|
1
|
Tachikawa Y, Hamano H, Chiwata N, Yoshikai H, Ikeda K, Maki Y, Takahashi Y, Koike M. Diffusion weighted imaging combining respiratory triggering and navigator echo tracking in the upper abdomen. MAGMA (NEW YORK, N.Y.) 2024; 37:873-886. [PMID: 38400926 DOI: 10.1007/s10334-024-01150-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To evaluate a new motion correction method, named RT + NV Track, for upper abdominal DWI that combines the respiratory triggering (RT) method using a respiration sensor and the Navigator Track (NV Track) method using navigator echoes. MATERIALS AND METHODS To evaluate image quality acquired upper abdominal DWI and ADC images with RT, NV, and RT + NV Track in 10 healthy volunteers and 35 patients, signal-to-noise efficiency (SNRefficiency) and the coefficient of variation (CV) of ADC values were measured. Five radiologists independently performed qualitative image-analysis assessments. RESULTS RT + NV Track showed significantly higher SNRefficiency than RT and NV (14.01 ± 4.86 vs 12.05 ± 4.65, 10.05 ± 3.18; p < 0.001, p < 0.001). RT + NV Track was superior to RT and equal or better quality than NV in CV and visual evaluation of ADC values (0.033 ± 0.018 vs 0.080 ± 0.042, 0.057 ± 0.034; p < 0.001, p < 0.001). RT + NV Track tends to acquire only expiratory data rather than NV, even in patients with relatively rapid breathing, and can correct for respiratory depth variations, a weakness of RT, thus minimizing image quality degradation. CONCLUSION The RT + NV Track method is an efficient imaging method that combines the advantages of both RT and NV methods in upper abdominal DWI, providing stably good images in a short scan time.
Collapse
Affiliation(s)
- Yoshihiko Tachikawa
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan.
| | - Hiroshi Hamano
- Philips Japan, Philips Building, 2-13-37 Kohnan, Minato-ku, Tokyo, 108-8507, Japan
| | - Naoya Chiwata
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Hikaru Yoshikai
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Kento Ikeda
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Yasunori Maki
- Division of Radiological Technology, Department of Medical Technology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Yukihiko Takahashi
- Department of Radiology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Makiko Koike
- Department of Radiology, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| |
Collapse
|
|
2
|
Raspe J, Harder FN, Rupp S, McTavish S, Peeters JM, Weiss K, Makowski MR, Braren RF, Karampinos DC, Van AT. Retrospective Motion Artifact Reduction by Spatial Scaling of Liver Diffusion-Weighted Images. Tomography 2023; 9:1839-1856. [PMID: 37888738 PMCID: PMC10610678 DOI: 10.3390/tomography9050146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
Cardiac motion causes unpredictable signal loss in respiratory-triggered diffusion-weighted magnetic resonance imaging (DWI) of the liver, especially inside the left lobe. The left liver lobe may thus be frequently neglected in the clinical evaluation of liver DWI. In this work, a data-driven algorithm that relies on the statistics of the signal in the left liver lobe to mitigate the motion-induced signal loss is presented. The proposed data-driven algorithm utilizes the exclusion of severely corrupted images with subsequent spatially dependent image scaling based on a signal-loss model to correctly combine the multi-average diffusion-weighted images. The signal in the left liver lobe is restored and the liver signal is more homogeneous after applying the proposed algorithm. Furthermore, overestimation of the apparent diffusion coefficient (ADC) in the left liver lobe is reduced. The proposed algorithm can therefore contribute to reduce the motion-induced bias in DWI of the liver and help to increase the diagnostic value of DWI in the left liver lobe.
Collapse
Affiliation(s)
- Johannes Raspe
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
- School of Natural Sciences, Technical University of Munich, 85748 Garching, Germany
| | - Felix N. Harder
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Selina Rupp
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Sean McTavish
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | | | - Kilian Weiss
- Philips GmbH Market DACH, 22335 Hamburg, Germany
| | - Marcus R. Makowski
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Rickmer F. Braren
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Dimitrios C. Karampinos
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Anh T. Van
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| |
Collapse
|
|
3
|
Obara M, Kwon J, Yoneyama M, Ueda Y, Cauteren MV. Technical Advancements in Abdominal Diffusion-weighted Imaging. Magn Reson Med Sci 2023; 22:191-208. [PMID: 36928124 PMCID: PMC10086402 DOI: 10.2463/mrms.rev.2022-0107] [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] [Indexed: 03/18/2023] Open
Abstract
Since its first observation in the 18th century, the diffusion phenomenon has been actively studied by many researchers. Diffusion-weighted imaging (DWI) is a technique to probe the diffusion of water molecules and create a MR image with contrast based on the local diffusion properties. The DWI pixel intensity is modulated by the hindrance the diffusing water molecules experience. This hindrance is caused by structures in the tissue and reflects the state of the tissue. This characteristic makes DWI a unique and effective tool to gain more insight into the tissue's pathophysiological condition. In the past decades, DWI has made dramatic technical progress, leading to greater acceptance in clinical practice. In the abdominal region, however, acquiring DWI with good quality is challenging because of several reasons, such as large imaging volume, respiratory and other types of motion, and difficulty in achieving homogeneous fat suppression. In this review, we discuss technical advancements from the past decades that help mitigate these problems common in abdominal imaging. We describe the use of scan acceleration techniques such as parallel imaging and compressed sensing to reduce image distortion in echo planar imaging. Then we compare techniques developed to mitigate issues due to respiratory motion, such as free-breathing, respiratory-triggering, and navigator-based approaches. Commonly used fat suppression techniques are also introduced, and their effectiveness is discussed. Additionally, the influence of the abovementioned techniques on image quality is demonstrated. Finally, we discuss the current and future clinical applications of abdominal DWI, such as whole-body DWI, simultaneous multiple-slice excitation, intravoxel incoherent motion, and the use of artificial intelligence. Abdominal DWI has the potential to develop further in the future, thanks to scan acceleration and image quality improvement driven by technological advancements. The accumulation of clinical proof will further drive clinical acceptance.
Collapse
Affiliation(s)
| | | | | | - Yu Ueda
- MR Clinical Science, Philips Japan Ltd
| | | |
Collapse
|
|
4
|
Son JS, Park HS, Park S, Kim YJ, Yu MH, Jung SI, Paek M, Nickel MD. Motion-Corrected versus Conventional Diffusion-Weighted Magnetic Resonance Imaging of the Liver Using Non-Rigid Registration. Diagnostics (Basel) 2023; 13:diagnostics13061008. [PMID: 36980314 PMCID: PMC10047344 DOI: 10.3390/diagnostics13061008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
It is challenging to overcome motion artifacts in diffusion-weighted imaging (DWI) of the abdomen. This study aimed to evaluate the image quality of motion-corrected DWI of the liver using non-rigid registration in comparison with conventional DWI (c-DWI) in patients with liver diseases. Eighty-nine patients who underwent 3-T magnetic resonance imaging (MRI) of the liver were retrospectively included. DWI was performed using c-DWI and non-rigid motion-corrected (moco) DWI was performed in addition to c-DWI. The image quality and conspicuity of hepatic focal lesions were scored using a five-point scale by two radiologists and compared between the two DWI image sets. The apparent diffusion coefficient (ADC) was measured in three regions of the liver parenchyma and in hepatic focal lesions, and compared between the two DWI image sets. Moco-DWI achieved higher scores in image quality compared to c-DWI in terms of liver edge sharpness and hepatic vessel margin delineation. The conspicuity scores of hepatic focal lesions were higher in moco-DWI. The standard deviation values of ADC of the liver parenchyma were lower in the moco-DWI than in the c-DWI. Moco-DWI using non-rigid registration showed improved overall image quality and provided more reliable ADC measurement, with an equivalent scan time, compared with c-DWI.
Collapse
Affiliation(s)
- Je Seung Son
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Hee Sun Park
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Correspondence: ; Tel.: +82-2-2030-5497; Fax: +82-2-2030-7748
| | - Sungeun Park
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Young Jun Kim
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Mi Hye Yu
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Sung Il Jung
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
- Department of Radiology, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Munyoung Paek
- Department of Diagnostic Imaging, Siemens Healthineers Ltd., The Asset Bldg. 10F, 14 Seocho-Daero 74-gil, Seocho-gu, Seoul 06620, Republic of Korea
| | - Marcel Dominik Nickel
- MR Application Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052 Erlangen, Germany
| |
Collapse
|
|
5
|
Pei Y, Xie S, Li W, Peng X, Qin Q, Ye Q, Li M, Hu J, Hou J, Li G, Hu S. Evaluation of simultaneous-multislice diffusion-weighted imaging of liver at 3.0 T with different breathing schemes. Abdom Radiol (NY) 2020; 45:3716-3729. [PMID: 32356004 DOI: 10.1007/s00261-020-02538-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To obtain the optimal simultaneous-multislice (SMS)-accelerated diffusion-weighted imaging (DWI) of the liver at 3.0 T MRI by systematically estimating the repeatability of apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR) and image quality of different breathing schemes in comparison to standard DWI (STD) and other SMS sequences. METHODS In this institutional review board-approved prospective study, hepatic DWIs (b = 50, 300, 600 s/mm2) were performed in 23 volunteers on 3.0 T MRI using SMS and STD with breath-hold (BH-SMS, BH-STD), free-breathing (FB-SMS, FB-STD) and respiratory-triggered (RT-SMS, RT-STD). Reduction of scan time with SMS-acceleration was calculated. ADC and SNR were measured in nine anatomic locations and image quality was assessed on all SMS and STD sequences. An optimal SMS-DWI was decided by systematically comparing the ADC repeatability, SNR and image quality among above DWIs. RESULTS SMS-DWI reduced scan time significantly by comparison with corresponding STD-DWI (27 vs. 42 s for BH, 54 vs. 78 s for FB and 42 vs. 97 s for RT). In all DWIs, BH-SMS had the greatest intraobserver agreement (intraclass correlation coefficient (ICC): 0.920-0.944) and good interobserver agreement (ICC: 0.831-0.886) for ADC measurements, and had the best ADC repeatability (mean ADC absolute differences: 0.046-0.058 × 10-3mm2/s, limits of agreement (LOA): 0.010-0.013 × 10-3mm2/s) in nine locations. BH-SMS had the highest SNR in three representative sections except for RT-STD. There were no significant differences in image quality between BH-SMS and other DWI sequences (median BH-SMS: 4.75, other DWI: 4.5-5.0; P > 0.0.5). CONCLUSION BH-SMS provides considerable scan time reduction with good image quality, sufficient SNR and highest ADC repeatability on 3.0 T MRI, which is thus recommended as the optimal hepatic DWI sequence for those subjects with adequate breath-holding capability.
