|
1
|
Vasquez JA, Brown M, Woolsey M, Abdul-Ghani M, Katabathina V, Deng S, Blangero J, Clarke GD. Reproducibility and Repeatability of Intravoxel Incoherent Motion MRI Acquisition Methods in Liver. J Magn Reson Imaging 2024; 60:1691-1703. [PMID: 38240167 PMCID: PMC11258206 DOI: 10.1002/jmri.29249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Intravoxel incoherent motion (IVIM) diffusion weighted MRI (DWI) has potential for evaluating hepatic fibrosis but image acquisition technique influence on diffusion parameter estimation bears investigation. PURPOSE To minimize variability and maximize repeatably in abdominal DWI in terms of IVIM parameter estimates. STUDY TYPE Prospective test-retest and image quality comparison. SUBJECTS Healthy volunteers (3F/7M, 29.9 ± 12.9 years) and Family Study subjects (18F/12M, 51.7 ± 16.7 years), without and with liver steatosis. FIELD STRENGTH/SEQUENCE Abdominal single-shot echo-planar imaging (EPI) and simultaneous multi-slice (SMS) DWI sequences with respiratory triggering (RT), breath-holding (BH), and navigator echo (NE) at 3 Tesla. ASSESSMENT SMS-BH, EPI-NE, and SMS-RT data from twice-scanned healthy volunteers were analyzed using 6 × b-values (0-800 s⋅mm-2) and lower (LO) and higher (HI) b-value ranges. Family Study subjects were scanned using SMS and standard EPI sequences. The biexponential IVIM model was used to estimate fast-diffusion coefficient (Df), fraction of fast diffusion (f), and slow-diffusion coefficient (Ds). Scan time, estimated signal-to-noise ratio (eSNR), eSNR per acquisition, and distortion ratio were compared. STATISTICAL TESTS Coefficients of variation (CoV) and Bland Altman analyses were performed for test-retest repeatability. Interclass correlation coefficient (ICC) assessed interobserver agreement with P < 0.05 deemed significant. RESULTS Within-subject CoVs among volunteers (N = 10) for f and Ds were lowest in EPI-NE-LO (11.6%) and SMS-RT-HI (11.1%). Inter-observer ICCs for f and Ds were highest for EPI-NE-LO (0.63) and SMS-RT-LO (0.76). Df could not be estimated for most subjects. Estimated eSNR (EPI = 21.9, SMS = 4.7) and eSNR time (EPI = 6.7, SMS = 16.6) were greater for SMS, with less distortion in the liver region (DR-PE: EPI = 23.6, SMS = 13.1). DATA CONCLUSION Simultaneous multislice acquisitions had significantly less variability and higher ICCs of Ds, higher eSNR, less distortion, and reduced scan time compared to EPI. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Juan A. Vasquez
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Marissa Brown
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Mary Woolsey
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Mohammad Abdul-Ghani
- Diabetes Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Venkata Katabathina
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Shengwen Deng
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - John Blangero
- Department of Human Genetics, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Geoffrey D. Clarke
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| |
Collapse
|
|
2
|
Loh M, Führes T, Stuprich C, Benkert T, Bickelhaupt S, Uder M, Laun FB. Effect of simultaneous multislice imaging, slice properties, and repetition time on the measured magnetic resonance biexponential intravoxel incoherent motion in the liver. PLoS One 2024; 19:e0306996. [PMID: 39121035 PMCID: PMC11315316 DOI: 10.1371/journal.pone.0306996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/26/2024] [Indexed: 08/11/2024] Open
Abstract
OBJECTIVES This study aims to investigate the previously reported dependency of intravoxel incoherent motion (IVIM) parameters on simultaneous multislice (SMS) acquisition and repetition time (TR). This includes the influence of slice thickness, slice gaps, and slice order on measured IVIM parameters. MATERIALS AND METHODS Diffusion-weighted imaging (DWI) of the liver was performed on 10 healthy volunteers (aged 20-30 years) at 3T with a slice thickness of 5 mm, a slice gap of 5 mm, and a linear slice order. Diffusion-weighted images were acquired with 19 b-values (0-800 s/mm2) using both conventional slice excitation with an acceleration factor of one (AF1) and SMS excitation with an acceleration factor of three (AF3). Each of these measurements were carried out with two repetition times (TRs)- 1,300 ms (prefix s) and 4,500 ms (prefix l)-resulting in four different combinations: sAF1, sAF3, lAF1, and lAF3. Five volunteers underwent additional measurements using a 10 mm slice thickness and with AF1. Median signal values in the liver were used to determine the biexponential IVIM parameters. Statistical significances were assessed using the Kruskal-Wallis test, Wilcoxon signed-rank test, and Student's t-test. In-silico investigations were also used to interpret the data. RESULTS There were no significant differences between the biexponential IVIM parameters acquired from sAF1, sAF3, lAF1, and lAF3. Median values of the perfusion fraction f were as follows: 29.9% (sAF1), 26.9% (sAF3), 28.1% (lAF1), and 27.5% (lAF3). In the 10 mm-thick slices, f decreased from 31.3% (lAF1) to 27.4% (sAF1) (p = 0.141). CONCLUSION The slice excitation mode did not appear to have any significant influence on the biexponential IVIM parameters. However, our simulations, as well as values reported from previous publications, show that slice thickness, slice gaps, and slice order are relevant and should thus be reported in IVIM studies.
Collapse
Affiliation(s)
- Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobit Führes
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Stuprich
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Sebastian Bickelhaupt
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
|
3
|
Yu T, Li L, Shi J, Gong X, Cheng Y, Wang W, Cao Y, Cao M, Jiang F, Wang L, Wang X, Zhang J. Predicting histopathological types and molecular subtype of breast tumors: A comparative study using amide proton transfer-weighted imaging, intravoxel incoherent motion and diffusion kurtosis imaging. Magn Reson Imaging 2024; 105:37-45. [PMID: 37890802 DOI: 10.1016/j.mri.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/07/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE To evaluate the predictive performance of multiparameter and histogram features derived from amide proton transfer-weighted imaging (APTWI), intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) for histopathological types of breast tumors. METHODS Region of interest (ROI) was delineated by outlining the largest slice of the tumor on the false-color images of the DKI, IVIM and APTWI parameters, and extracted the histogram features. Receiver operating characteristic (ROC) curve was used to evaluate the performance of parameters in predicting benign and malignant breast lesions, molecular prognostic biomarkers, lymph node status, and subtypes of breast lesions. The Spearman correlation coefficient was used to determine the correlations between each parameter and clinical-pathological factors. RESULTS All 52 breast lesions were enrolled in this prospective study, including 8 benign lesions and 44 breast cancers. To diagnose malignant and benign breast lesions, the value of APT (min) performed best, with the AUC reaching 0.983. According to the different imaging methods, the APTWI performed best. To predict the positive status of ER, PR, Ki67, the value of Dapp (uniformity), Dapp (uniformity), f (entropy) performed best, with the AUC values reaching 0.743, 0.770, 0.848, respectively. For the identification of Luminal B, HER2-enriched, and TNBC breast cancers, Kapp (max), f (kurtosis), and Dapp (uniformity) performed best, with AUC values reaching 0.679, 0.826, 0.771, respectively. CONCLUSION This study found the APTWI, IVIM and DKI parameters could diagnose breast cancer. The histogram features of DKI and IVIM, based on tumor heterogeneity, may help to predict breast cancer subtypes.
Collapse
Affiliation(s)
- Tao Yu
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Lan Li
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Jinfang Shi
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Xueqin Gong
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Yue Cheng
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Wei Wang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Ying Cao
- School of Medicine, Chongqing University, Chongqing 400030, China
| | - Meimei Cao
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Fujie Jiang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Lu Wang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Xiaoxia Wang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China.
| |
Collapse
|
|
4
|
Makino Y, Ohno N, Miyati T, Hori N, Matsuura Y, Kobayashi S, Gabata T. Tri- and bi-exponential diffusion analyses of the kidney: effect of respiratory-controlled acquisition on diffusion parameters. Radiol Phys Technol 2023; 16:478-487. [PMID: 37523080 DOI: 10.1007/s12194-023-00734-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
This study examined whether respiratory-controlled acquisition influences diffusion parameters obtained with intravoxel incoherent motion (IVIM) analysis using tri-exponential and bi-exponential models. Ten healthy volunteers were examined on a 3.0 T MRI system to obtain coronal diffusion-weighted images of both kidneys. The participants were scanned twice using respiratory-triggering (RT) and free-breathing (FB) acquisition to assess the repeatability of the measurements. We determined mean signal intensities in the renal cortex at each b value. Then, perfusion-related diffusion coefficient (Dp), fast-free diffusion coefficient (Df), slow-restricted diffusion coefficient (Ds), and their corresponding fractions (Fp, Ff, and Fs, respectively) were calculated using tri-exponential function. Moreover, perfusion-related diffusion coefficient (D*), the fraction (F), and perfusion-independent diffusion coefficient (D) were calculated using bi-exponential function. Normalized root-mean-square errors for the tri- and bi-exponential analyses (nRMSEtri and nRMSEbi, respectively) were determined to assess the deviation of the fitted to measured data, i.e., the fitting accuracy. Additionally, repeatability coefficients (RCs) were calculated from Bland-Altman plots to evaluate the repeatability of each diffusion parameter. These values were compared between the RT and FB groups. Dp and D* in the RT group were significantly lower than those in the FB group (P < 0.05). In addition, the RT group showed significantly lower nRMSEtri and nRMSEbi values than those in the FB group (P < 0.05). Moreover, Dp, Ds, Fs, and D* at RT showed lower RC values than those at FB. Respiratory-controlled acquisition affects perfusion-related diffusion parameters of the kidney obtained using tri-exponential and bi-exponential analyses.
Collapse
Affiliation(s)
- Yuki Makino
- Radiology Division, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 9208641, Japan
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 9200942, Japan.
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 9200942, Japan
| | - Naoki Hori
- Radiology Division, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 9208641, Japan
| | - Yukihiro Matsuura
- Radiology Division, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 9208641, Japan
| | - Satoshi Kobayashi
- Radiology Division, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 9208641, Japan
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 9200942, Japan
- Department of Radiology, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 9208641, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, 9208641, Japan
| |
Collapse
|
|
5
|
Loh M, Führes T, Stuprich C, Uder M, Saake M, Laun FB. Influence of saturation effects on biexponential liver intravoxel incoherent motion. Magn Reson Med 2023; 90:270-279. [PMID: 36861449 DOI: 10.1002/mrm.29622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/20/2023] [Accepted: 02/07/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE Studies on intravoxel incoherent motion (IVIM) imaging in the liver have been carried out with different acquisition protocols. The number of acquired slices and the distances between slices can influence IVIM measurements due to saturation effects, but these effects have often been disregarded. This study investigated differences in biexponential IVIM parameters between two slice settings. METHODS Fifteen healthy volunteers (21-30 years) were examined at a field strength of 3 T. Diffusion-weighted images of the abdomen were acquired with 16 b values (0-800 s/mm2 ), with four slices for the few slices setting and 24-27 slices for the many slices setting. Regions of interest were manually drawn in the liver. The data were fitted with a monoexponential signal curve and a biexponential IVIM curve, and biexponential IVIM parameters were determined. The dependence on the slice setting was assessed with Student's t test for paired samples (normally distributed IVIM parameters) and the Wilcoxon signed-rank test (non-normally distributed parameters). RESULTS None of the parameters were significantly different between the settings. For few slices and many slices, respectively, the mean values (SDs) for D $$ D $$ were 1.21 μm 2 / ms $$ 1.21{\upmu \mathrm{m}}^2/\mathrm{ms} $$ ( 0.19 μm 2 / ms $$ 0.19\kern0.3em {\upmu \mathrm{m}}^2/\mathrm{ms} $$ ) and 1.20 μm 2 / ms $$ 1.20{\upmu \mathrm{m}}^2/\mathrm{ms} $$ ( 0.11 μm 2 / ms $$ 0.11\kern0.3em {\upmu \mathrm{m}}^2/\mathrm{ms} $$ ); for f $$ f $$ they were 29.7% (6.2%) and 27.7% (3.6%); and for D * $$ {D}^{\ast } $$ they were 8.76 ⋅ 10 - 2 mm 2 / s $$ 8.76\cdot {10}^{-2}{\mathrm{mm}}^2/\mathrm{s} $$ ( 4.54 ⋅ 10 - 2 mm 2 / s $$ 4.54\cdot {10}^{-2}\kern0.3em {\mathrm{mm}}^2/\mathrm{s} $$ ) and 8.71 ⋅ 10 - 2 mm 2 / s $$ 8.71\cdot {10}^{-2}{\mathrm{mm}}^2/\mathrm{s} $$ ( 4.06 ⋅ 10 - 2 mm 2 / s $$ 4.06\cdot {10}^{-2}\kern0.3em {\mathrm{mm}}^2/\mathrm{s} $$ ). CONCLUSION Biexponential IVIM parameters in the liver are comparable among IVIM studies that use different slice settings, with mostly negligible saturation effects. However, this may not hold for studies that use much shorter TR.
