retest reliability, correlation with arterial spin labeling, and assessment of applicability in a small cohort of patients with malignant intracranial masses. The main results of this study are threefold: (i) accounting for regional differences in the separation of the perfusion and the diffusion components improves the reliability of the model parameters; (ii) if differences in the b-value threshold are not accounted for, a significant tissue-dependent systematic bias of the IVIM parameters occurs; (iii) accounting for voxel-wise differences in the b-value threshold improves the correlation with CBF measurements in healthy volunteers and patients. The proposed algorithm provides a robust characterization of regional micro-vascularization and cellularity without a priori assumptions on tissue diffusion properties. The glioblastoma multiforme with its inherently high variability of tumor vascularization and tumor cell density may benefit from a non-invasive clinical characterization of diffusion and perfusion properties. The novel IVIM algorithm accounts for regional differences in the separation of the perfusion and the diffusion components. The algorithm improves the reliability of IVIM parameters. The algorithm improves the correlation with CBF in healthy volunteers and patients.
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Affiliation(s)
- Sonja Stieb
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland
| | - Moritz C Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland
| | - Pinar S Özbay
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland; Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland
| | - Oliver Riesterer
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland
| | - Cristina Rossi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland.
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Jafar MM, Parsai A, Miquel ME. Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients, in-vitro and in-vivo reproducibility. World J Radiol 2016; 8:21-49. [PMID: 26834942 PMCID: PMC4731347 DOI: 10.4329/wjr.v8.i1.21] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/10/2015] [Accepted: 12/07/2015] [Indexed: 02/06/2023] Open
Abstract
There is considerable disparity in the published apparent diffusion coefficient (ADC) values across different anatomies. Institutions are increasingly assessing repeatability and reproducibility of the derived ADC to determine its variation, which could potentially be used as an indicator in determining tumour aggressiveness or assessing tumour response. In this manuscript, a review of selected articles published to date in healthy extra-cranial body diffusion-weighted magnetic resonance imaging is presented, detailing reported ADC values and discussing their variation across different studies. In total 115 studies were selected including 28 for liver parenchyma, 15 for kidney (renal parenchyma), 14 for spleen, 13 for pancreatic body, 6 for gallbladder, 13 for prostate, 13 for uterus (endometrium, myometrium, cervix) and 13 for fibroglandular breast tissue. Median ADC values in selected studies were found to be 1.28 × 10(-3) mm(2)/s in liver, 1.94 × 10(-3) mm(2)/s in kidney, 1.60 × 10(-3) mm(2)/s in pancreatic body, 0.85 × 10(-3) mm(2)/s in spleen, 2.73 × 10(-3) mm(2)/s in gallbladder, 1.64 × 10(-3) mm(2)/s and 1.31 × 10(-3) mm(2)/s in prostate peripheral zone and central gland respectively (combined median value of 1.54×10(-3) mm(2)/s), 1.44 × 10(-3) mm(2)/s in endometrium, 1.53 × 10(-3) mm(2)/s in myometrium, 1.71 × 10(-3) mm(2)/s in cervix and 1.92 × 10(-3) mm(2)/s in breast. In addition, six phantom studies and thirteen in vivo studies were summarized to compare repeatability and reproducibility of the measured ADC. All selected phantom studies demonstrated lower intra-scanner and inter-scanner variation compared to in vivo studies. Based on the findings of this manuscript, it is recommended that protocols need to be optimised for the body part studied and that system-induced variability must be established using a standardized phantom in any clinical study. Reproducibility of the measured ADC must also be assessed in a volunteer population, as variations are far more significant in vivo compared with phantom studies.
