Staging liver fibrosis with various diffusion-weighted magnetic resonance imaging models

Table 1 Demographic and clinical data of the study population

Parameter	Patients	Healthy control
No. of participants	59	17
Sex (male: female)	27:32	9:8
Mean age (yr)	41 ± 12	36 ± 11
AST level (U/L)	46.46 ± 68.71	-
ALT level (U/L)	49.86 ± 70.84	-
Serum albumin (g/L)	41.58 ± 5.17	-
TBIL (μmol/L)	22.13 ± 20.10	-
Platelet (× 109/L)	190.20 ± 72.88	-

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; TBIL: Total bilirubin.

Table 2 Diffusion-weighted imaging-derived parameters’ means and SDs of healthy volunteers (F0) and patients with liver fibrosis stages 1-4 (F1-F4)

Stage	n	Mono-ADC (× 10-3 mm2/s)	IVIM-D (× 10-3 mm2/s)	IVIM-D* (× 10-3 mm2/s)	IVIM-f (%)	DKI-MD (× 10-3 mm2/s)	DKI-MK	SEM-DDC (× 10-3 mm2/s)	SEM-α	FROC-D (× 10-3 mm2/s)	FROC-β	FROC-μ (μm)	CTRW-D (× 10-3 mm2/s)	CTRW-α	CTRW-β
0	17	1.099 ± 0.074	0.893 ± 0.088	1.168 ± 0.200	0.248 ± 0.071	1.616 ± 0.191	0.855 ± 0.110	1.580 ± 0.286	0.586 ± 0.081	0.902 ± 0.065	0.609 ± 0.085	4.103 ± 0.218	1.209 ± 0.085	0.980 (0.973-0.994)	0.551 ± 0.092
1	14	1.134 ± 0.081	0.980 ± 0.076	1.135 ± 0.299	0.196 ± 0.063	1.554 ± 0.200	0.745 ± 0.117	1.540 ± 0.270	0.629 ± 0.078	0.946 ± 0.061	0.659 ± 0.084	4.011 ± 0.368	1.214 ± 0.091	0.987 (0.979-0.993)	0.596 ± 0.095
2	28	1.062 ± 0.095	0.880 ± 0.095	1.122 ± 0.287	0.225 ± 0.062	1.513 ± 0.183	0.838 ± 0.114	1.451 ± 0.229	0.607 ± 0.081	0.879 ± 0.078	0.636 ± 0.083	3.988 ± 0.324	1.158 ± 0.107	0.982 (0.954-0.993)	0.580 ± 0.094
3	7	1.015 ± 0.119	0.845 ± 0.145	1.067 ± 0.115	0.216 ± 0.068	1.465 ± 0.187	0.868 ± 0.141	1.414 ± 0.263	0.611 ± 0.095	0.831 ± 0.113	0.642 ± 0.085	3.866 ± 0.250	1.116 ± 0.114	0.956 (0.946-0.989)	0.595 ± 0.087
4	10	1.018 ± 0.091	0.860 ± 0.072	1.057 ± 0.161	0.201 ± 0.042	1.427 ± 0.191	0.825 ± 0.066	1.341 ± 0.220	0.633 ± 0.040	0.836 ± 0.085	0.663 ± 0.042	3.809 ± 0.269	1.110 ± 0.119	0.955 (0.942-0.989)	0.615 ± 0.048
F/H1		3.704	3.980	0.418	1.624	1.929	2.458	1.830	0.830	4.300	1.044	1.820	2.764	8.342	1.003
P value		0.009	0.006	0.795	0.178	0.115	0.053	0.133	0.511	0.004	0.391	0.134	0.034	0.080	0.412

¹F is calculated from ANOVA tests, and H is calculated from Kruskal-Wallis tests.

ADC: Apparent diffusion coefficient; IVIM-D: Intravoxel incoherent motion model-derived true diffusion coefficient; IVIM-D^*: Intravoxel incoherent motion model-derived pseudo-diffusion coefficient; IVIM-f: Intravoxel incoherent motion model-derived perfusion fraction; DKI-MD: Diffusion kurtosis imaging-derived apparent diffusivity; DKI-MK: Diffusion kurtosis imaging-derived excess kurtosis; SEM-DDC: Stretched exponential model-derived distributed diffusion coefficient; SEM-α: Stretched exponential model-derived intravoxel heterogeneity index; FROC-D: Fractional order calculus model-derived diffusion coefficient; FROC-β: Fractional order calculus model-derived fractional order parameter; FROC-μ: Fractional order calculus model-derived microstructural quantity; CTRW-D: Continuous-time random-walk model-derived anomalous diffusion coefficient; CTRW-α: Continuous-time random-walk model-derived temporal diffusion heterogeneity index; CTRW-β: Continuous-time random-walk model-derived spatial diffusion heterogeneity index.

Table 3 Spearman correlation coefficients of diffusion-weighted imaging -derived parameters with the liver fibrosis stages

		Mono-ADC	IVIM-D	IVIM-D*	IVIM-f	DKI-MD	DKI-MK	SEM-DDC	SEM-α	FROC-D	FROC-β	FROC-μ	CTRW-D	CTRW-α	CTRW-β
S	r value	-0.362b	-0.251a	-0.154	-0.138	-0.297b	0.000	-0.263a	0.129	-0.350b	0.149	-0.321b	-0.356b	-0.297b	0.199
	P value	0.001	0.029	0.184	0.233	0.009	0.999	0.022	0.268	0.002	0.199	0.005	0.002	0.009	0.085

^aP ≤ 0.05.

^bP ≤ 0.01.

ADC: Apparent diffusion coefficient; IVIM-D: Intravoxel incoherent motion model-derived true diffusion coefficient; IVIM-D^*: Intravoxel incoherent motion model-derived pseudo-diffusion coefficient; IVIM-f: Intravoxel incoherent motion model-derived perfusion fraction; DKI-MD: Diffusion kurtosis imaging-derived apparent diffusivity; DKI-MK: Diffusion kurtosis imaging-derived excess kurtosis; SEM-DDC: Stretched exponential model-derived distributed diffusion coefficient; SEM-α: Stretched exponential model-derived intravoxel heterogeneity index; FROC-D: Fractional order calculus model-derived diffusion coefficient; FROC-β: Fractional order calculus model-derived fractional order parameter; FROC-μ: Fractional order calculus model-derived microstructural quantity; CTRW-D: Continuous-time random-walk model-derived anomalous diffusion coefficient; CTRW-α: Continuous-time random-walk model-derived temporal diffusion heterogeneity index; CTRW-β: Continuous-time random-walk model-derived spatial diffusion heterogeneity index; S: Liver fibrosis stages.