Collapse
|
|
6
|
Li J, Jiang J, Chu Z, Zhang Y, Cai W, Zhu J, Grimm R, Ji Q. Multiparametric MRI Evaluation of Liposomal Prostaglandins E1 Intervention on Hepatic Warm Ischemia‐Reperfusion Injury in Rabbits. J Magn Reson Imaging 2019; 52:217-228. [PMID: 31829483 DOI: 10.1002/jmri.27022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 01/19/2023] Open
Affiliation(s)
- Jingyao Li
- First Central Clinical College of Tianjin Medical University Nankai DistrictTianjin China
- Department of RadiologyTianjin First Central Hospital Nankai DistrictTianjin China
| | - Jiabing Jiang
- First Central Clinical College of Tianjin Medical University Nankai DistrictTianjin China
- Department of RadiologyTianjin First Central Hospital Nankai DistrictTianjin China
| | - Zhiqiang Chu
- Department of TransplantationTianjin First Central Hospital Nankai DistrictTianjin China
| | - Yuling Zhang
- First Central Clinical College of Tianjin Medical University Nankai DistrictTianjin China
- Department of RadiologyTianjin First Central Hospital Nankai DistrictTianjin China
| | - Wenjuan Cai
- Department of PathologyTianjin First Central Hospital Nankai DistrictTianjin China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Beijing China
| | | | - Qian Ji
- Department of RadiologyTianjin First Central Hospital Nankai DistrictTianjin China
| |
Collapse
|
|
7
|
Evaluation of Regional Variability and Measurement Reproducibility of Intravoxel Incoherent Motion Diffusion Weighted Imaging Using a Cardiac Stationary Phase Based ECG Trigger Method. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4604218. [PMID: 29850518 PMCID: PMC5932501 DOI: 10.1155/2018/4604218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/08/2018] [Indexed: 12/21/2022]
Abstract
Purpose To evaluate the performance of an optimized ECG trigger diffusion weighted imaging (DWI) sequence in liver and its application in liver disease. Materials and Methods Eighteen healthy volunteers underwent intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) scan of the liver twice in 1.5T MR scanner with signed informed consent approved by local ethic committees. A new method, called cardiac stationary phase based ECG trigger (CaspECG), and FB method were applied. The apparent diffusion coefficient (ADC) and the IVIM parameters, including pure diffusion coefficient (D), perfusion-related diffusion coefficient (D⁎), and perfusion fraction, (PF) were calculated, and then 18 region of interests were drawn on these parameter maps independently by two readers through whole hepatic lobe. The regional variability and reproducibility between two repeated scans were evaluated using interclass correlation coefficients (ICCs) and Bland-Altman plot, respectively, and compared between the CaspECG and FB methods. The signal-to-noise ratio (SNR) of DWI data was also evaluated. Result Compared to the FB method, the proposed CaspECG method showed significant higher SNRs in DWI data, lower regional variability between left and right hepatic lobes, and higher reproducibility of ADC, PF, D, and D⁎ between repeat scans [left lobe, limit of agreement (LOA) of Bland-Altman plot: 10.1%, 18.3%, 19.8%, and 59.2%; right lobe, LOA: 10.25%, 14.15%, 16.45%, and 39.45%]. D⁎ showed the worst reproducibility in all parameters. Conclusion The novel CaspECG method outperformed the FB method in compensating the cardiac motion induced artifacts in DWI data and generating more reliable quantitative parameters, with less regional variability and higher repeatability, especially in the left hepatic lobe.
Collapse
|
|
8
|
Shenoy-Bhangle A, Baliyan V, Kordbacheh H, Guimaraes AR, Kambadakone A. Diffusion weighted magnetic resonance imaging of liver: Principles, clinical applications and recent updates. World J Hepatol 2017; 9:1081-1091. [PMID: 28989564 PMCID: PMC5612839 DOI: 10.4254/wjh.v9.i26.1081] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 04/06/2017] [Accepted: 06/06/2017] [Indexed: 02/06/2023] Open
Abstract
Diffusion-weighted imaging (DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors such as the ease of acquisition and ability to obtain functional information in the absence of intravenous contrast, especially in patients with abnormal renal function, have contributed to the growing interest in exploring clinical applications of DWI. In the liver, DWI demonstrates a gamut of clinical applications ranging from detecting focal liver lesions to monitoring response in patients undergoing serial follow-up after loco-regional and systemic therapies. DWI is also being applied in the evaluation of diffuse liver diseases such as non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis. In this review, we intend to review the basic principles, technique, current clinical applications and future trends of DW-MRI in the liver.
Collapse
Affiliation(s)
| | - Vinit Baliyan
- Harvard Medical School, Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Hamed Kordbacheh
- Harvard Medical School, Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, Boston, MA 02114, United States
| | | | - Avinash Kambadakone
- Harvard Medical School, Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, Boston, MA 02114, United States.
| |
Collapse
|
|
9
|
Dijkstra H, Wolff D, van Melle JP, Bartelds B, Willems TP, Oudkerk M, Hillege H, van den Berg AP, Ebels T, Berger RMF, Sijens PE. Diminished liver microperfusion in Fontan patients: A biexponential DWI study. PLoS One 2017; 12:e0173149. [PMID: 28257439 PMCID: PMC5336266 DOI: 10.1371/journal.pone.0173149] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/15/2017] [Indexed: 12/13/2022] Open
Abstract
It has been demonstrated that hepatic apparent diffusion coefficients (ADC) are decreasing in patients with a Fontan circulation. It remains however unclear whether this is a true decrease of molecular diffusion, or rather reflects decreased microperfusion due to decreased portal blood flow. The purpose of this study was therefore to differentiate diffusion and microperfusion using intravoxel incoherent motion (IVIM) modeled diffusion-weighted imaging (DWI) for different liver segments in patients with a Fontan circulation, compare to a control group, and relate with liver function, chronic hepatic congestion and hepatic disease. For that purpose, livers of 59 consecutively included patients with Fontan circulation (29 men; mean-age, 19.1 years) were examined (Oct 2012─Dec 2013) with 1.5T MRI and DWI (b = 0,50,100,250,500,750,1500,1750 s/mm2). IVIM (Dslow, Dfast, ffast) and ADC were calculated for eight liver segments, compared to a control group (19 volunteers; 10 men; mean-age, 32.9 years), and correlated to follow-up duration, clinical variables, and laboratory measurements associated with liver function. The results demonstrated that microperfusion was reduced (p<0.001) in Fontan livers compared to controls with ─38.1% for Dfast and ─32.6% for ffast. Molecular diffusion (Dslow) was similar between patients and controls, while ADC was significantly lower (─14.3%) in patients (p<0.001). ADC decreased significantly with follow-up duration after Fontan operation (r = ─0.657). Dslow showed significant inverse correlations (r = ─0.591) with follow-up duration whereas Dfast and ffast did not. From these results it was concluded that the decreasing ADC values in Fontan livers compared with controls reflect decreases in hepatic microperfusion rather than any change in molecular diffusion. However, with the time elapsed since the Fontan operation molecular diffusion and ADC decreased while microperfusion remained stable. This indicates that after Fontan operation initial blood flow effects on the liver are followed by intracellular changes preceding the formation of fibrosis and cirrhosis.
Collapse
Affiliation(s)
- Hildebrand Dijkstra
- Center for Medical Imaging—North East Netherlands, Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Djoeke Wolff
- Center for Congenital Heart Diseases, Department of Pediatric Cardiology/Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joost P. van Melle
- Center for Congenital Heart Diseases, Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Beatrijs Bartelds
- Center for Congenital Heart Diseases, Department of Pediatric Cardiology/Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tineke P. Willems
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Matthijs Oudkerk
- Center for Medical Imaging—North East Netherlands, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hans Hillege
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Aad P. van den Berg
- Department of Gastroenterology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tjark Ebels
- Center for Congenital Heart Diseases, Department of Cardiothoracic Surgery University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rolf M. F. Berger
- Center for Congenital Heart Diseases, Department of Pediatric Cardiology/Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Paul E. Sijens
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
|
10
|
Intrasession and Intersession Repeatability of Diffusion Tensor Imaging in Healthy Human Liver. J Comput Assist Tomogr 2017; 41:578-585. [DOI: 10.1097/rct.0000000000000572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
11
|
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
|
|
12
|
Saito K, Yoshimura N, Shirota N, Saguchi T, Sugimoto K, Tokuuye K. Distinguishing liver haemangiomas from metastatic tumours using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced diffusion-weighted imaging at 1.5T MRI. J Med Imaging Radiat Oncol 2016; 60:599-606. [DOI: 10.1111/1754-9485.12487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 05/23/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Kazuhiro Saito
- Department of Radiology; Tokyo Medical University; Tokyo Japan
| | | | | | - Toru Saguchi
- Department of Radiology; Tokyo Medical University; Tokyo Japan
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology; Tokyo Medical University; Tokyo Japan
| | - Koichi Tokuuye
- Department of Radiology; Tokyo Medical University; Tokyo Japan
| |
Collapse
|
|
13
|
Pieper CC, Willinek WA, Meyer C, Ahmadzadehfar H, Kukuk GM, Sprinkart AM, Block W, Schild HH, Mürtz P. Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging for Prediction of Early Arterial Blood Flow Stasis in Radioembolization of Breast Cancer Liver Metastases. J Vasc Interv Radiol 2016; 27:1320-1328. [PMID: 27402526 DOI: 10.1016/j.jvir.2016.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/06/2016] [Accepted: 04/15/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To retrospectively evaluate predictive value of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for early arterial blood flow stasis during transarterial radioembolization (TARE) of liver dominant breast metastases (LdBM). MATERIALS AND METHODS Preinterventional 1.5T DWI (b0, b1, b2 = 0, 50, 800 s/mm(2)) data for 28 liver lobes of 18 female patients treated by resin-based radioembolization (10 bilobar and 8 unilobar treatments) were analyzed. Apparent diffusion coefficient (ADC) (0, 800) and an estimation of the true diffusion coefficient D' and of the perfusion fraction f' were calculated for the 2 largest metastases. Response rate at 3 months and survival were analyzed. Procedures without full dose application because of early stasis were assigned to group A (n = 15), and procedures with full dose application were assigned to group B (n = 13). RESULTS Metastases in group A showed significantly lower f' (0.035 ± 0.018 vs 0.076 ± 0.015, P < .0001) and a trend toward lower ADC(0, 800) with values given in 10(-6) mm(2)/s (1,066 ± 141 vs 1,189 ± 176, P = .051); no group difference was shown for D'. Groups were best discriminated by weighted mean f' values of the 2 largest metastases with accuracy of 100%. Mean tumor diameter before and after TARE was 51 mm ± 18 and 50 mm ± 24 in group A and 47 mm ± 27 and 48 mm ± 32 for group B. Imaging response did not differ between groups (P = .545). Overall survival did not differ significantly between group A (230 d) and B (155 d) (P = .124). CONCLUSIONS Perfusion-sensitive IVIM parameter f' may predict early blood flow stasis in patients undergoing TARE for LdBM. Determination of this parameter before intervention may increase awareness of the interventionalist and increase safety of microsphere administration.