Collapse
Affiliation(s)
- Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobit Führes
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Stuprich
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marc Saake
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
|
6
|
Englund EK, Reiter DA, Shahidi B, Sigmund EE. Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions. J Magn Reson Imaging 2022; 55:988-1012. [PMID: 34390617 PMCID: PMC8841570 DOI: 10.1002/jmri.27875] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022] Open
Abstract
Throughout the body, muscle structure and function can be interrogated using a variety of noninvasive magnetic resonance imaging (MRI) methods. Recently, intravoxel incoherent motion (IVIM) MRI has gained momentum as a method to evaluate components of blood flow and tissue diffusion simultaneously. Much of the prior research has focused on highly vascularized organs, including the brain, kidney, and liver. Unique aspects of skeletal muscle, including the relatively low perfusion at rest and large dynamic range of perfusion between resting and maximal hyperemic states, may influence the acquisition, postprocessing, and interpretation of IVIM data. Here, we introduce several of those unique features of skeletal muscle; review existing studies of IVIM in skeletal muscle at rest, in response to exercise, and in disease states; and consider possible confounds that should be addressed for muscle-specific evaluations. Most studies used segmented nonlinear least squares fitting with a b-value threshold of 200 sec/mm2 to obtain IVIM parameters of perfusion fraction (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D). In healthy individuals, across all muscles, the average ± standard deviation of D was 1.46 ± 0.30 × 10-3 mm2 /sec, D* was 29.7 ± 38.1 × 10-3 mm2 /sec, and f was 11.1 ± 6.7%. Comparisons of reported IVIM parameters in muscles of the back, thigh, and leg of healthy individuals showed no significant difference between anatomic locations. Throughout the body, exercise elicited a positive change of all IVIM parameters. Future directions including advanced postprocessing models and potential sequence modifications are discussed. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Erin K. Englund
- Department of Radiology, University of Colorado Anschutz Medical Campus
| | | | | | - Eric E. Sigmund
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health
- Center for Advanced Imaging and Innovation (CAIR), Bernard and Irene Schwarz Center for Biomedical Imaging (CBI), NYU Langone Health
| |
Collapse
|
|
7
|
Saake M, Seuß H, Riexinger A, Bickelhaupt S, Hammon M, Uder M, Laun FB. Image Quality and Detection of Small Focal Liver Lesions in Diffusion-Weighted Imaging: Comparison of Navigator Tracking and Free-Breathing Acquisition. Invest Radiol 2021; 56:579-590. [PMID: 33813572 DOI: 10.1097/rli.0000000000000776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this study was to compare intraindividual diffusion-weighted imaging (DWI) of the liver acquired with free breathing (FB) versus navigator triggering (NT) for assessing small focal liver lesions (FLLs) in noncirrhotic patients. MATERIALS AND METHODS Patients with known or suspected multiple FLLs were prospectively included, and spin-echo echo-planar DWI with NT and FB acquisition was performed (b-values, 50 and 800 s/mm2 [b50 and b800]). NT and FB DWI sequences with similar acquisitions times were used. Liver and lesion signal-to-noise ratios were measured at b800. The DWI scans were analyzed independently by 2 readers. Liver edge delineation, presence of stair-step artifacts, vessel sharpness, severity of cardiac motion artifacts, overall image quality, and lesion conspicuity were rated with 5-point Likert scales. Small and large FLLs (ie, <1 cm or ≥1 cm) were rated separately for lesion conspicuity. The FLL detectability was estimated by comparing the number of lesions visible with FB to those visible with NT. RESULTS Forty-three patients were included in the study. The FB acquisition performed better in terms of severity of cardiac motion artifacts. The NT performed better in terms of liver edge delineation and vessel sharpness. Little difference was found for stair-step artifact, overall image quality, and conspicuity of large FLL, whereas the conspicuity of small FLL was better for NT. For small FLL, both readers found more lesions with NT in 11 cases at b800. For large FLL, this effect was much less pronounced (1 case at b800 reported by 1 of the readers). The mean liver and lesion signal-to-noise ratios were 16.8/41.5 and 19.8/38.4 for NT/FB, respectively. CONCLUSIONS Small FLL detection is better with NT. Large FLL detection by FB and NT is similarly good. We conclude that NT should be used.
Collapse
Affiliation(s)
- Marc Saake
- From the Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | | | - Andreas Riexinger
- From the Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Sebastian Bickelhaupt
- From the Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Matthias Hammon
- From the Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Michael Uder
- From the Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Frederik B Laun
- From the Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| |
Collapse
|
|
8
|
Führes T, Riexinger AJ, Loh M, Martin J, Wetscherek A, Kuder TA, Uder M, Hensel B, Laun FB. Echo time dependence of biexponential and triexponential intravoxel incoherent motion parameters in the liver. Magn Reson Med 2021; 87:859-871. [PMID: 34453445 DOI: 10.1002/mrm.28996] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE Intravoxel incoherent motion (IVIM) studies are performed with different acquisition protocols. Comparing them requires knowledge of echo time (TE) dependencies. The TE-dependence of the biexponential perfusion fraction f is well-documented, unlike that of its triexponential counterparts f1 and f2 and the biexponential and triexponential pseudodiffusion coefficients D* , D 1 ∗ , and D 2 ∗ . The purpose was to investigate the TE-dependence of these parameters and to check whether the triexponential pseudodiffusion compartments are associated with arterial and venous blood. METHODS Fifteen healthy volunteers (19-58 y; mean: 24.7 y) underwent diffusion-weighted imaging of the abdomen with 24 b-values (0.2-800 s/mm2 ) at TEs of 45, 60, 75, and 90 ms. Regions of interest (ROIs) were manually drawn in the liver. One set of bi- and triexponential IVIM parameters per volunteer and TE was determined. The TE-dependence was assessed with the Kruskal-Wallis test. RESULTS TE-dependence was observed for f (P < .001), f1 (P = .001), and f2 (P < .001). Their median values at the four measured TEs were: f: 0.198/0.240/0.274/0.359, f1 : 0.113/0.139/0.146/0.205, f2 : 0.115/0.155/0.182/0.194. D, D* , D 1 ∗ , and D 2 ∗ showed no significant TE-dependence. Their values were: diffusion coefficient D (10-4 mm2 /s): 9.45/9.63/9.75/9.41, biexponential D* (10-2 mm2 /s): 5.26/5.52/6.13/5.82, triexponential D 1 ∗ (10-2 mm2 /s): 1.73/2.91/2.25/2.51, triexponential D 2 ∗ (mm2 /s): 0.478/1.385/0.616/0.846. CONCLUSION f1 and f2 show similar TE-dependence as f, ie, increase with rising TE; an effect that must be accounted for when comparing different studies. The diffusion and pseudodiffusion coefficients might be compared without TE correction. Because of the similar TE-dependence of f1 and f2 , the triexponential pseudodiffusion compartments are most probably not associated to venous and arterial blood.
Collapse
Affiliation(s)
- Tobit Führes
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Julian Riexinger
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Andreas Wetscherek
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Tristan Anselm Kuder
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bernhard Hensel
- Center for Medical Physics and Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
|
9
|
Lee SK, Lee J, Jang S, Lee E, Jeon CY, Lim KS, Jin YB, Choi J. Renal Diffusion-Weighted Imaging in Healthy Dogs: Reproducibility, Test-Retest Repeatability, and Selection of the Optimal b-value Combination. Front Vet Sci 2021; 8:641971. [PMID: 34277748 PMCID: PMC8282824 DOI: 10.3389/fvets.2021.641971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Diffusion-weighted imaging (DWI) magnetic resonance imaging can evaluate alterations in the microstructure of the kidney. The purpose of this study was to assess the apparent diffusion coefficient (ADC) and the intravoxel incoherent motion model (IVIM) parameters of a normal kidney in healthy dogs, to evaluate the effect of b-value combinations on the ADC value, and the reproducibility and test-retest repeatability in monoexponential and IVIM analysis. In this experimental study, the ADC, pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f p) were measured from both kidneys in nine healthy beagles using nine b-values (b = 0, 50, 70, 100, 150, 200, 500, 800, and 1,000 s/mm2) twice with a 1-week interval between measurements. Interobserver and intraobserver reproducibility, and test-retest repeatability of the measurements were calculated. ADC values were measured using 10 different b-value combinations consisting of three b-values each, and were compared to the ADC obtained from nine b-values. All the ADC, D, D*, and f p values measured from the renal cortex, medulla, and the entire kidney had excellent interobserver and intraobserver reproducibility, and test-retest repeatability. The ADC obtained from a b-value combination of 0, 100, and 800 s/mm2 had the highest intraclass correlation coefficient with the ADC from nine b-values. The results of this study indicated that DWI MRI using multiple b-values is feasible for the measurement of ADC and IVIM parameters with high reproducibility and repeatability in the kidneys of healthy dogs. A combination of b = 0, 100, and 800 s/mm2 can be used for ADC measurements when multiple b-values are not available in dogs.
Collapse
Affiliation(s)
- Sang-Kwon Lee
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Juryeoung Lee
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Seolyn Jang
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Eunji Lee
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Chang-Yeop Jeon
- National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju, South Korea
| | - Kyung-Seoub Lim
- Futuristic Animal Resource and Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju, South Korea
| | - Yeung Bae Jin
- College of Veterinary Medicine, Gyeongsang National University, Jinju, South Korea
| | - Jihye Choi
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| |
Collapse
|
|
10
|
Jerome NP, Vidić I, Egnell L, Sjøbakk TE, Østlie A, Fjøsne HE, Goa PE, Bathen TF. Understanding diffusion-weighted MRI analysis: Repeatability and performance of diffusion models in a benign breast lesion cohort. NMR IN BIOMEDICINE 2021; 34:e4508. [PMID: 33738878 DOI: 10.1002/nbm.4508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 06/12/2023]
Abstract
Diffusion-weighted MRI (DWI) is an important tool for oncology research, with great clinical potential for the classification and monitoring of breast lesions. The utility of parameters derived from DWI, however, is influenced by specific analysis choices. The purpose of this study was to critically evaluate repeatability and curve-fitting performance of common DWI signal representations, for a prospective cohort of patients with benign breast lesions. Twenty informed, consented patients with confirmed benign breast lesions underwent repeated DWI (3 T) using: sagittal single-shot spin-echo echo planar imaging, bipolar encoding, TR/TE: 11,600/86 ms, FOV: 180 x 180 mm, matrix: 90 x 90, slices: 60 x 2.5 mm, iPAT: GRAPPA 2, fat suppression, and 13 b-values: 0-700 s/mm2 . A phase-reversed scan (b = 0 s/mm2 ) was acquired for distortion correction. Voxel-wise repeat-measures coefficients of variation (CoVs) were derived for monoexponential (apparent diffusion coefficient [ADC]), biexponential (intravoxel incoherent motion: f, D, D*) and stretched exponential (α, DDC) across the parameter histograms for lesion regions of interest (ROIs). Goodness-of-fit for each representation was assessed by Bayesian information criterion. The volume of interest (VOI) definition was repeatable (CoV 13.9%). Within lesions, and across both visits and the cohort, there was no dominant best-fit model, with all representations giving the best fit for a fraction of the voxels. Diffusivity measures from the signal representations (ADC, D, DDC) all showed good repeatability (CoV < 10%), whereas parameters associated with pseudodiffusion (f, D*) performed poorly (CoV > 50%). The stretching exponent α was repeatable (CoV < 12%). This pattern of repeatability was consistent over the central part of the parameter percentiles. Assumptions often made in diffusion studies about analysis choices will influence the detectability of changes, potentially obscuring useful information. No single signal representation prevails within or across lesions, or across repeated visits; parameter robustness is therefore a critical consideration. Our results suggest that stretched exponential representation is more repeatable than biexponential, with pseudodiffusion parameters unlikely to provide clinically useful biomarkers.
Collapse
Affiliation(s)
- Neil Peter Jerome
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim, Norway
| | - Igor Vidić
- Department of Physics, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Liv Egnell
- Clinic of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim, Norway
- Department of Physics, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Torill E Sjøbakk
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim, Norway
| | - Agnes Østlie
- Department of Radiology, St. Olavs Hospital, Trondheim, Norway
| | - Hans E Fjøsne
- Department of Radiology, St. Olavs Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Pål Erik Goa
- Department of Physics, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim, Norway
| |
Collapse
|
|
11
|
Merisaari H, Laakso H, Liljenbäck H, Virtanen H, Aronen HJ, Minn H, Poutanen M, Roivainen A, Liimatainen T, Jambor I. Statistical Evaluation of Different Mathematical Models for Diffusion Weighted Imaging of Prostate Cancer Xenografts in Mice. Front Oncol 2021; 11:583921. [PMID: 34123770 PMCID: PMC8188898 DOI: 10.3389/fonc.2021.583921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 03/23/2021] [Indexed: 01/28/2023] Open
Abstract
Purpose To evaluate fitting quality and repeatability of four mathematical models for diffusion weighted imaging (DWI) during tumor progression in mouse xenograft model of prostate cancer. Methods Human prostate cancer cells (PC-3) were implanted subcutaneously in right hind limbs of 11 immunodeficient mice. Tumor growth was followed by weekly DWI examinations using a 7T MR scanner. Additional DWI examination was performed after repositioning following the fourth DWI examination to evaluate short term repeatability. DWI was performed using 15 and 12 b-values in the ranges of 0-500 and 0-2000 s/mm2, respectively. Corrected Akaike information criteria and F-ratio were used to evaluate fitting quality of each model (mono-exponential, stretched exponential, kurtosis, and bi-exponential). Results Significant changes were observed in DWI data during the tumor growth, indicated by ADCm, ADCs, and ADCk. Similar results were obtained using low as well as high b-values. No marked changes in model preference were present between the weeks 1−4. The parameters of the mono-exponential, stretched exponential, and kurtosis models had smaller confidence interval and coefficient of repeatability values than the parameters of the bi-exponential model. Conclusion Stretched exponential and kurtosis models showed better fit to DWI data than the mono-exponential model and presented with good repeatability.