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Assessment of Liver Perfusion by IntraVoxel Incoherent Motion (IVIM) Magnetic Resonance-Diffusion-Weighted Imaging: Correlation With Phase-Contrast Portal Venous Flow Measurements. J Comput Assist Tomogr 2015; 39:365-72. [PMID: 25700227 DOI: 10.1097/rct.0000000000000220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To prospectively verify, in vivo, Le Bihan's model of signal decay in magnetic resonance/diffusion-weighted imaging (intravoxel incoherent motion) in healthy liver parenchyma. METHODS Informed consent and institutional board approval were obtained. To measure both underfasting and postprandial conditions, apparent, slow, and fast diffusion (D*) coefficients and perfusion fraction of liver parenchyma, 40 healthy volunteers (19 women and 21 men) underwent a 3.0-T magnetic resonance imaging examination, including portal venous flow measurements by a 2-dimensional phase-contrast sequence, and multi-b diffusion-weighted imaging acquired before and 30 minutes after a 600-Kcal meal. Parameters were measured by fitting procedure with regions of interest drawn on the right liver lobe. Paired-sample t test was performed to search for any statistically significant difference between preprandial and postprandial values of each parameter and of portal flow. Pearson correlation coefficients were calculated to evaluate the relationship between portal flow increase and diffusion-weighted imaging parameter changes in postprandial conditions. Interobserver agreement for measurement of the intravoxel incoherent motion parameters was determined, both for preprandial and postprandial values. RESULTS Mean increase in postprandial portal flow was 98% (P < 0.0009). The t test did not show any statistically significant difference between the preprandial and postprandial values for apparent, slow diffusion coefficients and perfusion fraction (P ≥ 0.05), whereas a statistically significant postprandial increase (P < 0.01) of D* was detected. Correlation with portal venous flow increase at Pearson test was statistically significant for D* (P = 0.04) and nonsignificant for the other parameters. All the parameters showed wide variability, with a higher percent coefficient of variation for D*. Interobserver agreement was always greater than 0.70. CONCLUSIONS This study verifies Le Bihan's theory, confirming that in the liver, D* is influenced by perfusional changes related to portal venous flow.
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Winfield JM, Papoutsaki MV, Ragheb H, Morris DM, Heerschap A, ter Voert EGW, Kuijer JPA, Pieters IC, Douglas NHM, Orton M, de souza NM. Development of a diffusion-weighted MRI protocol for multicentre abdominal imaging and evaluation of the effects of fasting on measurement of apparent diffusion coefficients (ADCs) in healthy liver. Br J Radiol 2015; 88:20140717. [PMID: 25790061 PMCID: PMC4628478 DOI: 10.1259/bjr.20140717] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/04/2015] [Accepted: 03/18/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To assess the effect of fasting and eating on estimates of apparent diffusion coefficient (ADC) in the livers of healthy volunteers using a diffusion-weighted MRI protocol with b-values of 100, 500 and 900 s mm(-2) in a multicentre study at 1.5 T. METHODS 20 volunteers were scanned using 4 clinical 1.5-T MR scanners. Volunteers were scanned after fasting for at least 4 h and after eating a meal; the scans were repeated on a subsequent day. Median ADC estimates were calculated from all pixels in three slices near the centre of the liver. Analysis of variance (ANOVA) was used to assess the difference between ADC estimates in fasted and non-fasted states and between ADC estimates on different days. RESULTS ANOVA showed no difference between ADC estimates in fasted and non-fasted states (p = 0.8) nor between ADC estimates on different days (p = 0.8). The repeatability of the measurements was good, with coefficients of variation of 5.1% and 4.6% in fasted and non-fasted states, respectively. CONCLUSION There was no significant difference in ADC estimates between fasted and non-fasted measurements, indicating that the perfusion sensitivity of ADC estimates obtained from b-values of 100, 500 and 900 s mm(-2) is sufficiently low that changes in blood flow in the liver after eating are undetectable beyond the variability in the measurements. ADVANCES IN KNOWLEDGE Assessment of the effect of prandial state on ADC estimates is critical, in order to determine the appropriate patient preparation for biological validation in clinical trials.