Collapse
Affiliation(s)
- Claus Christian Pieper
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
| | | | - Carsten Meyer
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany
| | - Hojjat Ahmadzadehfar
- Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany
| | - Guido Matthias Kukuk
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany
| | - Alois Martin Sprinkart
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany
| | - Wolfgang Block
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany
| | - Hans Heinz Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany
| | - Petra Mürtz
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany
| |
Collapse
|
|
14
|
Mori Y, Tamai H, Shingaki N, Hayami S, Ueno M, Maeda Y, Moribata K, Deguchi H, Niwa T, Inoue I, Maekita T, Iguchi M, Kato J, Terada M, Yamaue H, Ichinose M. Hypointense hepatocellular carcinomas on apparent diffusion coefficient mapping: Pathological features and metastatic recurrence after hepatectomy. Hepatol Res 2016; 46:634-41. [PMID: 26407147 DOI: 10.1111/hepr.12598] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 12/18/2022]
Abstract
AIM The present study aimed to evaluate pathological features of hepatocellular carcinomas (HCC) appearing hypointense on the apparent diffusion coefficient (ADC) map, and to elucidate the association between the signal intensity on the ADC map and metastatic recurrences after hepatectomy. METHODS In total, 52 consecutive patients with initial hypervascular HCC (solitary lesion ≤5 cm in diameter) without vascular invasion on imaging were examined by diffusion-weighted magnetic resonance imaging before hepatectomy. The signal intensities of HCC on the ADC map were visually compared with the surrounding liver and categorized as hypointense or non-hypointense. Intrahepatic metastatic recurrence was defined as more than three intrahepatic recurrences. RESULTS The 52 HCC were evaluated as 26 hypointense and 26 non-hypointense tumors. No significant differences between the hypointense and non-hypointense groups were seen for age, sex, etiology, tumor size and tumor marker levels. However, in resected specimens, significant differences between the two groups were noted for histological grade and microscopic portal invasion. The percentages of poorly differentiated HCC and microscopic portal invasion in the hypointense group were significantly higher than those in the non-hypointense group. The cumulative 3-year metastatic recurrence rates of the hypointense and non-hypointense groups on the ADC map were 56% and 13% (P = 0.001), respectively. Multivariate analyses indicated that hypointensity on the ADC map was the only independent factor related to metastatic recurrence. CONCLUSION Hypointense HCC on ADC mapping are characterized by poor histological differentiation and more frequent microscopic portal invasion, and are significantly associated with metastatic recurrences after hepatectomy.
Collapse
Affiliation(s)
- Yoshiyuki Mori
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hideyuki Tamai
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Naoki Shingaki
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shinya Hayami
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masaki Ueno
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yoshimasa Maeda
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kosaku Moribata
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hisanobu Deguchi
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Toru Niwa
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Izumi Inoue
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takao Maekita
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Mikitaka Iguchi
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Jun Kato
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | | | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masao Ichinose
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| |
Collapse
|
|
15
|
Pitfalls in whole body MRI with diffusion weighted imaging performed on patients with lymphoma: What radiologists should know. Magn Reson Imaging 2016; 34:922-31. [PMID: 27114337 DOI: 10.1016/j.mri.2016.04.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 03/21/2016] [Accepted: 04/17/2016] [Indexed: 01/15/2023]
Abstract
The technological advances in radiological imaging and the relevance of a diagnostic tool that may reduce radiation-induced long-term effects have led to a widespread use of whole body magnetic resonance imaging (WB-MRI) with diffusion weighted imaging for oncologic patients. A lot of studies demonstrated the feasibility and reliability of WB-MRI as an alternative technique for lymphoma staging and response assessment during and after treatment. In this paper, taking advantage of our 2years of experience using WB-MRI for lymphoma, we discuss the main pitfalls and artifacts radiologists should know examining a WB-MRI performed on this typology of patients in order to avoid images misinterpretation.
Collapse
|
|
16
|
Kahraman AS, Kahraman B, Ozdemir ZM, Gormeli CA, Ozdemir F, Dogan M. Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values. Abdom Radiol (NY) 2016; 41:56-62. [PMID: 26830612 DOI: 10.1007/s00261-015-0613-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of this study was to determine the correlation between the liver and spleen apparent diffusion coefficient (ADC) values of patients with chronic liver disease and the presence and the degree of ascites. MATERIALS AND METHOD In this retrospective study, we assessed 107 patients with chronic liver disease and 39 control subjects who underwent upper abdominal MR imaging including echo-planar diffusion-weighted imaging (DWI). Among the 107 cirrhotic patients, 56 were classified as group 1, 25 as group 2, and 26 as group 3 according to the absence, the presence of minimal, and the presence of massive ascites, respectively. The scores of model for end-stage liver disease (MELD) were matched between groups as the standard reference. The liver ADC, spleen ADC, and normalized liver ADC values were compared between the control group and patients' groups. RESULTS Patients with massive ascites had significantly higher MELD score compared with the other groups. The MELD score was also significantly higher in patient groups than in control group. The liver and normalized liver ADCs of patients' groups were significantly lower than that of the control group. With some overlap among groups, the measured ADC values decreased as the amount of the ascites increased, and these relationships were statistically significant. Furthermore, compared to control group, patients with massive ascites had significantly higher spleen ADCs. CONCLUSION Our results indicate that the ADC value of the liver and spleen correlates with the presence and the degree of ascites in patients with chronic liver disease, and merits further study.
Collapse
Affiliation(s)
- Aysegul Sagir Kahraman
- Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey.
| | - Bayram Kahraman
- Department of Radiology, Private Malatya Hospital, Malatya, Turkey.
| | - Zeynep Maras Ozdemir
- Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey.
| | - Cemile Ayse Gormeli
- Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey.
| | - Fatih Ozdemir
- Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey.
| | - Metin Dogan
- Department of Radiology, Turgut Ozal Medical Center, Inonu University School of Medicine, 44315, Malatya, Turkey.
| |
Collapse
|
|
17
|
Jang M, Kim SM, Yun BL, Ahn HS, Kim SY, Kang E, Kim SW. Reproducibility of Apparent Diffusion Coefficient Measurements in Malignant Breast Masses. J Korean Med Sci 2015; 30:1689-97. [PMID: 26539016 PMCID: PMC4630488 DOI: 10.3346/jkms.2015.30.11.1689] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/30/2015] [Indexed: 01/26/2023] Open
Abstract
This study aimed to evaluate the reproducibility of apparent diffusion coefficient (ADC) measurements in malignant breast masses, and to determine the influence of mammographic parenchymal density on this reproducibility. Sixty-six patients with magnetic resonance findings of the mass were included. Two breast radiologists measured the ADC of the malignant breast mass and the same area on the contralateral normal breast in each patient twice. The effects of mammographic parenchymal density, histology, and lesion size on reproducibility were also assessed. There was no significant difference in the mean ADC between repeated measurements in malignant breast masses and normal breast tissue. The overall reproducibility of ADC measurements was good in both. The 95% limits of agreement for repeated ADCs were approximately 30.2%-33.4% of the mean. ADC measurements in malignant breast masses were highly reproducible irrespective of mass size, histologic subtype, or coexistence of microcalcifications; however, the measurements tended to be less reproducible in malignant breast masses with extremely dense parenchymal backgrounds. ADC measurements in malignant breast masses are highly reproducible; however, mammographic parenchymal density can potentially influence this reproducibility.