Collapse
Affiliation(s)
- Harri Merisaari
- Department of Radiology, University of Turku, Turku, Finland.,Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Hanne Laakso
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, Kuopio, Finland
| | - Heidi Liljenbäck
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Helena Virtanen
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.,Turku Center for Disease Modeling, University of Turku, Turku, Finland
| | - Hannu J Aronen
- Department of Radiology, University of Turku, Turku, Finland.,Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | - Heikki Minn
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.,Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - Matti Poutanen
- Turku Center for Disease Modeling, University of Turku, Turku, Finland
| | - Anne Roivainen
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.,Turku Center for Disease Modeling, University of Turku, Turku, Finland
| | - Timo Liimatainen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, Kuopio, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Clinical Radiology, Oulu University Hospital, Oulu, Finland.,Department of Radiology, University of Oulu, Oulu, Finland
| | - Ivan Jambor
- Department of Radiology, University of Turku, Turku, Finland.,Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| |
Collapse
|
|
12
|
Jerome NP, Periquito JS. Analysis of Renal Diffusion-Weighted Imaging (DWI) Using Apparent Diffusion Coefficient (ADC) and Intravoxel Incoherent Motion (IVIM) Models. Methods Mol Biol 2021; 2216:611-635. [PMID: 33476027 DOI: 10.1007/978-1-0716-0978-1_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Analysis of renal diffusion-weighted imaging (DWI) data to derive markers of tissue properties requires careful consideration of the type, extent, and limitations of the acquired data. Alongside data quality and general suitability for quantitative analysis, choice of diffusion model, fitting algorithm, and processing steps can have consequences for the precision, accuracy, and reliability of derived diffusion parameters. Here we introduce and discuss important steps for diffusion-weighted image processing, and in particular give example analysis protocols and pseudo-code for analysis using the apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) models. Following an overview of general principles, we provide details of optional steps, and steps for validation of results. Illustrative examples are provided, together with extensive notes discussing wider context of individual steps, and notes on potential pitfalls.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This analysis protocol chapter is complemented by two separate chapters describing the basic concepts and experimental procedure.
Collapse
Affiliation(s)
- Neil Peter Jerome
- Institute for Circulation and Diagnostic Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway.
| | - João S Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| |
Collapse
|
|
13
|
Xie S, Masokano IB, Liu W, Long X, Li G, Pei Y, Li W. Comparing the clinical utility of single-shot echo-planar imaging and readout-segmented echo-planar imaging in diffusion-weighted imaging of the liver at 3 tesla. Eur J Radiol 2020; 135:109472. [PMID: 33370640 DOI: 10.1016/j.ejrad.2020.109472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/26/2020] [Accepted: 12/08/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To compare the clinical utility of single-shot echo-planar imaging (SS-EPI) using different breathing schemes and readout-segmented EPI (RS-EPI) in the repeatability of apparent diffusion coefficient (ADC) measurements, signal-to-noise ratio (SNR) and image quality. METHODS In this institutional review board-approved prospective study, hepatic DWIs (b = 50, 300, 600 s/mm2) were performed in 22 volunteers on 3.0 T MRI using SS-EPI with free-breathing diffusion-weighted imaging (FB-DWI), breath-hold (BH-DWI), respiratory-triggered (RT-DWI) and navigator-triggered (NT-DWI), and readout-segmented EPI (RS-DWI). ADC and surrogate SNR (sSNR) were measured in nine anatomic locations in the right lobe, and image quality was assessed on all FB-DWI, BH-DWI, RT-DWI, NT-DWI, and RS-DWI sequences. The sequence with the optimal clinical utility was decided by systematically comparing the ADC repeatability, sSNR and image quality of the above DWIs. RESULTS In all the five sequences, NT-DWI had the most reliable intra-observer agreement (intraclass correlation coefficient (ICC): 0.900-0.922; all P > 0.05), and a better interobserver agreement (ICC: 0.853-0.960; all p > 0.05) than RS-DWI (ICC:0.881-0.916; some P < 0.05). NT-DWI had the best ADC repeatability in the nine locations (mean ADC absolute differences: 38.47-56.38 × 10-6 mm2/s, limits of agreement (LOA): 17.33-22.52 × 10-6 mm2/s). Also, NT-DWI had the highest sSNR (Reader 1: 50.58 ± 20.11 (Superior), 74.06 ± 28.37 (Central), 80.99 ± 38.11(Inferior)); Reader 2: 48.07 ± 23.92 (Superior), 68.23 ± 32.91 (Central), 76.78 ± 33.07 (Inferior)) in three representative sections except for RS-DWI. Furthermore, NT-DWI had a better image quality than RS-DWI (P < 0.05) and was superior to FB-DWI and BH-DWI in sharpness of the liver (at b = 300 s/mm2) (P < 0.05) CONCLUSION: RS-DWI has the best SNR. However, NT-DWI can provide sufficient SNR, excellent image quality, and the best ADC repeatability on 3.0 T MRI. It is thus the recommended sequence for the clinical application of hepatic DWI.
Collapse
Affiliation(s)
- Simin Xie
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Ismail Bilal Masokano
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Wenguang Liu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Xueying Long
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Guijin Li
- Siemens Healthcare Ltd, Guangzhou Branch, 510620, China
| | - Yigang Pei
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; Postdoctoral Fellow, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| | - Wenzheng Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| |
Collapse
|
|
14
|
Riexinger A, Laun FB, Bickelhaupt S, Seuß H, Uder M, Hensel B, Saake M. On the dependence of the cardiac motion artifact on the breathing cycle in liver diffusion-weighted imaging. PLoS One 2020; 15:e0239743. [PMID: 33002028 PMCID: PMC7529231 DOI: 10.1371/journal.pone.0239743] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/11/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose The purpose of this study was to investigate whether the cardiac motion artifact that regularly appears in diffusion-weighted imaging of the left liver lobe might be reduced by acquiring images in inspiration, when the coupling between heart and liver might be minimal. Materials and methods 43 patients with known or suspected focal liver lesions were examined at 1.5 T with breath hold acquisition, once in inspiration and once in expiration. Data were acquired with a diffusion-weighted echo planar imaging sequence and two b-values (b50 = 50 s/mm² and b800 = 800 s/mm²). The severity of the cardiac motion artifact in the left liver lobe was rated by two experienced radiologists for both b-values with a 5 point Likert scale. Additionally, the normalized signal S(b800)/S(b50) in the left liver lobe was computed. The Wilcoxon signed-rank test was used comparing the scores of the two readers obtained in inspiration and expiration, and to compare the normalized signal in inspiration and expiration. Results The normalized signal in inspiration was slightly higher than in expiration (0.349±0.077 vs 0.336±0.058), which would indicate a slight reduction of the cardiac motion artifact, but this difference was not significant (p = 0.24). In the qualitative evaluation, the readers did not observe a significant difference for b50 (reader 1: p = 0.61; reader 2: p = 0.18). For b800, reader 1 observed a significant difference of small effect size favouring expiration (p = 0.03 with a difference of mean Likert scores of 0.27), while reader 2 observed no significant difference (p = 0.62). Conclusion Acquiring the data in inspiration does not lead to a markedly reduced cardiac motion artifact in diffusion-weighted imaging of the left liver lobe and is in this regard not to be preferred over acquiring the data in expiration.
Collapse
Affiliation(s)
- Andreas Riexinger
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- * E-mail:
| | | | | | - Hannes Seuß
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Bernhard Hensel
- Center for Medical Physics and Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marc Saake
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| |
Collapse
|
|
15
|
Ye Z, Wei Y, Chen J, Yao S, Song B. Value of intravoxel incoherent motion in detecting and staging liver fibrosis: A meta-analysis. World J Gastroenterol 2020; 26:3304-3317. [PMID: 32684744 PMCID: PMC7336331 DOI: 10.3748/wjg.v26.i23.3304] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/26/2020] [Accepted: 05/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver fibrosis (LF) is a common pathological feature of all chronic liver diseases. With the accumulation of extracellular matrix in the fibrotic liver, true molecular water diffusion and perfusion-related diffusion are restricted. Intravoxel incoherent motion (IVIM) can capture the information on tissue diffusivity and microcapillary perfusion separately and reflect the fibrotic severity with diffusion coefficients. AIM To investigate the diagnostic performance of IVIM in detecting and staging LF with histology as a reference standard. METHODS A comprehensive literature search was conducted to identify studies on the diagnostic accuracy of IVIM for assessment of histologically proven LF. The stages of LF were classified as F0 (no fibrosis), F1 (portal fibrosis without septa), F2 (periportal fibrosis with few septa), F3 (septal fibrosis), and F4 (cirrhosis) according to histopathological findings. Data were extracted to calculate the pooled sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio, as well as the area under the summary receiver operating characteristic curve (AUC) in each group. RESULTS A total of 12 studies with 923 subjects were included in this meta-analysis with 5 studies (n = 465) for LF ≥ F1, 9 studies (n = 757) for LF ≥ F2, 4 studies (n = 413) for LF ≥ F3, and 6 studies (n = 562) for LF = F4. The pooled sensitivity and specificity were estimated to be 0.78 (95% confidence interval: 0.73-0.82) and 0.81 (0.74-0.86) for LF ≥ F1 detection with IVIM; 0.82 (0.79-0.86) and 0.80 (0.75-0.84) for staging F2 fibrosis; 0.85 (0.79-0.90) and 0.83 (0.77-0.87) for staging F3 fibrosis, and 0.90 (0.84-0.94) and 0.75 (0.70-0.79) for detecting F4 cirrhosis, respectively. The AUCs for LF ≥ F1, F2, F3, F4 detection were 0.862 (0.811-0.914), 0.883 (0.856-0.909), 0.886 (0.865-0.907), and 0.899 (0.866-0.932), respectively. Moderate to substantial heterogeneity was observed with inconsistency index (I 2) ranging from 0% to 77.9%. No publication bias was detected. CONCLUSION IVIM is a noninvasive tool with good diagnostic performance in detecting and staging LF. Optimized and standardized IVIM protocols are needed to further improve its diagnostic accuracy in clinical practice.
Collapse
Affiliation(s)
- Zheng Ye
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Wei
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jie Chen
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Shan Yao
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| |
Collapse
|
|
16
|
Improved Liver Diffusion-Weighted Imaging at 3 T Using Respiratory Triggering in Combination With Simultaneous Multislice Acceleration. Invest Radiol 2020; 54:744-751. [PMID: 31335634 DOI: 10.1097/rli.0000000000000594] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this study was to retrospectively compare optimized respiratory-triggered diffusion-weighted imaging with simultaneous multislice acceleration (SMS-RT-DWI) of the liver with a standard free-breathing echo-planar DWI (s-DWI) protocol at 3 T with respect to the imaging artifacts inherent to DWI. MATERIALS AND METHODS Fifty-two patients who underwent a magnetic resonance imaging study of the liver were included in this retrospective study. Examinations were performed on a 3 T whole-body magnetic resonance system (MAGNETOM Skyra; Siemens Healthcare, Erlangen, Germany). In all patients, both s-DWI and SMS-RT-DWI of the liver were obtained. Images were qualitatively evaluated by 2 independent radiologists with regard to overall image quality, liver edge sharpness, sequence-related artifacts, and overall scan preference. For quantitative evaluation, signal-to-noise ratio was measured from signal-to-noise ratio maps. The mean apparent diffusion coefficient (ADC) was measured in each liver quadrant. The Wilcoxon rank-sum test was used for analysis of the qualitative parameters and the paired Student t test for quantitative parameters. RESULTS Overall image quality, liver edge sharpness, and sequence-related artifacts of SMS-RT-DWI received significantly better ratings compared with s-DWI (P < 0.05 for all). For 90.4% of the examinations, both readers overall preferred SMS-RT-DWI to s-DWI. Acquisition time for SMS-RT-DWI was 34% faster than s-DWI. Signal-to-noise ratio values were significantly higher for s-DWI at b50 but did not statistically differ at b800, and they were more homogenous for SMS-RT-DWI, with a significantly lower standard deviation at b50. Mean ADC values decreased from the left to right hepatic lobe as well as from cranial to caudal for s-DWI. With SMS-RT-DWI, mean ADC values were homogeneous throughout the liver. CONCLUSIONS Optimized, multislice, respiratory-triggered DWI of the liver at 3 T substantially improves image quality with a reduced scan acquisition time compared with s-DWI.