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Affiliation(s)
- J M Winfield
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - M-V Papoutsaki
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - H Ragheb
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - D M Morris
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - A Heerschap
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - E G W ter Voert
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - J P A Kuijer
- Department Physics and Medical Technology, VU University Medical Center, Amsterdam, Netherlands
| | - I C Pieters
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, Netherlands
| | - N H M Douglas
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - M Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - N M de souza
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - on behalf of the QuIC-ConCePT Consortium
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, UK
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
- Department Physics and Medical Technology, VU University Medical Center, Amsterdam, Netherlands
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, Netherlands
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Arterial and portal venous liver perfusion using selective spin labelling MRI. Eur Radiol 2015; 25:1529-40. [DOI: 10.1007/s00330-014-3524-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/10/2014] [Accepted: 11/18/2014] [Indexed: 01/09/2023]
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16
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Impact of Measurement Parameters on Apparent Diffusion Coefficient Quantification in Diffusion-Weighted-Magnetic Resonance Imaging. Invest Radiol 2015; 50:46-56. [DOI: 10.1097/rli.0000000000000095] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Wurnig MC, Donati OF, Ulbrich E, Filli L, Kenkel D, Thoeny HC, Boss A. Systematic analysis of the intravoxel incoherent motion threshold separating perfusion and diffusion effects: Proposal of a standardized algorithm. Magn Reson Med 2014; 74:1414-22. [DOI: 10.1002/mrm.25506] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/02/2014] [Indexed: 12/23/2022]
Affiliation(s)
- Moritz C. Wurnig
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Olivio F. Donati
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Erika Ulbrich
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Lukas Filli
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - David Kenkel
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Harriet C. Thoeny
- Department of Diagnostic and Interventional Radiology; University Hospital Bern; Switzerland
| | - Andreas Boss
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
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Jajamovich GH, Dyvorne H, Donnerhack C, Taouli B. Quantitative liver MRI combining phase contrast imaging, elastography, and DWI: assessment of reproducibility and postprandial effect at 3.0 T. PLoS One 2014; 9:e97355. [PMID: 24840288 PMCID: PMC4026225 DOI: 10.1371/journal.pone.0097355] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 04/17/2014] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To quantify short-term reproducibility (in fasting conditions) and postprandial changes after a meal in portal vein (PV) flow parameters measured with phase contrast (PC) imaging, liver diffusion parameters measured with multiple b value diffusion-weighted imaging (DWI) and liver stiffness (LS) measured with MR elastography (MRE) in healthy volunteers and patients with liver disease at 3.0 T. MATERIALS AND METHODS In this IRB-approved prospective study, 30 subjects (11 healthy volunteers and 19 liver disease patients; 23 males, 7 females; mean age 46.5 y) were enrolled. Imaging included 2D PC imaging, multiple b value DWI and MRE. Subjects were initially scanned twice in fasting state to assess short-term parameter reproducibility, and then scanned 20 min. after a liquid meal. PV flow/velocity, LS, liver true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (PF) and apparent diffusion coefficient (ADC) were measured in fasting and postprandial conditions. Short-term reproducibility was assessed in fasting conditions by measuring coefficients of variation (CV) and Bland-Altman limits of agreement. Differences in MR metrics before and after caloric intake and between healthy volunteers and liver disease patients were assessed. RESULTS PV flow parameters, D, ADC and LS showed good to excellent short-term reproducibility in fasting state (CV <16%), while PF and D* showed acceptable and poor reproducibility (CV = 20.4% and 51.6%, respectively). PV flow parameters and LS were significantly higher (p<0.04) in postprandial state while liver diffusion parameters showed no significant change (p>0.2). LS was significantly higher in liver disease patients compared to healthy volunteers both in fasting and postprandial conditions (p<0.001). Changes in LS were significantly correlated with changes in PV flow (Spearman rho = 0.48, p = 0.013). CONCLUSIONS Caloric intake had no/minimal/large impact on diffusion/stiffness/portal vein flow, respectively. PC MRI and MRE but not DWI should be performed in controlled fasting state.
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Affiliation(s)
- Guido H. Jajamovich
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Hadrien Dyvorne
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Claudia Donnerhack
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Bachir Taouli
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- * E-mail:
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