Collapse
Affiliation(s)
- Mijung Jang
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sun Mi Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Bo La Yun
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hye Shin Ahn
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Soo Yeon Kim
- Department of Radiology, Hanyang University Guri Hospital, Guri, Korea
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung-Won Kim
- Department of Surgery, Breast Care Center, Daerim St. Mary's Hospital, Seoul, Korea
| |
Collapse
|
|
18
|
Chen J, Wu M, Liu R, Li S, Gao R, Song B. Preoperative evaluation of the histological grade of hepatocellular carcinoma with diffusion-weighted imaging: a meta-analysis. PLoS One 2015; 10:e0117661. [PMID: 25658359 PMCID: PMC4320049 DOI: 10.1371/journal.pone.0117661] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 12/29/2014] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the diagnostic performance of diffusion-weighted imaging (DWI) in the preoperative prediction of the histological grade of hepatocellular carcinoma (HCC). MATERIALS AND METHODS A comprehensive literature search was performed in several authoritative databases to identify relevant articles. QUADAS-2 was used to assess the quality of included studies. Data were extracted to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR). Summary receiver operating characteristic (SROC) curves were derived and areas under the SROC curve (AUC) were computed to indicate the diagnostic accuracy. Heterogeneity test, meta-regression analysis and sensitivity analysis were performed to identify factors and studies contributed to the heterogeneity. RESULTS A total of 11 studies with 912 HCCs were included in this meta-analysis. The pooled sensitivity, specificity, PLR and NLR with corresponding 95% confidence intervals (CI) were 0.54(0.47-0.61), 0.90(0.87-0.93), 4.88(2.99-7.97) and 0.46(0.27-0.77) for the prediction of well-differentiated HCC (w-HCC), 0.84(0.78-0.89), 0.48(0.43-0.52), 2.29(1.43-3.69) and 0.30(0.22-0.41) for the prediction of poorly-differentiated HCC (p-HCC). The AUC were 0.9311 and 0.8513 in predicting w-HCC and p-HCC, respectively. Results were further evaluated according to the method of image interpretation. Significant heterogeneity was observed. CONCLUSION DWI had excellent and moderately high diagnostic accuracy for the detection of w-HCC and p-HCC, respectively. Nonetheless, further studies in larger populations and an optimized image acquisition and interpretation are required before DWI-derived parameters can be used as a useful image biomarker for the prediction of the histological grade of HCC.
Collapse
Affiliation(s)
- Jie Chen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Mingpeng Wu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Rongbo Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Siyi Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Ronghui Gao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| |
Collapse
|
|
19
|
Mori Y, Tamai H, Shingaki N, Moribata K, Deguchi H, Ueda K, Inoue I, Maekita T, Iguchi M, Kato J, Terada M, Ichinose M. Signal intensity of small hepatocellular carcinoma on apparent diffusion coefficient mapping and outcome after radiofrequency ablation. Hepatol Res 2015; 45:75-87. [PMID: 24533527 DOI: 10.1111/hepr.12311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/20/2014] [Accepted: 02/10/2014] [Indexed: 02/08/2023]
Abstract
AIM It has been reported that the apparent diffusion coefficient (ADC) value of hepatocellular carcinomas (HCC) on diffusion-weighted magnetic resonance imaging (MRI) is associated with their histological grade. The present study aimed to evaluate whether the signal intensity of small hypervascular HCC on the ADC map is related to the treatment outcome of radiofrequency ablation (RFA). METHODS Between February 2008 and August 2012, 136 consecutive patients with initial small hypervascular HCC (≤3 tumors and ≤3 cm in diameter) were examined by diffusion-weighted MRI before RFA. The signal intensities of HCC on the ADC map were visually compared with the surrounding liver and categorized as hypointense and non-hypointense. Critical recurrence was defined as more than three intrahepatic recurrences, recurrence with vascular invasion, seeding, dissemination and/or extrahepatic metastasis. RESULTS The median follow up was 619 days. The cumulative 2-year recurrence rates of the hypointense and non-hypointense on the ADC map groups were 79% and 50% (P < 0.001), respectively, with cumulative 2-year local recurrence rates of 18% and 7% (P = 0.014) and cumulative 2-year critical recurrence rates of 38% and 13% (P = 0.005), respectively. The cumulative 3-year survival rates were 60% and 82% (P = 0.007), respectively. On multivariate analysis, hypointensity on the ADC map was the strongest independent factor related to recurrence and survival after RFA. CONCLUSION The signal intensity of HCC on the ADC map was strongly associated with outcome after RFA. These results suggest that treatment strategy should be determined carefully even for small HCC when they appear hypointense on the ADC map.
Collapse
Affiliation(s)
- Yoshiyuki Mori
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
20
|
Tokgöz Ö, Unal I, Turgut GG, Yildiz S. The value of liver and spleen ADC measurements in the diagnosis and follow up of hepatic fibrosis in chronic liver disease. Acta Clin Belg 2014; 69:426-32. [PMID: 25103596 DOI: 10.1179/2295333714y.0000000062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIMS To evaluate the value of spleen and liver apparent diffusion coefficients (ADC) in chronic liver disease patients, with and without hepatocellular carcinoma (HCC), and to investigate the use of diffusion-weighted imaging (DWI) in the diagnosis and follow-up of hepatic fibrosis. MATERIALS AND METHODS This study population comprised 68 chronic liver disease patients (Group 1) and 70 healthy volunteers as controls (Group 2). In Group 1, 40 patients had chronic hepatitis-B, 20 had chronic hepatitis-C, 5 had non-alcoholic steatohepatitis and 3 had alcoholic steatohepatitis. Diagnosis of chronic liver disease was made by percutaneous liver biopsy and the degree of fibrosis (stage) was determined using the METAVIR scoring system. HCC diagnosis was made with a lesion biopsy. The patient group was subdivided based on the degree of fibrosis (F1, F2, F3 and F4) and presence of HCC. After patient and control groups underwent b-value 600 s/mm(2) DWI examination, liver and spleen ADC values were mapped and measured. The ADC values of the patient groups (F1, F2, F3, F4; with HCC, without HCC) were compared with each other and with the control group. RESULTS Liver ADC values were lower in Group 1 compared to Group 2 (P<0·001). There was a statistically significant difference between the patient and control groups liver right lobe, left lobe and caudate lobe ADC values (P<0·001). Comparing the F1, F2, F3 and F4 groups, there was no statistically significant difference found in terms of ADC values (P>0·05). However, as degree of fibrosis increased there was a reduction in ADC values, though not statistically significant. Comparing the groups with HCC and without HCC, there was no statistically significant difference in ADC values (P>0·05). There was no statistical difference in average spleen ADC values between patient and control groups (P>0·05). CONCLUSIONS In chronic liver disease, ADC values were lower. As the degree of liver fibrosis increased, ADC levels decreased, though the relationship between ADC values and fibrosis degree was not statistically significant. Quantitative DWI may help in the diagnosis of fibrosis in chronic liver disease patients, however as it does not show the degree of fibrosis, its use in treatment planning and follow-up is controversial. Spleen DWI measurement is not a sufficient method to diagnose and determine the degree of fibrosis in chronic liver disease patients.
Collapse
|
|
21
|
Han X, Dong Y, Xiu JJ, Zhang J, Huang ZQ, Cai SF, Yuan XS, Liu QW. Diffusion-weighted imaging for the left hepatic lobe has higher diagnostic accuracy for malignant focal liver lesions. Asian Pac J Cancer Prev 2014; 15:6155-60. [PMID: 25124590 DOI: 10.7314/apjcp.2014.15.15.6155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was conducted to investigate whether apparent diffusion coefficient (ADC) measurements by dividing the liver into left and right hepatic lobes may be utilized to improve the accuracy of differential diagnosis of benign and malignant focal liver lesions. MATERIALS AND METHODS A total of 269 consecutive patients with 429 focal liver lesions were examined by 3-T magnetic resonance imaging that included diffusion-weighted imaging. For 58 patients with focal liver lesions of the same etiology in left and right hepatic lobes, ADCs of normal liver parenchyma and focal liver lesions were calculated and compared using the paired t-test. For all 269 patients, ADC cutoffs for focal liver lesions and diagnostic accuracy in the left hepatic lobe, right hepatic lobe and whole liver were evaluated by receiver operating characteristic curve analysis. RESULTS For the group of 58 patients, mean ADCs of normal liver parenchyma and focal liver lesions in the left hepatic lobe were significantly higher than those in the right hepatic lobe. For differentiating malignant lesions from benign lesions in all patients, the sensitivity and specificity were 92.6% and 92.0% in the left hepatic lobe, 94.4% and 94.4% in the right hepatic lobe, and 90.4% and 94.7% in the whole liver, respectively. The area under the curve of the right hepatic lobe, but not the left hepatic lobe, was higher than that of the whole liver. CONCLUSIONS ADCs of normal liver parenchyma and focal liver lesions in the left hepatic lobe were significantly higher than those in the right hepatic lobe. Optimal ADC cutoff for focal liver lesions in the right hepatic lobe, but not in the left hepatic lobe, had higher diagnostic accuracy compared with that in the whole liver.
Collapse
Affiliation(s)
- Xue Han
- Department of Radiology, Provincial Hospital, Shandong University, Jinan, China E-mail :
| | | | | | | | | | | | | | | |
Collapse
|
|
22
|
Rosenkrantz AB, Geppert C, Kiritsy M, Feiweier T, Mossa DJ, Chandarana H. Diffusion-weighted imaging of the liver: comparison of image quality between monopolar and bipolar acquisition schemes at 3T. ACTA ACUST UNITED AC 2014; 40:289-98. [DOI: 10.1007/s00261-014-0215-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
|
23
|
Vermoolen MA, Kersten MJ, Fijnheer R, van Leeuwen MS, Kwee TC, Nievelstein RAJ. Magnetic resonance imaging of malignant lymphoma. Expert Rev Hematol 2014; 4:161-71. [DOI: 10.1586/ehm.11.17] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
|
24
|
Sutherland T, Steele E, van Tonder F, Yap K. Solid focal liver lesion characterisation with apparent diffusion coefficient ratios. J Med Imaging Radiat Oncol 2013; 58:32-7. [DOI: 10.1111/1754-9485.12087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 05/25/2013] [Indexed: 01/18/2023]
Affiliation(s)
- Tom Sutherland
- Medical Imaging Department; St Vincents Hospital; Melbourne Victoria Australia
| | - Emma Steele
- Medical Imaging Department; St Vincents Hospital; Melbourne Victoria Australia
| | - Frans van Tonder
- Medical Imaging Department; St Vincents Hospital; Melbourne Victoria Australia
| | - Kelvin Yap
- Medical Imaging Department; St Vincents Hospital; Melbourne Victoria Australia
| |
Collapse
|
|
25
|
Schmid-Tannwald C, Oto A, Reiser MF, Zech CJ. Diffusion-weighted MRI of the abdomen: current value in clinical routine. J Magn Reson Imaging 2013; 37:35-47. [PMID: 23255414 DOI: 10.1002/jmri.23643] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 02/17/2012] [Indexed: 02/01/2023] Open
Abstract
Magnetic resonance imaging (MRI) provides high tissue contrast without ionizing radiation exposure and unenhanced images are often diagnostic. Therefore, MRI is especially an attractive tool for patients with allergies for gadolinium-based contrast agents or renal failure. Technical advantages have led to the increasing use of diffusion-weighted (DW) MRI in abdominal imaging, which provides qualitative and quantitative information of tissue cellularity and the integrity of cellular membranes. This review article presents the current status of noncontrast MRI with the focus of DW-MRI. Technical background and clinical applications are explained and discussed.