Collapse
|
|
17
|
|
|
18
|
Gurney‐Champion OJ, Rauh SS, Harrington K, Oelfke U, Laun FB, Wetscherek A. Optimal acquisition scheme for flow-compensated intravoxel incoherent motion diffusion-weighted imaging in the abdomen: An accurate and precise clinically feasible protocol. Magn Reson Med 2020; 83:1003-1015. [PMID: 31566262 PMCID: PMC6899942 DOI: 10.1002/mrm.27990] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/14/2019] [Accepted: 08/17/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Flow-compensated (FC) diffusion-weighted MRI (DWI) for intravoxel-incoherent motion (IVIM) modeling allows for a more detailed description of tissue microvasculature than conventional IVIM. The long acquisition time of current FC-IVIM protocols, however, has prohibited clinical application. Therefore, we developed an optimized abdominal FC-IVIM acquisition with a clinically feasible scan time. METHODS Precision and accuracy of the FC-IVIM parameters were assessed by fitting the FC-IVIM model to signal decay curves, simulated for different acquisition schemes. Diffusion-weighted acquisitions were added subsequently to the protocol, where we chose the combination of b-value, diffusion time and gradient profile (FC or bipolar) that resulted in the largest improvement to its accuracy and precision. The resulting two optimized FC-IVIM protocols with 25 and 50 acquisitions (FC-IVIMopt25 and FC-IVIMopt50 ), together with a complementary acquisition consisting of 50 diffusion-weighting (FC-IVIMcomp ), were acquired in repeated abdominal free-breathing FC-IVIM imaging of seven healthy volunteers. Intersession and intrasession within-subject coefficient of variation of the FC-IVIM parameters were compared for the liver, spleen, and kidneys. RESULTS Simulations showed that the performance of FC-IVIM improved in tissue with larger perfusion fraction and signal-to-noise ratio. The scan time of the FC-IVIMopt25 and FC-IVIMopt50 protocols were 8 and 16 min. The best in vivo performance was seen in FC-IVIMopt50 . The intersession within-subject coefficients of variation of FC-IVIMopt50 were 11.6%, 16.3%, 65.5%, and 36.0% for FC-IVIM model parameters diffusivity, perfusion fraction, characteristic time and blood flow velocity, respectively. CONCLUSIONS We have optimized the FC-IVIM protocol, allowing for clinically feasible scan times (8-16 min).
Collapse
Affiliation(s)
- Oliver J. Gurney‐Champion
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
| | - Susanne S. Rauh
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
- Institute of RadiologyUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Kevin Harrington
- Targeted Therapy teamThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
| | - Uwe Oelfke
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
| | - Frederik B. Laun
- Institute of RadiologyUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Andreas Wetscherek
- Joint Department of PhysicsThe Institute of Cancer Research and The Royal Marsden NHS Foundation TrustLondonUnited Kingdom
| |
Collapse
|
|
19
|
Ljimani A, Caroli A, Laustsen C, Francis S, Mendichovszky IA, Bane O, Nery F, Sharma K, Pohlmann A, Dekkers IA, Vallee JP, Derlin K, Notohamiprodjo M, Lim RP, Palmucci S, Serai SD, Periquito J, Wang ZJ, Froeling M, Thoeny HC, Prasad P, Schneider M, Niendorf T, Pullens P, Sourbron S, Sigmund EE. Consensus-based technical recommendations for clinical translation of renal diffusion-weighted MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:177-195. [PMID: 31676990 PMCID: PMC7021760 DOI: 10.1007/s10334-019-00790-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 12/13/2022]
Abstract
Objectives Standardization is an important milestone in the validation of DWI-based parameters as imaging biomarkers for renal disease. Here, we propose technical recommendations on three variants of renal DWI, monoexponential DWI, IVIM and DTI, as well as associated MRI biomarkers (ADC, D, D*, f, FA and MD) to aid ongoing international efforts on methodological harmonization. Materials and methods Reported DWI biomarkers from 194 prior renal DWI studies were extracted and Pearson correlations between diffusion biomarkers and protocol parameters were computed. Based on the literature review, surveys were designed for the consensus building. Survey data were collected via Delphi consensus process on renal DWI preparation, acquisition, analysis, and reporting. Consensus was defined as ≥ 75% agreement. Results Correlations were observed between reported diffusion biomarkers and protocol parameters. Out of 87 survey questions, 57 achieved consensus resolution, while many of the remaining questions were resolved by preference (65–74% agreement). Summary of the literature and survey data as well as recommendations for the preparation, acquisition, processing and reporting of renal DWI were provided. Discussion The consensus-based technical recommendations for renal DWI aim to facilitate inter-site harmonization and increase clinical impact of the technique on a larger scale by setting a framework for acquisition protocols for future renal DWI studies. We anticipate an iterative process with continuous updating of the recommendations according to progress in the field. Electronic supplementary material The online version of this article (10.1007/s10334-019-00790-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Anna Caroli
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Susan Francis
- Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | | | - Octavia Bane
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fabio Nery
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, 13125, Berlin, Germany
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean-Paul Vallee
- Department of Diagnostic, Geneva University Hospital and University of Geneva, 1211, Geneva-14, Switzerland
| | - Katja Derlin
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Mike Notohamiprodjo
- Die Radiologie, Munich, Germany.,Department of Radiology, University Hospital Tuebingen, Tübingen, Germany
| | - Ruth P Lim
- Department of Radiology, Austin Health, The University of Melbourne, Melbourne, Australia
| | - Stefano Palmucci
- Department of Medical Surgical Sciences and Advanced Technologies, Radiology I Unit, University Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Suraj D Serai
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Joao Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, 13125, Berlin, Germany
| | - Zhen Jane Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Martijn Froeling
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Harriet C Thoeny
- Department of Radiology, Hôpital Cantonal Fribourgois (HFR), University of Fribourg, 1708, Fribourg, Switzerland
| | - Pottumarthi Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA
| | - Moritz Schneider
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center, German Center for Lung Research, Munich, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, 13125, Berlin, Germany
| | - Pim Pullens
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium.,Department of Radiology, University Hospital Ghent, Ghent, Belgium
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Eric E Sigmund
- Department of Radiology, Center for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Health, New York, NY, USA
| |
Collapse
|
|
20
|
Rydhög A, Pasternak O, Ståhlberg F, Ahlgren A, Knutsson L, Wirestam R. Estimation of diffusion, perfusion and fractional volumes using a multi-compartment relaxation-compensated intravoxel incoherent motion (IVIM) signal model. Eur J Radiol Open 2019; 6:198-205. [PMID: 31193664 PMCID: PMC6538803 DOI: 10.1016/j.ejro.2019.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
Compartmental diffusion MRI models that account for intravoxel incoherent motion (IVIM) of blood perfusion allow for estimation of the fractional volume of the microvascular compartment. Conventional IVIM models are known to be biased by not accounting for partial volume effects caused by free water and cerebrospinal fluid (CSF), or for tissue-dependent relaxation effects. In this work, a three-compartment model (tissue, free water and blood) that includes relaxation terms is introduced. To estimate the model parameters, in vivo human data were collected with multiple echo times (TE), inversion times (TI) and b-values, which allowed a direct relaxation estimate alongside estimation of perfusion, diffusion and fractional volume parameters. Compared to conventional two-compartment models (with and without relaxation compensation), the three-compartment model showed less effects of CSF contamination. The proposed model yielded significantly different volume fractions of blood and tissue compared to the non-relaxation-compensated model, as well as to the conventional two-compartment model, suggesting that previously reported parameter ranges, using models that do not account for relaxation, should be reconsidered.
Collapse
Key Words
- CSF, cerebrospinal fluid
- Diffusion
- GM, grey matter
- IR, inversion recovery
- IVIM, intravoxel incoherent motion
- Intravoxel incoherent motion
- PVE, partial volume effect
- Perfusion fraction
- Pseudo-diffusion
- ROI, region of interest
- Relaxation
- SNR, signal-to-noise ratio
- T1, longitudinal relaxation time
- T2, transverse relaxation time
- TE, echo time
- TI, inversion time
- TR, repetition time
- WM, white matter
Collapse
Affiliation(s)
- Anna Rydhög
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Freddy Ståhlberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,Department of Diagnostic Radiology, Lund University, Lund, Sweden.,Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - André Ahlgren
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ronnie Wirestam
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| |
Collapse
|
|
21
|
Intra-individual comparison of conventional and simultaneous multislice-accelerated diffusion-weighted imaging in upper abdominal solid organs: value of ADC normalization using the spleen as a reference organ. Abdom Radiol (NY) 2019; 44:1808-1815. [PMID: 30737546 DOI: 10.1007/s00261-019-01924-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the apparent diffusion coefficient (ADC) value of conventional diffusion-weighted imaging (cDWI) to simultaneous multislice-accelerated DWI (sDWI) and to evaluate the possibility of ADC normalization using the spleen as a reference organ. METHODS We retrospectively evaluated 92 patients (68 men, 24 women; mean age 60.0 years) who underwent liver magnetic resonance imaging (MRI) including both cDWI and sDWI. sDWI was obtained with an acceleration factor of 2. ADC values were measured from the right liver lobe, left liver lobe, spleen, pancreas, right kidney, and left kidney. ADC values of the spleen were used for normalization. Paired sample t test, Pearson's correlation coefficient, and Bland-Altman method were used for statistical analysis. RESULTS ADC values of cDWI were significantly lower than sDWI in all six anatomic regions (p < 0.001). The mean difference in ADC value between cDWI and sDWI ranged from 0.048 to 0.125 × 10-3 mm2/s. ADC values from cDWI and sDWI showed a moderate to very high positive correlation (p < 0.001). After ADC normalization using the spleen as a reference organ, there was no significant difference between normalized ADC of cDWI and sDWI in all 5 anatomic regions (p = 0.11 - 0.74). CONCLUSIONS Normalization of ADC using the spleen could be useful for comparing upper abdominal organs acquired with either cDWI or sDWI in longitudinal and follow-up studies.
Collapse
|
|
22
|
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: 6] [Impact Index Per Article: 1.0] [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.
Collapse
|
|
23
|
Deng Y, Yang B, Peng Y, Liu Z, Luo J, Du G. Use of intravoxel incoherent motion diffusion-weighted imaging to detect early changes in diabetic kidneys. Abdom Radiol (NY) 2018. [PMID: 29541833 DOI: 10.1007/s00261-018-1521-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of the study was to examine differences in kidney intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in early-stage diabetic patients versus healthy controls. MATERIALS AND METHODS Nineteen type 2 diabetic patients (group A) with a urinary albumin-to-creatinine ratio (ACR) < 30 mg/g and an estimated glomerular filtration rate (eGFR) of 80-120 mL/(min 1.73 m2) and twelve healthy volunteers (group B) were recruited. Kidneys were scanned with 1.5-Tesla IVIM-DWI. Nine b values (0, 50, 100, 150, 200, 300, 400, 600, and 800 s/mm2) were used. The parameters derived from IVIM-DWI were calculated for each kidney by two radiologists and included the perfusion fraction (f), diffusion coefficient (D), and pseudo-diffusion coefficient (D*). The mean values of f, D, and D* were calculated by selecting multiple regions of interest in the kidney. The diagnostic performance of the f, D, and D* values for the diagnosis of early diabetic kidney changes was determined by receiver operating characteristic analysis. Three radiologists independently measured the parameters derived from IVIM-DWI in the two groups by free-hand placing regions of interest, and the interclass coefficients (ICCs) were analyzed by SPSS.16.0 software. RESULTS The f values of the kidneys were significantly higher in diabetic patients than in healthy volunteers. The D value of the kidneys was significantly lower in diabetic patients than in healthy volunteers. No significant differences in the D* values of the kidneys were observed between diabetic patients and healthy volunteers. The D values of the right kidneys were significantly higher than those of the left kidneys in both groups. The results of the receiver operating characteristic analysis were as follows: left kidney-f value AUC = 0.650 (cutoff point ≥ 27.49%) and D value AUC = 0.752 (cutoff point ≤ 1.68 × 10-3 mm2/s); and right kidney-f value AUC = 0.650 (cutoff point ≥ 28.24%) and D value AUC = 0.752 (cutoff point ≤ 1.81 × 10-3 mm2/s). The diagnostic performance of the D* value was very low (AUC < 0.6). No significant differences were present between the areas under the curves of the f and D values (P > 0.05). The ICCs of the f value and D value were between 0.637 and 0.827. The ICC of the D* value was less than 0.3. CONCLUSION The results of our study suggest that changes in kidneys detected by IVIM-DWI may serve as indicators of early diabetic kidney disease.
Collapse
Affiliation(s)
- Yi Deng
- The First Affiliated Hospital, Jinan University, Guangzhou, 510632, People's Republic of China.
