Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2031-2039
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2031
Reproducibility study of intravoxel incoherent motion and apparent diffusion coefficient parameters in normal pancreas
Xiang Liu, Yi-Feng Wang, Xiao-Hui Qi, Zhi-Lei Zhang, Jiang-Yang Pan, Xue-Li Fan, Yu Du, Ying-Min Zhai, Qi Wang
Xiang Liu, Yi-Feng Wang, Xiao-Hui Qi, Zhi-Lei Zhang, Jiang-Yang Pan, Xue-Li Fan, Yu Du, Ying-Min Zhai, Qi Wang, Department of CT and MRI, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Author contributions: Liu X, Wang YF, and Wang Q designed the research study; Qi XH, Zhang ZL, Pan JY, and Fan XL performed the research; Du Y and Zhai YM contributed analytic tools; Liu X, Wang YF, and Wang Q analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Supported by The Fourth Hospital of Hebei Medical University, No. 20210423.
Institutional review board statement: This study was approved by the institutional review board of The Fourth Hospital of Hebei Medical University.
Informed consent statement: Informed consent was obtained from all participants.
Conflict-of-interest statement: There is no conflict of interest to disclose.
Data sharing statement: The data are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi Wang, Doctor, Chief Doctor, Department of CT and MRI, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang 050000, Hebei Province, China. 47400852@hebmu.edu.cn
Received: February 22, 2024
Revised: April 11, 2024
Accepted: May 27, 2024
Published online: July 27, 2024
Processing time: 151 Days and 9 Hours
Abstract
BACKGROUND

The consistency of pancreatic apparent diffusion coefficient (ADC) values and intravoxel incoherent motion (IVIM) parameter values across different magnetic resonance imaging (MRI) devices significantly impacts the patient’s diagnosis and treatment.

AIM

To explore consistency in image quality, ADC values, and IVIM parameter values among different MRI devices in pancreatic examinations.

METHODS

This retrospective study was approved by the local ethics committee, and informed consent was obtained from all participants. In total, 22 healthy volunteers (10 males and 12 females) aged 24-61 years (mean, 28.9 ± 2.3 years) underwent pancreatic diffusion-weighted imaging using 3.0T MRI equipment from three vendors. Two independent observers subjectively scored image quality and measured the pancreas’s overall ADC values and signal-to-noise ratios (SNRs). Subsequently, regions of interest (ROIs) were delineated for the IVIM parameters (true diffusion coefficient, pseudo-diffusion coefficient, and perfusion fraction) using post-processing software. These ROIs were on the head, body, and tail of the pancrease. The subjective image ratings were assessed using the kappa consistency test. Intraclass correlation coefficients (ICCs) and mixed linear models were used to evaluate each device’s quantitative parameter values. Finally, a pairwise analysis of IVIM parameter values across each device was performed using Bland-Altman plots.

RESULTS

The Kappa value for the subjective ratings of the different observers was 0.776 (P < 0.05). The ICC values for inter-observer and intra-observer agreements for the quantitative parameters were 0.803 [95% confidence interval (CI): 0.684-0.880] and 0.883 (95%CI: 0.760-0.945), respectively (P < 0.05). The ICCs for the SNR between different devices was comparable (P > 0.05), and the ICCs for the ADC values from different devices were 0.870, 0.707, and 0.808, respectively (P < 0.05). Notably, only a few statistically significant inter-device agreements were observed for different IVIM parameters, and among those, the ICC values were generally low. The mixed linear model results indicated differences (P < 0.05) in the f-value for the pancreas head, D-value for the pancreas body, and D-value for the pancreas tail obtained using different MRI machines. The Bland-Altman plots showed significant variability at some data points.

CONCLUSION

ADC values are consistent among different devices, but the IVIM parameters’ repeatability is moderate. Therefore, the variability in the IVIM parameter values may be associated with using different MRI machines. Thus, caution should be exercised when using IVIM parameter values to assess the pancreas.

Keywords: Intravoxel incoherent motion; Pancreas; Image quality; Consistency test

Core Tip: The purpose of this study was to investigate whether the intravoxel incoherent motion (IVIM) parameter values of the normal pancreas are consistent when imaging with different magnetic resonance imaging (MRI) devices, and it was found that the variability of IVIM parameter values may be related to the use of different MRI machines.