Collapse
|
|
26
|
Penner AH, Sprinkart AM, Kukuk GM, Gütgemann I, Gieseke J, Schild HH, Willinek WA, Mürtz P. Intravoxel incoherent motion model-based liver lesion characterisation from three b-value diffusion-weighted MRI. Eur Radiol 2013; 23:2773-83. [PMID: 23666233 DOI: 10.1007/s00330-013-2869-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/15/2013] [Accepted: 03/25/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate intravoxel incoherent motion (IVIM) model-based liver lesion characterisation from three b-value diffusion-weighted imaging (DWI). METHODS The 1.5-T DWI data from a respiratory gated spin-echo echo-planar magnetic resonance imaging sequence (b = 0, 50, 800 s/mm(2)) were retrospectively analysed in 38 patients with different liver lesions. Conventional apparent diffusion coefficient ADC = ADC(0,800) as well as IVIM-based parameters D' = ADC(50,800), ADC_low = ADC(0,50), and f' were calculated voxel-wise. Sixty-one regions of interest in hepatocellular carcinomas (HCCs, n = 24), haemangiomas (HEMs, n = 11), focal nodular hyperplasias (FNHs, n = 11), and healthy liver tissue (REFs, n = 15) were analysed. Group differences were investigated using Student's t-test and receiver-operating characteristic (ROC) analysis. RESULTS Mean values ± standard deviations of ADC, D', ADC_low (in 10(-5) mm(2)/s), and f' (in %) for REFs/FNHs/HEMs/HCCs were 130 ± 11/143 ± 27/168 ± 16/113 ± 25, 104 ± 12/123 ± 25/162 ± 18/102 ± 23, 518 ± 66/437 ± 97/268 ± 69/283 ± 120, and 18 ± 3/14 ± 4/6 ± 3/9 ± 5, respectively. Differences between lesions and REFs were more significant for IVIM-based parameters than for conventional ADC. ROC analysis showed the best discriminability between HCCs and FNHs for ADC_low and f' and between HEMs and FNHs or HCCs for D'. CONCLUSION Three instead of two b-value DWI enables a numerically stable and voxel-wise IVIM-based analysis for improved liver lesion characterisation with tolerable acquisition time. KEY POINTS • Quantitative analysis of diffusion-weighted MRI helps liver lesion characterisation. • Analysis of intravoxel incoherent motion is superior to apparent diffusion coefficient determination. • Only three b-values enable separation of diffusion and microcirculation effects. • The method presented is numerically stable, with voxel-wise results and short acquisition times.
Collapse
Affiliation(s)
- A-H Penner
- Department of Radiology, University of Bonn, Bonn, Germany
| | | | | | | | | | | | | | | |
Collapse
|
|
27
|
Schmid-Tannwald C, Jiang Y, Dahi F, Rist C, Sethi I, Oto A. Diffusion-weighted MR imaging of focal liver lesions in the left and right lobes: is there a difference in ADC values? Acad Radiol 2013; 20:440-5. [PMID: 23498984 DOI: 10.1016/j.acra.2012.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 10/27/2012] [Accepted: 10/27/2012] [Indexed: 02/08/2023]
Abstract
RATIONALE AND OBJECTIVES To determine possible differences between the left and right hepatic lobes in apparent diffusion coefficient (ADC) values of benign and malignant focal liver lesions (FLLs) and normal liver parenchyma. MATERIALS AND METHODS Thirty-six patients (16 males, 20 females; mean age 56.8 years) with FLLs of the same etiology in both the left and right hepatic lobes (13 patients with 26 benign FLLs and 23 patients with 46 malignant FLLs) who underwent 1.5T magnetic resonance imaging (MRI) including diffusion-weighted MRI (b values: 0 and 800 seconds/mm) with respiratory gating and without cardiac gating were included in this Health Insurance Portability and Accountability Act-compliant and institutional review board-approved study. ADC values of normal liver parenchyma and FLLs in each hepatic lobe were calculated and compared by using Student's t-test and Wilcoxon signed-rank test, respectively. RESULTS The mean ADC values of normal liver parenchyma, benign FLLs, and malignant FLLs were significantly higher (P < .001, P = .003, and P = .005, respectively) in the left hepatic lobe (1.74 × 10(-3), 1.81 × 10(-3), and 1.48 × 10(-3) mm²/second, respectively) than in the right hepatic lobe (1.48 × 10(-3), 1.54 × 10(-3), and 1.24 × 10(-3) mm²/second, respectively). CONCLUSION ADC values of benign and malignant FLLs calculated from noncardiac-gated DW-MRI are significantly higher in the left hepatic lobe compared with the right hepatic lobe. This may be a limitation for characterization of FLLs based on ADC measurements.
Collapse
|
|
28
|
Akay S, Kocaoglu M, Emer O, Battal B, Arslan N. Diagnostic accuracy of whole-body diffusion-weighted magnetic resonance imaging with 3.0 T in detection of primary and metastatic neoplasms. J Med Imaging Radiat Oncol 2013; 57:274-82. [PMID: 23721135 DOI: 10.1111/1754-9485.12026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 09/09/2012] [Indexed: 12/27/2022]
Abstract
INTRODUCTION To discuss the accuracy of the whole-body diffusion-weighted imaging with background body signal suppression (WB-DWIBS) technique performed in the 3.0-T system. METHODS We studied 17 patients who underwent positron emission tomography (PET)/CT and WB-DWIBS examinations for staging their diseases. The DWIBS pulse and echo-planar imaging-short T1 inversion recovery single-shot pulse sequences were performed for WB-DWIBS. A PET/CT scan was performed with 18-fluorodeoxyglucose. The lesions were localised and counted in both of the examinations, and WB-DWIBS was evaluated for the neoplastic tissue detection rate, while PET/CT was accepted as the reference standard modality. RESULTS The WB-DWIBS scan had a room occupation time of 32-35 min. All of the metastasis positive patients (n = 12) detected with PET/CT were also detected with WB-DWIBS (100%). In our patient group, there were a total of 109 bone metastases on PET/CT scans, and 93 of them (85.3%) were demonstrated with WB-DWIBS. We detected 128 metastatic lymph nodes on PET/CT, and 123 of them (96.3%) were demonstrated with WB-DWIBS. There were a total of 17 liver metastases on PET/CT, and 15 of them (88.2%) were detected with WB-DWIBS. There was no statistically significant difference between the two imaging modalities in detecting bone, lymph node and liver metastases (P > 0.05). CONCLUSIONS WB-DWIBS is a non-invasive technique that may successfully detect the spreading of the tumoural tissue in cancer patients when compared with PET/CT.
Collapse
Affiliation(s)
- Sinan Akay
- Department of Radiology, Gulhane Military Medical School, Ankara, Turkey.
| | | | | | | | | |
Collapse
|
|
29
|
Dyvorne HA, Galea N, Nevers T, Fiel MI, Carpenter D, Wong E, Orton M, de Oliveira A, Feiweier T, Vachon ML, Babb JS, Taouli B. Diffusion-weighted imaging of the liver with multiple b values: effect of diffusion gradient polarity and breathing acquisition on image quality and intravoxel incoherent motion parameters--a pilot study. Radiology 2012; 266:920-9. [PMID: 23220895 DOI: 10.1148/radiol.12120686] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To optimize intravoxel incoherent motion (IVIM) diffusion-weighted (DW) imaging by estimating the effects of diffusion gradient polarity and breathing acquisition scheme on image quality, signal-to-noise ratio (SNR), IVIM parameters, and parameter reproducibility, as well as to investigate the potential of IVIM in the detection of hepatic fibrosis. MATERIALS AND METHODS In this institutional review board-approved prospective study, 20 subjects (seven healthy volunteers, 13 patients with hepatitis C virus infection; 14 men, six women; mean age, 46 years) underwent IVIM DW imaging with four sequences: (a) respiratory-triggered (RT) bipolar (BP) sequence, (b) RT monopolar (MP) sequence, (c) free-breathing (FB) BP sequence, and (d) FB MP sequence. Image quality scores were assessed for all sequences. A biexponential analysis with the Bayesian method yielded true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (PF) in liver parenchyma. Mixed-model analysis of variance was used to compare image quality, SNR, IVIM parameters, and interexamination variability between the four sequences, as well as the ability to differentiate areas of liver fibrosis from normal liver tissue. RESULTS Image quality with RT sequences was superior to that with FB acquisitions (P = .02) and was not affected by gradient polarity. SNR did not vary significantly between sequences. IVIM parameter reproducibility was moderate to excellent for PF and D, while it was less reproducible for D*. PF and D were both significantly lower in patients with hepatitis C virus than in healthy volunteers with the RT BP sequence (PF = 13.5% ± 5.3 [standard deviation] vs 9.2% ± 2.5, P = .038; D = [1.16 ± 0.07] × 10(-3) mm(2)/sec vs [1.03 ± 0.1] × 10(-3) mm(2)/sec, P = .006). CONCLUSION The RT BP DW imaging sequence had the best results in terms of image quality, reproducibility, and ability to discriminate between healthy and fibrotic liver with biexponential fitting.