- Department of Medical imaging, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China.
| | - Biran Yang
- Department of Medical imaging, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| | - Yan Peng
- Department of Medical imaging, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| | - Zhiqiang Liu
- Department of Medical imaging, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| | - Jinwen Luo
- Department of Medical imaging, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| | - Guoxin Du
- Department of Medical imaging, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People's Republic of China
| |
Collapse
|
|
24
|
Lv J, Huang W, Zhang J, Wang X. Performance of U-net based pyramidal lucas-kanade registration on free-breathing multi-b-value diffusion MRI of the kidney. Br J Radiol 2018. [PMID: 29528241 DOI: 10.1259/bjr.20170813] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE In free-breathing multi-b-value diffusion-weighted imaging (DWI), a series of images typically requires several minutes to collect. During respiration the kidney is routinely displaced and may also undergo deformation. These respiratory motion effects generate artifacts and these are the main sources of error in the quantification of intravoxel incoherent motion (IVIM) derived parameters. This work proposes a fully automated framework that combines a kidney segmentation to improve the registration accuracy. METHODS 10 healthy subjects were recruited to participate in this experiment. For the segmentation, U-net was adopted to acquire the kidney's contour. The segmented kidney then served as a region of interest (ROI) for the registration method, known as pyramidal Lucas-Kanade. Our proposed framework confines the kidney's solution range, thus increasing the pyramidal Lucas-Kanade's accuracy. To demonstrate the feasibility of our presented framework, eight regions of interest were selected in the cortex and medulla, and data stability was estimated by comparing the normalized root-mean-square error (NRMSE) values of the fitted data from the bi-exponential intravoxel incoherent motion model pre- and post- registration. RESULTS The results show that the NRMSE was significantly lower after registration both in the cortex (p < 0.05) and medulla (p < 0.01) during free-breathing measurements. In addition, expert visual scoring of the derived apparent diffusion coefficient (ADC), f, D and D* maps indicated there were significant improvements in the alignment of the kidney in the post-registered image. CONCLUSION The proposed framework can effectively reduce the motion artifacts of misaligned multi-b-value DWIs and the inaccuracies of the ADC, f, D and D* estimations. Advances in knowledge: This study demonstrates the feasibility of our proposed fully automated framework combining U-net based segmentation and pyramidal Lucas-Kanade registration method for improving the alignment of multi-b-value diffusion-weighted MRIs and reducing the inaccuracy of parameter estimation during free-breathing.
Collapse
Affiliation(s)
- Jun Lv
- 1 Academy for Advanced Interdisciplinary Studies, Peking University , Beijing , China
| | - Wenjian Huang
- 1 Academy for Advanced Interdisciplinary Studies, Peking University , Beijing , China
| | - Jue Zhang
- 1 Academy for Advanced Interdisciplinary Studies, Peking University , Beijing , China.,2 College of Engineering, Peking University , Beijing , China
| | - Xiaoying Wang
- 1 Academy for Advanced Interdisciplinary Studies, Peking University , Beijing , China.,3 Department of Radiology, Peking University First Hospital , Beijing , China
| |
Collapse
|
|
25
|
deSouza NM, Winfield JM, Waterton JC, Weller A, Papoutsaki MV, Doran SJ, Collins DJ, Fournier L, Sullivan D, Chenevert T, Jackson A, Boss M, Trattnig S, Liu Y. Implementing diffusion-weighted MRI for body imaging in prospective multicentre trials: current considerations and future perspectives. Eur Radiol 2018; 28:1118-1131. [PMID: 28956113 PMCID: PMC5811587 DOI: 10.1007/s00330-017-4972-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 05/24/2017] [Accepted: 06/28/2017] [Indexed: 12/18/2022]
Abstract
For body imaging, diffusion-weighted MRI may be used for tumour detection, staging, prognostic information, assessing response and follow-up. Disease detection and staging involve qualitative, subjective assessment of images, whereas for prognosis, progression or response, quantitative evaluation of the apparent diffusion coefficient (ADC) is required. Validation and qualification of ADC in multicentre trials involves examination of i) technical performance to determine biomarker bias and reproducibility and ii) biological performance to interrogate a specific aspect of biology or to forecast outcome. Unfortunately, the variety of acquisition and analysis methodologies employed at different centres make ADC values non-comparable between them. This invalidates implementation in multicentre trials and limits utility of ADC as a biomarker. This article reviews the factors contributing to ADC variability in terms of data acquisition and analysis. Hardware and software considerations are discussed when implementing standardised protocols across multi-vendor platforms together with methods for quality assurance and quality control. Processes of data collection, archiving, curation, analysis, central reading and handling incidental findings are considered in the conduct of multicentre trials. Data protection and good clinical practice are essential prerequisites. Developing international consensus of procedures is critical to successful validation if ADC is to become a useful biomarker in oncology. KEY POINTS • Standardised acquisition/analysis allows quantification of imaging biomarkers in multicentre trials. • Establishing "precision" of the measurement in the multicentre context is essential. • A repository with traceable data of known provenance promotes further research.
Collapse
Affiliation(s)
- N. M. deSouza
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - J. M. Winfield
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - J. C. Waterton
- Manchester Academic Health Sciences Institute, University of Manchester, Manchester, UK
| | - A. Weller
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - M.-V. Papoutsaki
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - S. J. Doran
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - D. J. Collins
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - L. Fournier
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Radiology Department, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - D. Sullivan
- Duke Comprehensive Cancer Institute, Durham, NC USA
| | - T. Chenevert
- Department of Radiology, University of Michigan Health System, Ann Arbor, MI USA
| | - A. Jackson
- Manchester Academic Health Sciences Institute, University of Manchester, Manchester, UK
| | - M. Boss
- Applied Physics Division, National Institute of Standards and Technology (NIST), Boulder, CO USA
| | - S. Trattnig
- Department of Biomedical Imaging and Image guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Y. Liu
- European Organisation for Research and Treatment of Cancer, Headquarters, Brussels, Belgium
| |
Collapse
|
|
26
|
Zhang B, Dong Y, Guo B, Chen W, Ouyang F, Lian Z, Liu J, Zhang S. Application of noninvasive functional imaging to monitor the progressive changes in kidney diffusion and perfusion in contrast-induced acute kidney injury rats at 3.0 T. Abdom Radiol (NY) 2018; 43:655-662. [PMID: 28677006 DOI: 10.1007/s00261-017-1247-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Contrast-induced acute kidney injury is a prevalent cause of renal failure, and the noninvasive tools to monitor its progress are lacking. We applied intravoxel incoherent motion (IVIM) DWI to measure the progressive changes in kidney diffusion and perfusion of CI-AKI. METHODS Twenty-four rats received Iopromide (370 mg/ml, 1600 mg iodine/kg) to induce CI-AKI. IVIM DWI was performed on rats (n = 6) at 24 h prior to and 12, 24, 48, 72, and 96 h after the injection using a 3.0 T MRI scanner. The progressive changes in the diffusion (D) and perfusion parameters (D* and f) were studied in the cortex (CO), outer medulla (OM), and inner medulla (IM). For the histology group (n = 18), three rats were sacrificed at each time point. RESULTS In the CO, D reduced progressively from 24 to 48 h (P < 0.001) and increased starting from 72 h (P < 0.001). However, D decreased until to 72 h in the medulla (P < 0.001) and increased starting from 96 h (P < 0.001). D* decreased to the bottom at 24 h in the cortex and medulla (P = 0.037) and started to recover at 48 h (P = 0.007). f decreased in the cortex and medulla in an early stage (12 h) (P = 0.035) of CI-AKI and then ascended in the later stage (72 h) (P = 0.017). The H & E staining showed different degrees of serial pathological change including cloudy swelling, atrophy, even necrosis, and interstitial vasodilation of tubule epithelial cells and glomerulus cells. CONCLUSION Our study demonstrates the feasibility of using IVIM DWI to monitor the progress of CI-AKI, implying that IVIM DWI is a useful biomarker in the staging of CI-AKI.
Collapse
|
|
27
|
Barnes A, Alonzi R, Blackledge M, Charles-Edwards G, Collins DJ, Cook G, Coutts G, Goh V, Graves M, Kelly C, Koh DM, McCallum H, Miquel ME, O’Connor J, Padhani A, Pearson R, Priest A, Rockall A, Stirling J, Taylor S, Tunariu N, van der Meulen J, Walls D, Winfield J, Punwani S. UK quantitative WB-DWI technical workgroup: consensus meeting recommendations on optimisation, quality control, processing and analysis of quantitative whole-body diffusion-weighted imaging for cancer. Br J Radiol 2018; 91:20170577. [PMID: 29076749 PMCID: PMC5966219 DOI: 10.1259/bjr.20170577] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Application of whole body diffusion-weighted MRI (WB-DWI) for oncology are rapidly increasing within both research and routine clinical domains. However, WB-DWI as a quantitative imaging biomarker (QIB) has significantly slower adoption. To date, challenges relating to accuracy and reproducibility, essential criteria for a good QIB, have limited widespread clinical translation. In recognition, a UK workgroup was established in 2016 to provide technical consensus guidelines (to maximise accuracy and reproducibility of WB-MRI QIBs) and accelerate the clinical translation of quantitative WB-DWI applications for oncology. METHODS A panel of experts convened from cancer centres around the UK with subspecialty expertise in quantitative imaging and/or the use of WB-MRI with DWI. A formal consensus method was used to obtain consensus agreement regarding best practice. Questions were asked about the appropriateness or otherwise on scanner hardware and software, sequence optimisation, acquisition protocols, reporting, and ongoing quality control programs to monitor precision and accuracy and agreement on quality control. RESULTS The consensus panel was able to reach consensus on 73% (255/351) items and based on consensus areas made recommendations to maximise accuracy and reproducibly of quantitative WB-DWI studies performed at 1.5T. The panel were unable to reach consensus on the majority of items related to quantitative WB-DWI performed at 3T. CONCLUSION This UK Quantitative WB-DWI Technical Workgroup consensus provides guidance on maximising accuracy and reproducibly of quantitative WB-DWI for oncology. The consensus guidance can be used by researchers and clinicians to harmonise WB-DWI protocols which will accelerate clinical translation of WB-DWI-derived QIBs.
Collapse
Affiliation(s)
- Anna Barnes
- Centre for Medical Imaging, University College London,University College London, London, UK
| | - Roberto Alonzi
- Clinical Oncology, Mount Vernon Cancer Centre, Northwood, UK
| | - Matthew Blackledge
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research,Institute of Cancer Research, Sutton, UK
| | | | | | | | - Glynn Coutts
- MR Physics, The Christie NHS Foundation Trust, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Martin Graves
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Charles Kelly
- Department of Radiology, Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust,Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust, Newcastle upon Tyne, UK
| | | | - Hazel McCallum
- Department of Radiology, Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust,Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust, Newcastle upon Tyne, UK
| | | | | | - Anwar Padhani
- Paul Strickland Cancer Centre, Mount Vernon Cancer Centre, Northwood, UK
| | | | - Andrew Priest
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Andrea Rockall
- Department of Radiology, The Royal Marsden Hospital Foundation Trust,The Royal Marsden Hospital Foundation Trust, Surrey, UK
| | | | | | | | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine,London School of Hygiene and Tropical Medicine, London, UK
| | - Darren Walls
- Institute Nuclear Medicine, University College London, London, UK
| | | | | |
Collapse
|
|
28
|
Lecler A, Savatovsky J, Balvay D, Zmuda M, Sadik JC, Galatoire O, Charbonneau F, Bergès O, Picard H, Fournier L. Repeatability of apparent diffusion coefficient and intravoxel incoherent motion parameters at 3.0 Tesla in orbital lesions. Eur Radiol 2017; 27:5094-5103. [PMID: 28677061 PMCID: PMC5674133 DOI: 10.1007/s00330-017-4933-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate repeatability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters in the orbit. METHODS From December 2015 to March 2016, 22 patients were scanned twice using an IVIM sequence with 15b values (0-2,000 s/mm2) at 3.0T. Two readers independently delineated regions of interest in an orbital mass and in different intra-orbital and extra-orbital structures. Short-term test-retest repeatability and inter-observer agreement were assessed using the intra-class correlation coefficient (ICC), the coefficient of variation (CV) and Bland-Altman limits of agreements (BA-LA). RESULTS Test-retest repeatability of IVIM parameters in the orbital mass was satisfactory for ADC and D (mean CV 12% and 14%, ICC 95% and 93%), poor for f and D*(means CV 43% and 110%, ICC 90% and 65%). Inter-observer repeatability agreement was almost perfect in the orbital mass for all the IVIM parameters (ICC = 95%, 93%, 94% and 90% for ADC, D, f and D*, respectively). CONCLUSIONS IVIM appeared to be a robust tool to measure D in orbital lesions with good repeatability, but this approach showed a poor repeatability of f and D*. KEY POINTS • IVIM technique is feasible in the orbit. • IVIM has a good-acceptable repeatability of D (CV range 12-25 %). • IVIM interobserver repeatability agreement is excellent (ICC range 90-95 %). • f or D* provide higher test-retest and interobserver variabilities.
Collapse
Affiliation(s)
- Augustin Lecler
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France.
