Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma

Abstract

The morbidity and mortality of hepatocellular carcinoma (HCC) rank 6^th and 4^th, respectively, among malignant tumors worldwide. Traditional diffusion-weighted imaging (DWI) uses the apparent diffusion coefficient (ADC) obtained by applying the monoexponential model to reflect water molecule diffusion in active tissue; however, the value of ADC is affected by microcirculation perfusion. Using a biexponential model, intravoxel incoherent motion (IVIM)-DWI quantitatively measures information related to pure water molecule diffusion and microcirculation perfusion, thus compensating for the shortcomings of DWI. The number of studies examining the application of IVIM-DWI in patients with HCC has gradually increased over the last few years, and many results show that IVIM-DWI has vital value for HCC differentiation, pathological grading, and predicting and evaluating the treatment response. The present study principally reviews the principle of IVIM-DWI and its research progress in HCC differentiation, pathological grading, predicting and evaluating the treatment response, predicting postoperative recurrence and predicting gene expression prediction.

Keywords: Hepatocellular carcinoma; Intravoxel incoherent motion; Differentiation; Pathological grading; Treatment response; Gene expression

Core Tip: Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) quantitatively measures information related to pure water molecule diffusion and microcirculation perfusion using a biexponential model, thus compensating for the shortcomings of traditional DWI. The number of studies assessing IVIM-DWI in patients with hepatocellular carcinoma (HCC) has gradually increased over the last few years. This review, which is based on the literature, identified an imaging biomarker for HCC differentiation, pathological grading, predicting and evaluating the treatment response, predicting postoperative recurrence and predicting gene expression prediction. The results of this analysis show that IVIM-DWI has important value in the treatment and diagnosis of HCC.