Collapse
Affiliation(s)
- Hadrien A Dyvorne
- Department of Radiology, Body MRI and Translational and Molecular Imaging Institute, Division of Liver Diseases, Mount Sinai School of Medicine, One Gustave Levy Place, Box 1234, New York, NY 10029, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
30
|
Mazaheri Y, Do RK, Shukla-Dave A, Deasy JO, Lu Y, Akin O. Motion correction of multi-b-value diffusion-weighted imaging in the liver. Acad Radiol 2012; 19:1573-80. [PMID: 22963726 DOI: 10.1016/j.acra.2012.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 07/05/2012] [Accepted: 07/20/2012] [Indexed: 12/16/2022]
Abstract
RATIONALE AND OBJECTIVES Motion artifacts are a significant source of error in the acquisition and quantification of parameters from multi-b-value diffusion-weighted imaging (DWI). The objective of this article is to present a reliable method to reduce motion-related artifacts during free-breathing at higher b-values when signal levels are low. MATERIALS AND METHODS Twelve patients referred for magnetic resonance imaging of the liver underwent a clinical magnetic resonance imaging examination of the abdominal region that included DWI. Conventional single-shot spin-echo echo planar imaging acquisitions of the liver during free breathing were repeated in a "time-resolved" manner during a single acquisition to obtain data for multi-b-value analysis, alternating between low and high b-values. Image registration using a normalized mutual information similarity measure was used to correct for spatial misalignment of diffusion-weighted volumes caused by motion. Registration error was estimated indirectly by comparing the normalized root-mean-square error (NRMSE) values of data fitted to the biexponential intra-voxel incoherent motion model before and after motion correction. Regions of interest (ROIs) were selected in the liver close to the surface of the liver and close to internal structures such as large bile ducts and blood vessels. RESULTS For the 12 patient datasets, the mean NRMSE value for the motion-corrected ROIs (0.38 ± 0.16) was significantly lower than the mean NRMSE values for the non-motion-corrected ROIs (0.41 ± 0.13) (P < .05). In cases where there was substantial respiratory motion during the acquisition, visual inspection verified that the algorithm markedly improved alignment of the liver contours between frames. CONCLUSIONS The proposed method addresses motion-related artifacts to increase robustness in multi-b-value acquisitions.
Collapse
|
|
31
|
|
|
32
|
Koh DM, Collins DJ, Wallace T, Chau I, Riddell AM. Combining diffusion-weighted MRI with Gd-EOB-DTPA-enhanced MRI improves the detection of colorectal liver metastases. Br J Radiol 2011; 85:980-9. [PMID: 22167501 DOI: 10.1259/bjr/91771639] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To compare the diagnostic accuracy of gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI, diffusion-weighted MRI (DW-MRI) and a combination of both techniques for the detection of colorectal hepatic metastases. METHODS 72 patients with suspected colorectal liver metastases underwent Gd-EOB-DTPA MRI and DW-MRI. Images were retrospectively reviewed with unenhanced T(1) and T(2) weighted images as Gd-EOB-DTPA image set, DW-MRI image set and combined image set by two independent radiologists. Each lesion detected was scored for size, location and likelihood of metastasis, and compared with surgery and follow-up imaging. Diagnostic accuracy was compared using receiver operating characteristics and interobserver agreement by kappa statistics. RESULTS 417 lesions (310 metastases, 107 benign) were found in 72 patients. For both readers, diagnostic accuracy using the combined image set was higher [area under the curve (Az)=0.96, 0.97] than Gd-EOB-DTPA image set (Az=0.86, 0.89) or DW-MRI image set (Az=0.93, 0.92). Using combined image set improved identification of liver metastases compared with Gd-EOB-DTPA image set (p<0.001) or DW-MRI image set (p<0.001). There was very good interobserver agreement for lesion classification (κ=0.81-0.88). CONCLUSIONS Combining DW-MRI with Gd-EOB-DTPA-enhanced T(1) weighted MRI significantly improved the detection of colorectal liver metastases.
Collapse
Affiliation(s)
- D-M Koh
- Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, UK.
| | | | | | | | | |
Collapse
|
|
33
|
Effects of microperfusion in hepatic diffusion weighted imaging. Eur Radiol 2011; 22:891-9. [PMID: 22080250 PMCID: PMC3297749 DOI: 10.1007/s00330-011-2313-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 08/30/2011] [Accepted: 09/09/2011] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Clinical hepatic diffusion weighted imaging (DWI) generally relies on mono-exponential diffusion. The aim was to demonstrate that mono-exponential diffusion in the liver is contaminated by microperfusion and that the bi-exponential model is required. METHODS Nineteen fasting healthy volunteers were examined with DWI (seven b-values) using fat suppression and respiratory triggering (1.5 T). Five different regions in the liver were analysed regarding the mono-exponentially fitted apparent diffusion coefficient (ADC), and the bi-exponential model: molecular diffusion (D (slow)), microperfusion (D (fast)) and the respective fractions (f (slow/fast)). Data were compared using ANOVA and Kruskal-Wallis tests. Simulations were performed by repeating our data analyses, using just the DWI series acquired with b-values approximating those of previous studies. RESULTS Median mono-exponentially fitted ADCs varied significantly (P < 0.001) between 1.107 and 1.423 × 10(-3) mm(2)/s for the five regions. Bi-exponential fitted D(slow) varied between 0.923 and 1.062 × 10(-3) mm(2)/s without significant differences (P = 0.140). D (fast) varied significantly, between 17.8 and 46.8 × 10(-3) mm(2)/s (P < 0.001). F-tests showed that the diffusion data fitted the bi-exponential model significantly better than the mono-exponential model (F > 21.4, P < 0.010). These results were confirmed by the simulations. CONCLUSION ADCs of normal liver tissue are significantly dependent on the measurement location because of substantial microperfusion contamination; therefore the bi-exponential model should be used. KEY POINTS Diffusion weighted MR imaging helps clinicians to differentiate tumours by diffusion properties. Fast moving water molecules experience microperfusion, slow molecules diffusion. Hepatic diffusion should be measured by bi-exponential models to avoid microperfusion contamination. Mono-exponential models are contaminated with microperfusion, resulting in apparent regional diffusion differences. Bi-exponential models are necessary to measure diffusion and microperfusion in the liver.
Collapse
|
|
34
|
Liau J, Lee J, Schroeder ME, Sirlin CB, Bydder M. Cardiac motion in diffusion-weighted MRI of the liver: artifact and a method of correction. J Magn Reson Imaging 2011; 35:318-27. [PMID: 21959926 DOI: 10.1002/jmri.22816] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 08/17/2011] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To characterize cardiac motion artifacts in the liver and assess the use of a postprocessing method to mitigate these artifacts in repeat measurements. MATERIALS AND METHODS Three subjects underwent breathhold diffusion-weighted (DW) scans consisting of 25 repetitions for three b-values (0, 500, 1000 sec/mm(2)). Statistical maps computed from these repetitions were used to assess the distribution and behavior of cardiac motion artifacts in the liver. An objective postprocessing method to reduce the artifacts was compared with radiologist-defined gold standards. RESULTS Signal dropout is pronounced in areas proximal to the heart, such as the left lobe, but also present in the right lobe and in distal liver segments. The dropout worsens with b-value and leads to overestimation of the diffusivity. By reference to a radiologist-defined gold standard, a postprocessing correction method is shown to reduce cardiac motion artifact. CONCLUSION Cardiac motion leads to significant artifacts in liver DW imaging; we propose a postprocessing method that may be used to mitigate the artifact and is advantageous to standard signal averaging in acquisitions with multiple repetitions.
Collapse
Affiliation(s)
- Joy Liau
- Department of Radiology, University of California San Diego, San Diego, CA 92103-8226, USA
| | | | | | | | | |
Collapse
|
|
35
|
Bilgili MYK. Reproductibility of apparent diffusion coefficients measurements in diffusion-weighted MRI of the abdomen with different b values. Eur J Radiol 2011; 81:2066-8. [PMID: 21724354 DOI: 10.1016/j.ejrad.2011.06.045] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 06/07/2011] [Indexed: 12/13/2022]
Abstract
PURPOSE To test the reproducibility of apparent diffusion coefficients (ADC) measurements of the normal liver, kidney and spleen parenchyma with different b values. MATERIALS AND METHODS Eleven healthy volunteers were imaged twice with use of the same protocol. Each DWI was performed with b-factors of 0, 100 and 500 s/mm(2). The ADCs were organized according to session (1 or 2), anatomic location and repetition (twice with two different b value per session). The ADC data were analyzed with repeated-measures analysis of variance to demonstrate the influence of anatomic location, session and different b values. The coefficient of variation was calculated for each subject, b value and anatomic location, then analyzed by using repeated-measures analysis of variance. RESULTS There were significant differences in mean ADCs among the three anatomic locations and with different b values (P<.05). There were no significant differences in ADCs between imaging sessions 1 or 2 for both b values (P>.05). The CV values range between 7.3% and 14.7%. There were no significant differences in CV values neither between the two b values nor for the various organ locations (P>.05). CONCLUSION Using the same technical parameters, patients and the same observer, CV values range between 7.3% and 14.7%. And we recommend to be careful in examination and comparison of the measured ADC values, below these limits, without knowledge technical parameters that has been used, otherwise differences that are merely because of changes in the measurement technique could be interpreted as differences because of progression of disease or therapy.
Collapse
|
|
36
|
Accuracy of Apparent Diffusion Coefficient Value Measurement on PACS Workstation: A Comparative Analysis. AJR Am J Roentgenol 2011; 196:W280-4. [DOI: 10.2214/ajr.10.4706] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
|
37
|
Kwee TC, Takahara T, Ochiai R, Koh DM, Ohno Y, Nakanishi K, Niwa T, Chenevert TL, Luijten PR, Alavi A. Complementary roles of whole-body diffusion-weighted MRI and 18F-FDG PET: the state of the art and potential applications. J Nucl Med 2010; 51:1549-58. [PMID: 20847177 DOI: 10.2967/jnumed.109.073908] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
(18)F-FDG PET is an established functional imaging modality for the evaluation of human disease. Diffusion-weighted MRI (DWI) is another rapidly evolving functional imaging modality that can be used to evaluate oncologic and nononcologic lesions throughout the body. The information provided by (18)F-FDG PET and DWI can be complementary, because the 2 methods are based on completely different biophysical underpinnings. This article will describe the basic principles, clinical applications, and limitations of DWI. In addition, the available evidence that correlates and compares (18)F-FDG PET and DWI will be reviewed.