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France.
| | - Julien Savatovsky
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Daniel Balvay
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France
| | - Mathieu Zmuda
- Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Jean-Claude Sadik
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Olivier Galatoire
- Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Frédérique Charbonneau
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Olivier Bergès
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Hervé Picard
- Clinical Research Unit, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Laure Fournier
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Radiology Department, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| |
Collapse
|
|
29
|
Vidić I, Egnell L, Jerome NP, Teruel JR, Sjøbakk TE, Østlie A, Fjøsne HE, Bathen TF, Goa PE. Support vector machine for breast cancer classification using diffusion-weighted MRI histogram features: Preliminary study. J Magn Reson Imaging 2017; 47:1205-1216. [PMID: 29044896 DOI: 10.1002/jmri.25873] [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: 07/11/2017] [Accepted: 09/23/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Diffusion-weighted MRI (DWI) is currently one of the fastest developing MRI-based techniques in oncology. Histogram properties from model fitting of DWI are useful features for differentiation of lesions, and classification can potentially be improved by machine learning. PURPOSE To evaluate classification of malignant and benign tumors and breast cancer subtypes using support vector machine (SVM). STUDY TYPE Prospective. SUBJECTS Fifty-one patients with benign (n = 23) and malignant (n = 28) breast tumors (26 ER+, whereof six were HER2+). FIELD STRENGTH/SEQUENCE Patients were imaged with DW-MRI (3T) using twice refocused spin-echo echo-planar imaging with echo time / repetition time (TR/TE) = 9000/86 msec, 90 × 90 matrix size, 2 × 2 mm in-plane resolution, 2.5 mm slice thickness, and 13 b-values. ASSESSMENT Apparent diffusion coefficient (ADC), relative enhanced diffusivity (RED), and the intravoxel incoherent motion (IVIM) parameters diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction (f) were calculated. The histogram properties (median, mean, standard deviation, skewness, kurtosis) were used as features in SVM (10-fold cross-validation) for differentiation of lesions and subtyping. STATISTICAL TESTS Accuracies of the SVM classifications were calculated to find the combination of features with highest prediction accuracy. Mann-Whitney tests were performed for univariate comparisons. RESULTS For benign versus malignant tumors, univariate analysis found 11 histogram properties to be significant differentiators. Using SVM, the highest accuracy (0.96) was achieved from a single feature (mean of RED), or from three feature combinations of IVIM or ADC. Combining features from all models gave perfect classification. No single feature predicted HER2 status of ER + tumors (univariate or SVM), although high accuracy (0.90) was achieved with SVM combining several features. Importantly, these features had to include higher-order statistics (kurtosis and skewness), indicating the importance to account for heterogeneity. DATA CONCLUSION Our findings suggest that SVM, using features from a combination of diffusion models, improves prediction accuracy for differentiation of benign versus malignant breast tumors, and may further assist in subtyping of breast cancer. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1205-1216.
Collapse
Affiliation(s)
- Igor Vidić
- Department of Physics, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Liv Egnell
- Department of Physics, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Neil P Jerome
- Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Jose R Teruel
- Department of Radiology, University of California San Diego, La Jolla, California, USA.,Department of Radiation Oncology, NYU Langone Medical Center, New York, New York, USA
| | - Torill E Sjøbakk
- Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Agnes Østlie
- Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Hans E Fjøsne
- Department of Cancer Research and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Erik Goa
- Department of Physics, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| |
Collapse
|
|
30
|
Kuai ZX, Liu WY, Zhu YM. Effect of multiple perfusion components on pseudo-diffusion coefficient in intravoxel incoherent motion imaging. ACTA ACUST UNITED AC 2017; 62:8197-8209. [DOI: 10.1088/1361-6560/aa8d0c] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
|
31
|
Evaluation and Minimization of the Pseudohepatic Anisotropy Artifact in Liver Intravoxel Incoherent Motion. J Comput Assist Tomogr 2017; 41:679-687. [PMID: 28708735 DOI: 10.1097/rct.0000000000000604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this study was to evaluate the effect of the pseudohepatic anisotropy artifact on liver intravoxel incoherent motion (IVIM) metrics and whether the use of multiple gradient directions in the IVIM acquisition minimizes the artifact. MATERIALS AND METHODS Multiple breath-holding and forced shallow free-breathing IVIM scans were performed on 8 healthy volunteers using 1 and 6 gradient directions. Cluster analysis was carried out to separate motion-contaminated parenchyma from liver parenchyma and vessels. Nonlinear motion analysis was also performed to look for a possible link between IVIM metrics and nonlinear liver motion. RESULTS On the basis of the resulted clusters, motion-contaminated parenchyma is often noted in the left liver lobe, where the prominent pseudohepatic artifact has previously been identified. A significant reduction in outliers was obtained with the acquisition of 6 noncoplanar gradient directions and when using forced shallow free-breathing. CONCLUSION The pseudohepatic anisotropy artifact can be minimized when using multiple diffusion-encoding gradient directions and forced free-breathing during IVIM acquisition.
Collapse
|
|
32
|
Takayama Y, Nishie A, Asayama Y, Ishigami K, Kakihara D, Ushijima Y, Fujita N, Shirabe K, Takemura A, Honda H. Image quality and diagnostic performance of free-breathing diffusion-weighted imaging for hepatocellular carcinoma. World J Hepatol 2017; 9:657-666. [PMID: 28588750 PMCID: PMC5437610 DOI: 10.4254/wjh.v9.i14.657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/11/2017] [Accepted: 04/24/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To retrospectively evaluate the diagnostic performance of free-breathing diffusion-weighted imaging (FB-DWI) with modified imaging parameter settings for detecting hepatocellular carcinomas (HCCs).
METHODS Fifty-one patients at risk for HCC were scanned with both FB-DWI and respiratory-triggered DWI with the navigator echo respiratory-triggering technique (RT-DWI). Qualitatively, the sharpness of the liver contour, the image noise and the chemical shift artifacts on each DWI with b-values of 1000 s/mm2 were independently evaluated by three radiologists using 4-point scoring. We compared the image quality scores of each observer between the two DWI methods, using the Wilcoxon signed-rank test. Quantitatively, we compared the signal-to-noise ratios (SNRs) of the liver parenchyma and lesion-to-nonlesion contrast-to-noise ratios (CNRs) after measuring the signal intensity on each DWI with a b-factor of 1000 s/mm2. The average SNRs and CNRs between the two DWI methods were compared by the paired t-test. The detectability of HCC on each DWI was also analyzed by three radiologists. The detectability provided by the two DWI methods was compared using McNemar’s test.
RESULTS For all observers, the averaged image quality scores of FB-DWI were: Sharpness of the liver contour [observer (Obs)-1, 3.08 ± 0.81; Obs-2, 2.98 ± 0.73; Obs-3, 3.54 ± 0.75], those of the distortion (Obs-1, 2.94 ± 0.50; Obs-2, 2.71 ± 0.70; Obs-3, 3.27 ± 0.53), and the chemical shift artifacts (Obs-1, 3.38 ± 0.60; Obs-2, 3.15 ± 1.07; Obs-3, 3.21 ± 0.85). The averaged image quality scores of RT-DWI were: Sharpness of the liver contour (Obs-1, 2.33 ± 0.65; Obs-2, 2.37 ± 0.74; Obs-3, 2.75 ± 0.81), distortion (Obs-1, 2.81 ± 0.56; Obs-2, 2.25 ± 0.74; Obs-3, 2.96 ± 0.71), and the chemical shift artifacts (Obs-1, 2.92 ± 0.59; Obs-2, 2.21 ± 0.85; Obs-3, 2.77 ± 1.08). All image quality scores of FB-DWI were significantly higher than those of RT-DWI (P < 0.05). The average SNR of the normal liver parenchyma by FB-DWI (11.0 ± 4.8) was not significantly different from that shown by RT-DWI (11.0 ± 5.0); nor were the lesion-to-nonlesion CNRs significantly different (FB-DWI, 21.4 ± 17.7; RT-DWI, 20.1 ± 15.1). For all three observers, the detectability of FB-DWI (Obs-1, 43.6%; Obs-2, 53.6%; and Obs-3, 45.0%) was significantly higher than that of RT-DWI (Obs-1, 29.1%; Obs-2, 43.6%; and Obs-3, 34.5%) (P < 0.05).
CONCLUSION FB-DWI showed better image quality and higher detectability of HCC compared to RT-DWI, without significantly reducing the SNRs of the liver parenchyma and lesion-to-nonlesion CNRs.
Collapse
|
|
33
|
DCE-MRI, DW-MRI, and MRS in Cancer: Challenges and Advantages of Implementing Qualitative and Quantitative Multi-parametric Imaging in the Clinic. Top Magn Reson Imaging 2017; 25:245-254. [PMID: 27748710 PMCID: PMC5081190 DOI: 10.1097/rmr.0000000000000103] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Multi-parametric magnetic resonance imaging (mpMRI) offers a unique insight into tumor biology by combining functional MRI techniques that inform on cellularity (diffusion-weighted MRI), vascular properties (dynamic contrast-enhanced MRI), and metabolites (magnetic resonance spectroscopy) and has scope to provide valuable information for prognostication and response assessment. Challenges in the application of mpMRI in the clinic include the technical considerations in acquiring good quality functional MRI data, development of robust techniques for analysis, and clinical interpretation of the results. This article summarizes the technical challenges in acquisition and analysis of multi-parametric MRI data before reviewing the key applications of multi-parametric MRI in clinical research and practice.
Collapse
|
|
34
|
Comparison of Turbo Spin Echo and Echo Planar Imaging for intravoxel incoherent motion and diffusion tensor imaging of the kidney at 3Tesla. Z Med Phys 2017; 27:193-201. [PMID: 28410964 DOI: 10.1016/j.zemedi.2016.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/26/2016] [Accepted: 12/19/2016] [Indexed: 01/09/2023]
Abstract
Echo Planar Imaging (EPI) is most commonly applied to acquire diffusion-weighted MR-images. EPI is able to capture an entire image in very short time, but is prone to distortions and artifacts. In diffusion-weighted EPI of the kidney severe distortions may occur due to intestinal gas. Turbo Spin Echo (TSE) is robust against distortions and artifacts, but needs more time to acquire an entire image compared to EPI. Therefore, TSE is more sensitive to motion during the readout. In this study we compare diffusion-weighted TSE and EPI of the human kidney with regard to intravoxel incoherent motion (IVIM) and diffusion tensor imaging (DTI). Images were acquired with b-values between 0 and 750s/mm2 with TSE and EPI. Distortions were observed with the EPI readout in all volunteers, while the TSE images were virtually distortion-free. Fractional anisotropy of the diffusion tensor was significantly lower for TSE than for EPI. All other parameters of DTI and IVIM were comparable for TSE and EPI. Especially the main diffusion directions yielded by TSE and EPI were similar. The results demonstrate that TSE is a worthwhile distortion-free alternative to EPI for diffusion-weighted imaging of the kidney at 3Tesla.
Collapse
|
|
35
|
Li YT, Cercueil JP, Yuan J, Chen W, Loffroy R, Wáng YXJ. Liver intravoxel incoherent motion (IVIM) magnetic resonance imaging: a comprehensive review of published data on normal values and applications for fibrosis and tumor evaluation. Quant Imaging Med Surg 2017; 7:59-78. [PMID: 28275560 DOI: 10.21037/qims.2017.02.03] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A comprehensive literature review was performed on liver intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) technique and its applications. Heterogeneous data have been reported. IVIM parameters are magnetic field strength dependent to a mild extent. A lower Dslow (D) value at 3 T than at 1.5 T and higher perfusion fraction (PF) value at 3 T than at 1.5 T were noted. An increased number of b values are associated with increased IVIM parameter measurement accuracy. With the current status of art, IVIM technique is not yet capable of detecting early stage liver fibrosis and diagnosing liver fibrosis grades, nor can it differentiate liver tumors. Though IVIM parameters show promise for tumor treatment monitoring, till now how PF and Dfast (D*) add diagnostic value to Dslow or apparent diffusion coefficient (ADC) remains unclear. This paper shows the state-of-art IVIM MR technique is still not able to offer reliable measurement for liver. More works on the measurement robustness are warranted as they are essential to justify follow-up clinical studies on patients.
Collapse
Affiliation(s)
- Yáo T Li
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China
| | - Jean-Pierre Cercueil
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France
| | - Jing Yuan
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, University of Burgundy, Dijon, France
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China
| |
Collapse
|
|
36
|
Jerome NP, d’Arcy JA, Feiweier T, Koh DM, Leach MO, Collins DJ, Orton MR. Extended T2-IVIM model for correction of TE dependence of pseudo-diffusion volume fraction in clinical diffusion-weighted magnetic resonance imaging. Phys Med Biol 2016; 61:N667-N680. [PMID: 27893459 PMCID: PMC5952260 DOI: 10.1088/1361-6560/61/24/n667] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/24/2016] [Accepted: 11/01/2016] [Indexed: 01/19/2023]
Abstract
The bi-exponential intravoxel-incoherent-motion (IVIM) model for diffusion-weighted MRI (DWI) fails to account for differential T 2 s in the model compartments, resulting in overestimation of pseudodiffusion fraction f. An extended model, T2-IVIM, allows removal of the confounding echo-time (TE) dependence of f, and provides direct compartment T 2 estimates. Two consented healthy volunteer cohorts (n = 5, 6) underwent DWI comprising multiple TE/b-value combinations (Protocol 1: TE = 62-102 ms, b = 0-250 mm-2s, 30 combinations. Protocol 2: 8 b-values 0-800 mm-2s at TE = 62 ms, with 3 additional b-values 0-50 mm-2s at TE = 80, 100 ms; scanned twice). Data from liver ROIs were fitted with IVIM at individual TEs, and with the T2-IVIM model using all data. Repeat-measures coefficients of variation were assessed for Protocol 2. Conventional IVIM modelling at individual TEs (Protocol 1) demonstrated apparent f increasing with longer TE: 22.4 ± 7% (TE = 62 ms) to 30.7 ± 11% (TE = 102 ms); T2-IVIM model fitting accounted for all data variation. Fitting of Protocol 2 data using T2-IVIM yielded reduced f estimates (IVIM: 27.9 ± 6%, T2-IVIM: 18.3 ± 7%), as well as T 2 = 42.1 ± 7 ms, 77.6 ± 30 ms for true and pseudodiffusion compartments, respectively. A reduced Protocol 2 dataset yielded comparable results in a clinical time frame (11 min). The confounding dependence of IVIM f on TE can be accounted for using additional b/TE images and the extended T2-IVIM model.