Collapse
Affiliation(s)
- Thomas C Kwee
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
38
|
Lu TLC, Meuli RA, Marques-Vidal PM, Bize P, Denys A, Schmidt S. Interobserver and intraobserver variability of the apparent diffusion coefficient in treated malignant hepatic lesions on a 3.0T machine: Measurements in the whole lesion versus in the area with the most restricted diffusion. J Magn Reson Imaging 2010; 32:647-53. [DOI: 10.1002/jmri.22301] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
|
39
|
Dogan Y, Soylu A, Kilickesmez O, Demirtas T, Kilickesmez KO, Dogan SN, Eren G, Sevindir I, Yasar N, Poturoglu S, Sonmez K. The value of hepatic diffusion-weighted MR imaging in demonstrating hepatic congestion secondary to pulmonary hypertension. Cardiovasc Ultrasound 2010; 8:28. [PMID: 20663149 PMCID: PMC2920852 DOI: 10.1186/1476-7120-8-28] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 07/21/2010] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Congestive hepatomegaly might be the first sign for pulmonary hypertension. Apparent diffusion coefficient (ADC) value obtained with quantitative diffusion-weighted magnetic resonance imaging (DW-MRI) is affected by liver fibrosis and perfusion. We aimed to evaluate the diagnostic value of DW-MRI in cooperation with biochemical markers, ultrasonography (US) and echocardiography (TTE) in determining the degree of hepatic congestion secondary to pulmonary hypertension (PHT). METHODS 35 patients with PHT and 26 control subjects were included in the study. PHT was diagnosed if pulmonary artery systolic pressure (PASP) was measured above 35 mmHg with TTE. Study group was classified into mild and moderate PHT. DW-MRI was performed with b-factors of 0, 500 and 1000 sec/mm(2). Mean ADC, ADC-II (Average of the ADC values of right lobe anterior and posterior segments), US, TTE and blood biochemical parameters of both groups were compared. RESULTS There exists a positive correlation between liver size and the diameters of vena cava inferior, right atrium, right hepatic vein(RHV), mid-hepatic vein(MHV), left hepatic vein(LHV) (p < 0.01). There was a positive correlation between PASP and RHV, MHV, LHV. The patients had lower ejection fractions (p < 0.01) and higher LDH (p < 0.01) and ALP (p < 0.05) levels than the control group. The ADC values of the patients with moderate PASP were higher than those with a mild PASP (p < 0.05). Mean ADC was higher in patients with moderate PHT compared to control group (p = 0.009). There was a positive correlation between PASP and ADC values of right lobe posterior segment of the liver (p < 0.05). The ADC-II and mean ADC values of the patients with moderate PASP were higher than those of the control group (p < 0.01). CONCLUSIONS Congestion due to moderate PHT might be diagnosed with DW-MRI. As PASP increase; mean ADC and ADC-II values increase.
Collapse
Affiliation(s)
- Yuksel Dogan
- Department of Cardiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Aliye Soylu
- Department of Gastroenterology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | | | - Tuna Demirtas
- Department of Radiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | | | - Sebahat Nacar Dogan
- Department of Radiology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Gulay Eren
- Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Isa Sevindir
- Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Nurgul Yasar
- Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Sule Poturoglu
- Department of Gastroenterology, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Kenan Sonmez
- Department of Cardiology, Kosuyolu Heart and Research Hospital, Cardiology Clinic, Istanbul, Turkey
| |
Collapse
|
|
40
|
Kim SY, Lee SS, Byun JH, Park SH, Kim JK, Park B, Kim N, Lee MG. Malignant Hepatic Tumors: Short-term Reproducibility of Apparent Diffusion Coefficients with Breath-hold and Respiratory-triggered Diffusion-weighted MR Imaging. Radiology 2010; 255:815-23. [DOI: 10.1148/radiol.10091706] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
|
41
|
Muhi A, Ichikawa T, Motosugi U, Sano K, Matsuda M, Kitamura T, Nakazawa T, Araki T. High-b-value diffusion-weighted MR imaging of hepatocellular lesions: estimation of grade of malignancy of hepatocellular carcinoma. J Magn Reson Imaging 2010; 30:1005-11. [PMID: 19856432 DOI: 10.1002/jmri.21931] [Citation(s) in RCA: 145] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of diffusion-weighted magnetic resonance imaging (DWI) in estimating the grade of malignancy of hepatocellular carcinoma. MATERIALS AND METHODS Dynamic contrast-enhanced computed tomography (CE-CT) and DWI (b value, 1000 s/mm(2)) were performed on 73 patients. Using DW images, the lesions were classified as "visible" or "invisible." The apparent diffusion coefficient (ADC) of the lesions was measured. Furthermore, the lesions were classified as hypervascular or iso-hypovascular using arterial phase CE-CT images. The image findings for each lesion type were compared. RESULTS The 73 patients had 98 hepatocellular lesions, of which 12 were histologically diagnosed as dysplastic nodules; 39, well-differentiated HCCs; 33, moderately differentiated HCCs; and 14, poorly differentiated HCCs. The mean ADC values of moderately poorly-differentiated HCCs were significantly lower than well-differentiated HCCs and dysplastic nodules (P < 0.01). On DW images, >90% of moderately (30/33) and poorly differentiated HCCs (13/14) were visible, while 51% of well-differentiated HCCs (20/39) and all dysplastic nodules were invisible. Of 22 iso-hypovascular lesions, 4 were visible on DW images and were poorly differentiated HCCs, whereas 18 were invisible and were dysplastic nodules (12/18) or well-differentiated HCCs (6/18). CONCLUSION A combination of hypovascularity and visibility on DW images can help distinguish poorly differentiated HCCs from low-grade hepatocellular lesions (dysplastic nodules and well-differentiated HCCs).
Collapse
Affiliation(s)
- Ali Muhi
- Department of Radiology, University of Yamanashi, Yamanshi, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
|
42
|
Koike N, Cho A, Nasu K, Seto K, Nagaya S, Ohshima Y, Ohkohchi N. Role of diffusion-weighted magnetic resonance imaging in the differential diagnosis of focal hepatic lesions. World J Gastroenterol 2009; 15:5805-12. [PMID: 19998501 PMCID: PMC2791273 DOI: 10.3748/wjg.15.5805] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the utility of diffusion-weighted imaging (DWI) in screening and differential diagnosis of benign and malignant focal hepatic lesions.
METHODS: Magnetic resonance imaging (MRI) examinations were performed using the Signa Excite Xl Twin Speed 1.5T system (GE Healthcare, Milwaukee, WI, USA). Seventy patients who had undergone MRI of the liver [29 hepatocellular carcinomas (HCC), four cholangiocarcinomas, 34 metastatic liver cancers, 10 hemangiomas, and eight cysts] between April 2004 and August 2008 were retrospectively evaluated. Visualization of lesions, relative contrast ratio (RCR), and apparent diffusion coefficient (ADC) were compared between benign and malignant lesions on DWI. Superparamagnetic iron oxide (SPIO) was administered to 59 patients, and RCR was compared pre- and post-administration.
RESULTS: DWI showed higher contrast between malignant lesions (especially in multiple small metastatic cancers) and surrounding liver parenchyma than did contrast-enhanced computed tomography. ADCs (mean ± SD × 10-3 mm2/s) were significantly lower (P < 0.05) in malignant lesions (HCC: 1.31 ± 0.28 and liver metastasis: 1.11 ± 0.22) and were significantly higher in benign lesions (hemangioma: 1.84 ± 0.37 and cyst: 2.61 ± 0.45) than in the surrounding hepatic tissues. RCR between malignant lesions and surrounding hepatic tissues significantly improved after SPIO administration, but RCRs in benign lesions were not improved.
CONCLUSION: DWI is a simple and sensitive method for screening focal hepatic lesions and is useful for differential diagnosis.
Collapse
|
|
43
|
Diffusion-weighted imaging of surgically resected hepatocellular carcinoma: imaging characteristics and relationship among signal intensity, apparent diffusion coefficient, and histopathologic grade. AJR Am J Roentgenol 2009; 193:438-44. [PMID: 19620441 DOI: 10.2214/ajr.08.1424] [Citation(s) in RCA: 156] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of our study was to determine the relationship between the signal intensity of hepatocellular carcinoma (HCC) assessed with diffusion-weighted imaging (DWI) and T2-weighted imaging and the apparent diffusion coefficient (ADC) with the histopathologic grade of each nodule. MATERIALS AND METHODS MR examinations including DWI and T2-weighted imaging of 125 surgically resected hypervascular HCCs in 99 patients were retrospectively reviewed. Pathologic examinations revealed 25 well-, 61 moderately, and 39 poorly differentiated HCCs. Two radiologists reviewed the images and classified the signal intensity of each tumor on DWI and T2-weighted imaging by mutual agreement. The incidence of each signal intensity and the relationship between signal intensity and histopathologic grade were assessed for each sequence. The relationship between the ADC and histopathologic grade was also evaluated. RESULTS On DWI, 11 of 125 HCCs appeared hypo- to isointense, 27 tumors appeared slightly hyperintense, and the remaining 87 tumors appeared obviously hyperintense to the surrounding liver. Overall, 91.2% (114/125) of HCCs showed hyperintensity to the surrounding hepatic parenchyma. Statistical analysis showed that this rate on DWI was significantly higher than that on T2 turbo spin-echo (TSE) imaging (p < 0.001). On DWI, the tumors tended to show a brighter signal with rising histopathologic grade (p = 0.031), but this trend was not observed on T2-weighted imaging. ADC measurements revealed that the mean ADCs of well-, moderately, and poorly differentiated HCCs were approximately 1.45, 1.46, and 1.36 x 10(-3) mm(2)/s, respectively. There was no significant correlation between ADC and histopathologic grade. CONCLUSION The histopathologic grade of HCC had no correlation with the ADC, but HCC tumors tended to show a higher signal on DWI as the histopathologic grade rose. However, predicting the correct histopathologic grade of each HCC before surgery on the basis of DWI findings was difficult because of the large overlap among histopathologic grades.