Collapse
Affiliation(s)
- N P Jerome
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | - J A d’Arcy
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | | | - D-M Koh
- Department of Radiology, Royal Marsden Hospital, Sutton, Surrey, UK
| | - M O Leach
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | - D J Collins
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | - M R Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| |
Collapse
|
|
37
|
Saito K, Tajima Y, Harada TL. Diffusion-weighted imaging of the liver: Current applications. World J Radiol 2016; 8:857-867. [PMID: 27928467 PMCID: PMC5120245 DOI: 10.4329/wjr.v8.i11.857] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/10/2016] [Accepted: 10/24/2016] [Indexed: 02/06/2023] Open
Abstract
Diffusion-weighted imaging (DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibrosis, tumor detection/characterization, and following/predicting therapy. To improve reliability including accuracy and reproducibility, researchers have validated this new technique in terms of image acquisition, data sampling, and analysis. The added value of DWI in contrast-enhanced magnetic resonance imaging was established in the detection of malignant liver lesions. However, some limitations remain in terms of lesion characterization and fibrosis detection. Furthermore, the methodologies of image acquisition and data analysis have been inconsistent. Therefore, researchers should make every effort to not only improve accuracy and reproducibility but also standardize imaging parameters.
Collapse
|
|
38
|
Deng Y, Li X, Lei Y, Liang C, Liu Z. Use of diffusion-weighted magnetic resonance imaging to distinguish between lung cancer and focal inflammatory lesions: a comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient. Acta Radiol 2016; 57:1310-1317. [PMID: 25972370 DOI: 10.1177/0284185115586091] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Using imaging techniques to diagnose malignant and inflammatory lesions in the lung can be challenging. Purpose To compare intravoxel incoherent motion (IVIM) and apparent diffusion coefficient (ADC) magnetic resonance imaging (MRI) analysis in their ability to discriminate lung cancer from focal inflammatory lung lesions. Material and Methods Thirty-eight patients with lung masses were included: 30 lung cancers and eight inflammatory lesions. Patients were imaged with 3.0T MRI diffusion weighted imaging (DWI) using 10 b values (range, 0-1000 s/mm2). Tissue diffusivity ( D), pseudo-diffusion coefficient ( D*), and perfusion fraction ( f) were calculated using segmented biexponential analysis. ADC (total) was calculated with monoexponential fitting of the DWI data. D, D*, f, and ADC were compared between lung cancer and inflammatory lung lesions. Receiver operating characteristic analysis was performed for all DWI parameters. Results The ADC was significantly higher for inflammatory lesions than for lung cancer ([1.21 ± 0.20] × 10-3 mm2/s vs. [0.97 ± 0.15] × 10-3 mm2/s; P = 0.004). By IVIM, f was found to be significantly higher in inflammatory lesions than lung cancer ([46.10 ± 12.92] % vs. [29.29 ± 10.89] %; P = 0.005). There was no difference in D and D* between lung cancer and inflammatory lesions ( P = 0.747 and 0.124, respectively). f showed comparable diagnostic performance with ADC in differentiating lung cancer from inflammatory lung lesions, with areas under the curve of 0.833 and 0.826, sensitivity 80.0% and 73.3%, and specificity 75.0% and 87.5%, respectively. Conclusion The IVIM parameter f value provides comparable diagnostic performance with ADC and could be used as a surrogate marker for differentiating lung cancer from inflammatory lesions.
Collapse
Affiliation(s)
- Yu Deng
- Southern Medical University, Guangzhou, PR China
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, PR China
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Xinchun Li
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Yongxia Lei
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Changhong Liang
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, PR China
| | - Zaiyi Liu
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, PR China
| |
Collapse
|
|
39
|
Hilbert F, Bock M, Neubauer H, Veldhoen S, Wech T, Bley TA, Köstler H. An intravoxel oriented flow model for diffusion-weighted imaging of the kidney. NMR IN BIOMEDICINE 2016; 29:1403-1413. [PMID: 27488570 DOI: 10.1002/nbm.3584] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/06/2016] [Accepted: 06/21/2016] [Indexed: 06/06/2023]
Abstract
By combining intravoxel incoherent motion (IVIM) and diffusion tensor imaging (DTI) we introduce a new diffusion model called intravoxel oriented flow (IVOF) that accounts for anisotropy of diffusion and the flow-related signal. An IVOF model using a simplified apparent flow fraction tensor (IVOFf ) is applied to diffusion-weighted imaging of human kidneys. The kidneys of 13 healthy volunteers were examined on a 3 T scanner. Diffusion-weighted images were acquired with six b values between 0 and 800 s/mm(2) and 30 diffusion directions. Diffusivity and flow fraction were calculated for different diffusion models. The Akaike information criterion was used to compare the model fit of the proposed IVOFf model to IVIM and DTI. In the majority of voxels the proposed IVOFf model with a simplified apparent flow fraction tensor performs better than IVIM and DTI. Mean diffusivity is significantly higher in DTI compared with models that account for the flow-related signal. The fractional anisotropy of diffusion is significantly reduced when flow fraction is considered to be anisotropic. Anisotropy of the apparent flow fraction tensor is significantly higher in the renal medulla than in the cortex region. The IVOFf model describes diffusion-weighted data in the human kidney more accurately than IVIM or DTI. The apparent flow fraction in the kidney proved to be anisotropic.
Collapse
Affiliation(s)
- Fabian Hilbert
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany.
| | - Maximilian Bock
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Henning Neubauer
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Simon Veldhoen
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Tobias Wech
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Thorsten Alexander Bley
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| |
Collapse
|
|
40
|
Taouli B, Beer AJ, Chenevert T, Collins D, Lehman C, Matos C, Padhani AR, Rosenkrantz AB, Shukla-Dave A, Sigmund E, Tanenbaum L, Thoeny H, Thomassin-Naggara I, Barbieri S, Corcuera-Solano I, Orton M, Partridge SC, Koh DM. Diffusion-weighted imaging outside the brain: Consensus statement from an ISMRM-sponsored workshop. J Magn Reson Imaging 2016; 44:521-40. [PMID: 26892827 PMCID: PMC4983499 DOI: 10.1002/jmri.25196] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/28/2016] [Accepted: 01/30/2016] [Indexed: 12/11/2022] Open
Abstract
The significant advances in magnetic resonance imaging (MRI) hardware and software, sequence design, and postprocessing methods have made diffusion-weighted imaging (DWI) an important part of body MRI protocols and have fueled extensive research on quantitative diffusion outside the brain, particularly in the oncologic setting. In this review, we summarize the most up-to-date information on DWI acquisition and clinical applications outside the brain, as discussed in an ISMRM-sponsored symposium held in April 2015. We first introduce recent advances in acquisition, processing, and quality control; then review scientific evidence in major organ systems; and finally describe future directions. J. Magn. Reson. Imaging 2016;44:521-540.
Collapse
Affiliation(s)
- Bachir Taouli
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ambros J. Beer
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Thomas Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Collins
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | - Constance Lehman
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Celso Matos
- Department of Radiology, Champalimaud Clinical Centre, Lisbon, Portugal
| | | | | | - Amita Shukla-Dave
- Departments of Medical Physics and Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Eric Sigmund
- Irene and Bernard Schwartz Center for Biomedical Imaging (CBI) and Center for Advanced Imaging and Innovation (CAIR), Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - Lawrence Tanenbaum
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Harriet Thoeny
- Department of Diagnostic Radiology, Inselspital Bern, Bern, Switzerland
| | | | | | - Idoia Corcuera-Solano
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matthew Orton
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | | | - Dow-Mu Koh
- Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| |
Collapse
|
|
41
|
Bane O, Wagner M, Zhang JL, Dyvorne HA, Orton M, Rusinek H, Taouli B. Assessment of renal function using intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI. J Magn Reson Imaging 2016; 44:317-26. [PMID: 26855407 PMCID: PMC4946973 DOI: 10.1002/jmri.25171] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/13/2016] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To assess the correlation between each of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) metrics in renal parenchyma with renal function, in a cohort of patients with chronic liver disease. MATERIALS AND METHODS Thirty patients with liver disease underwent abdominal MRI at 1.5T, including a coronal respiratory-triggered IVIM-DWI sequence and a coronal 3D FLASH DCE-MRI acquisition. Diffusion signals in the renal cortex and medulla were fitted to the IVIM model to estimate the diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (PF). The apparent diffusion coefficient (ADC) was calculated using all b-values. The glomerular filtration rate (GFR), cortical and medullary renal plasma flow (RPF), mean transit times (MTT) of vascular and tubular compartments and the whole kidney, were calculated from DCE-MRI data by fitting to a three-compartment model. The estimated GFR (eGFR) was calculated from serum creatinine measured 30 ± 27 days of MRI. RESULTS ADC, PF, and RPF were significantly higher in renal cortex vs. medulla (P < 10(-5) ). DCE-MRI GFR significantly correlated with, but underestimated, eGFR (Spearman's r/P = 0.49/0.01). IVIM-DWI parameters were not significantly correlated with eGFR. DCE-MRI GFR correlated weakly with D (cortex, r/P = 0.3/0.03; medulla r/P = 0.27/0.05) and ADC (cortex r/P = 0.28/0.04; medulla r/P = 0.34/0.01). Weak correlations were observed for pooled cortical and medullar RPF with PF (r/P = 0.32/10(-3) ) and with ADC (r/P = 0.29/0.0025). Significant negative correlations were observed for vascular MTT with cortical D* (r/P = -0.38/0.004) and D*×PF (r/P = -0.34/0.01). CONCLUSION The weak correlations between renal IVIM and DCE-MRI perfusion parameters imply that these functional measures could be complementary. J. Magn. Reson. Imaging 2016;44:317-326.
Collapse
Affiliation(s)
- Octavia Bane
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mathilde Wagner
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jeff L. Zhang
- Departments of Radiology and Biomedical Engineering, University of Utah, Salt Lake City, UT
| | - Hadrien A. Dyvorne
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Matthew Orton
- Division of Radiotherapy and Imaging, Institute of Cancer Research, Sutton, Surrey, UK
| | - Henry Rusinek
- Departments of Radiology and Biomedical Engineering, New York University, New York, NY
| | - Bachir Taouli
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
|
42
|
Dohan A, Taylor S, Hoeffel C, Barret M, Allez M, Dautry R, Zappa M, Savoye-Collet C, Dray X, Boudiaf M, Reinhold C, Soyer P. Diffusion-weighted MRI in Crohn's disease: Current status and recommendations. J Magn Reson Imaging 2016; 44:1381-1396. [PMID: 27249184 DOI: 10.1002/jmri.25325] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 05/12/2016] [Indexed: 12/19/2022] Open
Abstract
Over the past years, technological improvements and refinements in magnetic resonance imaging (MRI) hardware have made high-quality diffusion-weighted imaging (DWI) routinely possible for the bowel. DWI is promising for the detection and characterization of lesions in Crohn's disease (CD) and has been advocated as an alternative to intravenous gadolinium-based contrast agents. Furthermore, quantification using the apparent diffusion coefficient may have value as a biomarker of CD activity and has shown promise. In this article we critically review the literature pertaining to the value of DWI in CD for detection, characterization, and quantification of disease activity and complications. Although the body of supportive evidence is growing, it is clear that well-designed, multicenter studies are required before the role of DWI in clinical practice can be fully established. J. Magn. Reson. Imaging 2016;44:1381-1396.
Collapse
Affiliation(s)
- Anthony Dohan
- McGill University Health Center, Department of Radiology, McGill University Health Center, Montreal, QC, Canada
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
- INSERM UMR 965, Paris, France
| | - Stuart Taylor
- Centre for Medical Imaging, University College London, Podium Level 2, University College Hospital, London, UK
| | | | - Maximilien Barret
- Department of Gastroenterology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Matthieu Allez
- Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
- Department of Gastroenterology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Raphael Dautry
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Magaly Zappa
- Department of Radiology, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | | | - Xavier Dray
- Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
- Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mourad Boudiaf
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Caroline Reinhold
- McGill University Health Center, Department of Radiology, McGill University Health Center, Montreal, QC, Canada
| | - Philippe Soyer
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
- INSERM UMR 965, Paris, France
| |
Collapse
|
|
43
|
Orton MR, Messiou C, Collins D, Morgan VA, Tessier J, Young H, deSouza N, Leach MO. Diffusion-weighted MR imaging of metastatic abdominal and pelvic tumours is sensitive to early changes induced by a VEGF inhibitor using alternative diffusion attenuation models. Eur Radiol 2016; 26:1412-9. [PMID: 26253255 PMCID: PMC4820470 DOI: 10.1007/s00330-015-3933-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/16/2015] [Accepted: 07/20/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To assess the utility of diffusion weighted imaging for monitoring early treatment effects associated with a VEGF inhibitor. MATERIALS AND METHODS Twenty-nine patients with metastatic abdominal and pelvic tumours were recruited and imaged with DW-MRI: twice at baseline, and after 7 and 28 days of treatment with cediranib. Tumour measures were derived using mono-exponential, bi-exponential and stretched-exponential models, and parameter repeatability and treatment effects seen after 7 and 28 days were assessed. Correlations with volume changes and DCE-MRI metrics were also assessed. RESULTS Diffusion coefficient repeatabilities from all models were < 6%; f and D* (bi-exponential) were 22% and 44%; α (stretched-exponential) was 4.2%. Significant increases in the diffusion coefficients from all models were observed at day 28 but not day 7. Significant decreases in D* and f.D* were observed at day 7 and in f at day 28; significant increases in α were observed at both time-points. Weak correlations between DW-MRI changes and volume changes and DCE-MRI changes were observed. CONCLUSION DW-MRI is sensitive to early and late treatment changes caused by a VEGF inhibitor using non-mono-exponential models. Evidence of over-fitting using the bi-exponential model suggests that the stretched-exponential model is best suited to monitor such changes. KEY POINTS • Non-mono-exponential diffusion models widen sensitivity to a broader class of tissue properties. • A stretched-exponential model robustly detects changes after 7 days of VEGF-inhibitor treatment. • There are very weak correlations between DWI-IVIM perfusion and similar DCE-MRI measures. • Diffusion-weighted MRI is a highly informative technique for assessing novel tumour therapies.
Collapse
Affiliation(s)
- Matthew R Orton
- CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK.
- Institute of Cancer Research, 15 Cotswold Road, Belmont, Sutton, Surrey, SM2 5MG, UK.
| | - Christina Messiou
- CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
- Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - David Collins
- CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Veronica A Morgan
- Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Jean Tessier
- Early Clinical Development, AstraZeneca, Macclesfield, UK
| | - Helen Young
- Early Clinical Development, AstraZeneca, Macclesfield, UK
| | - Nandita deSouza
- CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
- Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Martin O Leach
- CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| |
Collapse
|
|
44
|
Intravoxel incoherent motion analysis of abdominal organs: computation of reference parameters in a large cohort of C57Bl/6 mice and correlation to microvessel density. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:751-63. [DOI: 10.1007/s10334-016-0540-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 02/19/2016] [Accepted: 02/22/2016] [Indexed: 12/30/2022]
|
|
45
|
Ye Q, Chen Z, Zhao Y, Zhang Z, Miao H, Xiao Q, Wang M, Li J. Initial experience of generalized intravoxel incoherent motion imaging and diffusion tensor imaging (GIVIM-DTI) in healthy subjects. J Magn Reson Imaging 2016; 44:732-8. [PMID: 27079733 DOI: 10.1002/jmri.25262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 03/18/2016] [Indexed: 11/06/2022] Open
Affiliation(s)
- Qiong Ye
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| | - Zhongwei Chen
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| | - Youfan Zhao
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| | - Zhenhua Zhang
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| | - Haiwei Miao
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| | - Qinqin Xiao
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| | - Meihao Wang
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| | - Jiance Li
- Department of Radiology; The First Affiliated Hospital of Wenzhou Medical University; ZheJiang P.R. China
| |
Collapse
|
|
46
|
Taron J, Martirosian P, Erb M, Kuestner T, Schwenzer NF, Schmidt H, Honndorf VS, Weiβ J, Notohamiprodjo M, Nikolaou K, Schraml C. Simultaneous multislice diffusion-weighted MRI of the liver: Analysis of different breathing schemes in comparison to standard sequences. J Magn Reson Imaging 2016; 44:865-79. [PMID: 26919580 DOI: 10.1002/jmri.25204] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To systematically evaluate image characteristics of simultaneous-multislice (SMS)-accelerated diffusion-weighted imaging (DWI) of the liver using different breathing schemes in comparison to standard sequences. MATERIALS AND METHODS DWI of the liver was performed in 10 healthy volunteers and 12 patients at 1.5T using an SMS-accelerated echo planar imaging sequence performed with respiratory-triggering and free breathing (SMS-RT, SMS-FB). Standard DWI sequences served as reference (STD-RT, STD-FB). Reduction of scan time by SMS-acceleration was measured. Image characteristics of SMS-DWI and STD-DWI with both breathing schemes were analyzed quantitatively (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR]) and qualitatively (5-point Likert scale, 5 = excellent). Qualitative and quantitative parameters were compared using Friedman test and Dunn-Bonferroni post-hoc method with P-values < 0.05 considered statistically significant. RESULTS SMS-DWI provided diagnostic image quality in volunteers and patients both with RT and FB with a reduction of scan time of 70% (0:56 vs. 3:20 min in FB). Overall image quality did not significantly differ between FB and RT acquisition in both STD and SMS sequences (median STD-RT 5.0, STD-FB 4.5, SMS-RT: 4.75; SMS-FB: 4.5; P = 0.294). SNR in the right hepatic lobe was comparable between the four tested sequences. ADC values were significantly lower in SMS-DWI compared to STD-DWI irrespective of the breathing scheme (1.2 ± 0.2 × 10(-3) mm(2) /s vs. 1.0 ± 0.2 × 10(-3) mm(2) /s; P < 0.001). CONCLUSION SMS-acceleration provides considerable scan time reduction for hepatic DWI with equivalent image quality compared to the STD technique both using RT and FB. Discrepancies in ADC between STD-DWI and SMS-DWI need to be considered when transferring the SMS technique to clinical routine reading. J. MAGN. RESON. IMAGING 2016;44:865-879.
Collapse
Affiliation(s)
- Jana Taron
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Petros Martirosian
- Section on Experimental Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University Hospital of Tuebingen, Tuebingen, Germany
| | - Thomas Kuestner
- Institute of Signal Processing and System Theory, University of Stuttgart, Stuttgart, Germany
| | - Nina F Schwenzer
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Holger Schmidt
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Valerie S Honndorf
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Jakob Weiβ
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Mike Notohamiprodjo
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Konstantin Nikolaou
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Christina Schraml
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital of Tuebingen, Tuebingen, Germany.
| |
Collapse
|
|
47
|
Comparison of Free-Breathing With Navigator-Triggered Technique in Diffusion Weighted Imaging for Evaluation of Small Hepatocellular Carcinoma: Effect on Image Quality and Intravoxel Incoherent Motion Parameters. J Comput Assist Tomogr 2015. [PMID: 26196345 DOI: 10.1097/rct.0000000000000278] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the effect on image quality and intravoxel incoherent motion (IVIM) parameters of small hepatocellular carcinoma (HCC) from choice of either free-breathing (FB) or navigator-triggered (NT) diffusion-weighted (DW) imaging. METHODS Thirty patients with 37 small HCCs underwent IVIM DW imaging using 12 b values (0-800 s/mm) with 2 sequences: NT, FB. A biexponential analysis with the Bayesian method yielded true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) in small HCCs and liver parenchyma. Apparent diffusion coefficient (ADC) was also calculated. The acquisition time and image quality scores were assessed for 2 sequences. Independent sample t test was used to compare image quality, signal intensity ratio, IVIM parameters, and ADC values between the 2 sequences; reproducibility of IVIM parameters, and ADC values between 2 sequences was assessed with the Bland-Altman method (BA-LA). RESULTS Image quality with NT sequence was superior to that with FB acquisition (P = 0.02). The mean acquisition time for FB scheme was shorter than that of NT sequence (6 minutes 14 seconds vs 10 minutes 21 seconds ± 10 seconds P < 0.01). The signal intensity ratio of small HCCs did not vary significantly between the 2 sequences. The ADC and IVIM parameters from the 2 sequences show no significant difference. Reproducibility of D*and f parameters in small HCC was poor (BA-LA: 95% confidence interval, -180.8% to 189.2% for D* and -133.8% to 174.9% for f). A moderate reproducibility of D and ADC parameters was observed (BA-LA: 95% confidence interval, -83.5% to 76.8% for D and -74.4% to 88.2% for ADC) between the 2 sequences. CONCLUSIONS The NT DW imaging technique offers no advantage in IVIM parameters measurements of small HCC except better image quality, whereas FB technique offers greater confidence in fitted diffusion parameters for matched acquisition periods.
Collapse
|
|
48
|
Barbieri S, Donati OF, Froehlich JM, Thoeny HC. Comparison of Intravoxel Incoherent Motion Parameters across MR Imagers and Field Strengths: Evaluation in Upper Abdominal Organs. Radiology 2015; 279:784-94. [PMID: 26678455 DOI: 10.1148/radiol.2015151244] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose To determine the reproducibility of intravoxel incoherent motion (IVIM) parameters measured in upper abdominal organs with magnetic resonance (MR) imagers from different vendors and with different field strengths. Materials and Methods This prospective study was approved by the independent ethics committees of Kanton Bern and Kanton Zurich, and signed informed consent was obtained from all participants. Abdominal diffusion-weighted images in 10 healthy men (mean age, 37 years ± 8 [standard deviation]) were acquired by using 1.5- and 3.0-T MR imagers from three different vendors. Two readers independently delineated regions of interest that were used to measure IVIM parameters (diffusion coefficient [Dt], perfusion fraction [Fp], and pseudodiffusion coefficient [Dp]) in the left and right lobes of the liver, and in the pancreas, spleen, renal cortex, and renal medulla. Measurement reproducibility between readers was assessed with intraclass correlation coefficients (ICCs). Variability across MR imagers was analyzed by using between- and within-subject coefficients of variation (CVs) and analysis of variance (ANOVA). Results Between-reader reproducibility was high for Dt (ICC, 94.6%), intermediate for Fp (ICC, 81.7%), and low for Dp (ICC, 69.5%). Between- and within-subject CVs of Dt were relatively high (>20%) in the left lobe of the liver and relatively low (<10%) in the renal cortex and renal medulla. CVs generally exceeded 15% for Fp values and 20% for Dp. ANOVA indicated significant differences (P < .05) between MR imagers. Conclusion IVIM parameters in the upper abdomen may differ substantially across MR imagers. (©) RSNA, 2015 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Sebastiano Barbieri
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| | - Olivio F Donati
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| | - Johannes M Froehlich
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| | - Harriet C Thoeny
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| |
Collapse
|
|
49
|
Malyarenko DI, Pang Y, Senegas J, Ivancevic MK, Ross BD, Chenevert TL. Correction of Gradient Nonlinearity Bias in Quantitative Diffusion Parameters of Renal Tissue with Intra Voxel Incoherent Motion. ACTA ACUST UNITED AC 2015; 1:145-151. [PMID: 26811845 PMCID: PMC4724207 DOI: 10.18383/j.tom.2015.00160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Spatially nonuniform diffusion weighting bias as a result of gradient nonlinearity (GNL) causes substantial errors in apparent diffusion coefficient (ADC) maps for anatomical regions imaged distant from the magnet isocenter. Our previously described approach effectively removed spatial ADC bias from 3 orthogonal diffusion-weighted imaging (DWI) measurements for monoexponential media of arbitrary anisotropy. This work evaluates correction feasibility and performance for quantitative diffusion parameters of the 2-component intravoxel incoherent motion (IVIM) model for well-perfused and nearly isotropic renal tissue. Sagittal kidney DWI scans of a volunteer were performed on a clinical 3T magnetic resonance imaging scanner near isocenter and offset superiorly. Spatially nonuniform diffusion weighting caused by GNL resulted both in shifting and broadening of perfusion-suppressed ADC histograms for off-center DWI relative to unbiased measurements close to the isocenter. Direction-average diffusion weighting bias correctors were computed based on the known gradient design provided by the vendor. The computed bias maps were empirically confirmed by coronal DWI measurements for an isotropic gel-flood phantom. Both phantom and renal tissue ADC bias for off-center measurements was effectively removed by applying precomputed 3D correction maps. Comparable ADC accuracy was achieved for corrections of both b maps and DWI intensities in the presence of IVIM perfusion. No significant bias impact was observed for the IVIM perfusion fraction.
Collapse
Affiliation(s)
| | - Yuxi Pang
- Department of Radiology, University of Michigan, Ann Arbor, MI
| | | | | | - Brian D Ross
- Department of Radiology, University of Michigan, Ann Arbor, MI
| | | |
Collapse
|
|
50
|
Metens T, Absil J, Denolin V, Bali MA, Matos C. Liver apparent diffusion coefficient repeatability with individually predetermined optimal cardiac timing and artifact elimination by signal filtering. J Magn Reson Imaging 2015; 43:1100-10. [DOI: 10.1002/jmri.25089] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/26/2015] [Indexed: 12/11/2022] Open
Affiliation(s)
- Thierry Metens
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
| | - Julie Absil
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
| | | | - Maria Antonietta Bali
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
| | - Celso Matos
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
| |
Collapse
|