Collapse
|
|
44
|
Kwee TC, Takahara T, Niwa T, Ivancevic MK, Herigault G, Van Cauteren M, Luijten PR. Influence of cardiac motion on diffusion-weighted magnetic resonance imaging of the liver. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2009; 22:319-25. [PMID: 19727877 DOI: 10.1007/s10334-009-0183-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 08/03/2009] [Accepted: 08/12/2009] [Indexed: 12/21/2022]
Abstract
PURPOSE To assess cardiac motion-induced signal loss in diffusion-weighted magnetic resonance imaging (DWI) of the liver using dynamic DWI. MATERIALS AND METHODS Three volunteers underwent dynamic coronal DWI of the liver under breathholding, in the diastolic (DWI(diast)) or systolic (DWI(syst)) cardiac phase, and with motion probing gradients (MPGs) in phase encoding (P, left-right), frequency encoding (M, superior-inferior), or slice select (S, anterior-posterior) direction. Liver-to-background contrasts (LBCs) of DWI(syst) were compared to those of DWI(diast), for both the left and right liver lobes, using nonparametric tests. Signal decrease ratios (SDRs) were calculated as (1-(LBCDWI(syst)/LBCDWI(diast))) x 100%. DWI(syst) was further analyzed to determine which direction of MPGs was most affected by cardiac motion. RESULTS In the left liver lobe, LBCs of DWI(syst) (median 3.35) were significantly lower (P < 0.0001) than those of DWI(diast) (median 4.84). In the right liver lobe, LBCs of DWI(syst) (median 4.17) were also significantly lower (P < 0.0001) than those of DWI(diast) (median 5.35 ). SDRs of the left and right liver lobes were 25.5% and 17.3%, respectively. In DWI(syst), the significantly lowest (P < 0.05) LBCs were observed in the M direction (left liver lobe) and P direction (right liver lobe) of MPGs. CONCLUSION Signal intensity of both liver lobes are affected by cardiac motion in DWI. In the left liver lobe, signal loss especially occurs in the superior-inferior direction of MPGs, whereas in the right lobe, signal loss especially occurs in the left-right direction of MPGs.
Collapse
Affiliation(s)
- Thomas C Kwee
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
|
45
|
Nasu K, Kuroki Y, Minami M. Feasibility of diffusion-weighted imaging under split breath-hold acquisition and postprocessing (DWI-SBAP): an attempt to suppress hepatic pseudo-anisotropy. Jpn J Radiol 2009; 27:78-85. [DOI: 10.1007/s11604-008-0303-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 11/18/2008] [Indexed: 12/27/2022]
|
|
46
|
Luciani A, Vignaud A, Cavet M, Nhieu JTV, Mallat A, Ruel L, Laurent A, Deux JF, Brugieres P, Rahmouni A. Liver cirrhosis: intravoxel incoherent motion MR imaging--pilot study. Radiology 2008; 249:891-9. [PMID: 19011186 DOI: 10.1148/radiol.2493080080] [Citation(s) in RCA: 516] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To retrospectively evaluate a respiratory-triggered diffusion-weighted (DW) magnetic resonance (MR) imaging sequence combined with parallel acquisition to allow the calculation of pure molecular-based (D) and perfusion-related (D*, f) diffusion parameters, on the basis of the intravoxel incoherent motion (IVIM) theory, to determine if these parameters differ between patients with cirrhosis and patients without liver fibrosis. MATERIALS AND METHODS The institutional review board approved this retrospective study; informed consent was waived. IVIM DW imaging was tested on three alkane phantoms, on which the signal-intensity decay curves according to b factors were logarithmically plotted. Ten b factors (0, 10, 20, 30, 50, 80, 100, 200, 400, 800 sec/mm(2)) were used in patients. Patients with documented liver cirrhosis (cirrhotic liver group, n = 12) and patients without chronic liver disease (healthy liver group, n = 25) were included. The mean liver D, D*, and f values were measured and compared with the apparent diffusion coefficient (ADC) computed by using four b values (0, 200, 400, 800 sec/mm(2)). Liver ADC and D, f, and D* parameters were compared between the cirrhotic liver group and healthy liver group. Means were compared by using the Student t test. RESULTS Signal-intensity decay curves were monoexponential on phantoms and biexponential in patients. In vivo, mean ADC values were significantly higher than D in the healthy liver group (ADC = 1.39 x 10(-3) mm(2)/sec +/- 0.2 [standard deviation] vs D = 1.10 x 10(-3) mm(2)/sec +/- 0.7) and in the cirrhotic liver group (ADC = 1.23 x 10(-3) mm(2)/sec +/- 0.4 vs D = 1.19 x 10(-3) mm(2)/sec +/- 0.5) (P = .03). ADC and D* were significantly reduced in the cirrhotic liver group compared with those in the healthy liver group (respective P values of .03 and .008). CONCLUSION Restricted diffusion observed in patients with cirrhosis may be related to D* variations, which reflect decreased perfusion, as well as alterations in pure molecular water diffusion in cirrhotic livers.
Collapse
Affiliation(s)
- Alain Luciani
- INSERM Unite U 841, Equipe 17, Molecular Mechanisms of Liver Fibrosis, Creteil, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
47
|
Koh DM, Takahara T, Imai Y, Collins DJ. Practical aspects of assessing tumors using clinical diffusion-weighted imaging in the body. Magn Reson Med Sci 2008; 6:211-24. [PMID: 18239358 DOI: 10.2463/mrms.6.211] [Citation(s) in RCA: 176] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Diffusion-weighted magnetic resonance (MR) imaging (DWI) is increasingly applied to evaluate tumors in the abdomen and pelvis. However, DWI is susceptible to a variety of artifacts that arise from motion, use of strong gradient pulses, and echo-planar imaging technique. We discuss practical issues to help radiologists optimize the use of DWI to evaluate tumors in the body, including breath-hold DWI, multiple-acquisition non-breath-hold DWI, and diffusion-weighted whole-body imaging with background body signal suppression (DWIBS). Considerations of meticulous technique, sequence optimization, and quality assurance are emphasized for consistent acquisition of high quality images. We illustrate the potential use of these techniques to detect and characterize tumors and to monitor treatment effects.
Collapse
Affiliation(s)
- Dow-Mu Koh
- CR UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research and Academic Department of Radiology, Royal Marsden Hospital, Sutton, UK.
| | | | | | | |
Collapse
|
|
48
|
Nasu K, Kuroki Y, Fujii H, Minami M. Hepatic pseudo-anisotropy: a specific artifact in hepatic diffusion-weighted images obtained with respiratory triggering. ACTA ACUST UNITED AC 2007; 20:205-11. [PMID: 17960439 DOI: 10.1007/s10334-007-0084-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Revised: 08/14/2007] [Accepted: 09/24/2007] [Indexed: 12/21/2022]
Abstract
PURPOSE Hepatic pseudo-anisotropy is an artifact observed in hepatic diffusion-weighted imaging under respiratory triggering (RT-DWI). To determine the clinical significance of this phenomenon, hepatic RT-DW images were reviewed. METHODS One hundred and five MR examinations, including RT-DWI, were assessed. The patient group included 62 non-cirrhotic and 43 cirrhotic individuals. All images were evaluated by mutual agreement of two radiologists from the viewpoints of incidence of pseudo-anisotropy and correlation between pseudo-anisotropy and the quality of trace images. The ADC of normal hepatic parenchyma of non-cirrhotic livers were measured in both areas with and without pseudo-anisotropy. RESULTS Pseudo-anisotropy was observed in 60% of non-cirrhotic (37/62) and 30% of cirrhotic (13/43) images. The difference between the two groups was statistically significant (P < 0.001). The quality of trace images showed a tendency to worsen as pseudo-anisotropy became significant. However, the quality of trace images was generally satisfactory, with only two patients whose trace images were difficult to interpret due to pseudo-anisotropy. The areas with pseudo-anisotropy showed higher ADC than those without pseudo-anisotropy (P < 0.001). CONCLUSION Pseudo-anisotropy is a type of artifact that originates from respiratory movement. Even though respiratory triggering is employed, ADC measurement of the liver is inaccurate because of pseudo-anisotropy, especially in non-cirrhotic patients.
Collapse
Affiliation(s)
- Katsuhiro Nasu
- Department of Diagnostic Radiology, Tsukuba University School of Medicine, Tsukuba, Ibaraki, Japan.
| | | | | | | |
Collapse
|
|
49
|
Mürtz P, Krautmacher C, Träber F, Gieseke J, Schild HH, Willinek WA. Diffusion-weighted whole-body MR imaging with background body signal suppression: a feasibility study at 3.0 Tesla. Eur Radiol 2007; 17:3031-7. [PMID: 17646990 DOI: 10.1007/s00330-007-0717-8] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Revised: 05/07/2007] [Accepted: 06/15/2007] [Indexed: 12/30/2022]
Abstract
The purpose was to provide a diffusion-weighted whole-body magnetic resonance (MR) imaging sequence with background body signal suppression (DWIBS) at 3.0 Tesla. A diffusion-weighted spin-echo echo-planar imaging sequence was combined with the following methods of fat suppression: short TI inversion recovery (STIR), spectral attenuated inversion recovery (SPAIR), and spectral presaturation by inversion recovery (SPIR). Optimized sequences were implemented on a 3.0- and a 1.5-Tesla system and evaluated in three healthy volunteers and six patients with various lesions in the neck, chest, and abdomen on the basis of reconstructed maximum intensity projection images. In one patient with metastases of malignant melanoma, DWIBS was compared with (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET). Good fat suppression for all regions and diagnostic image quality in all cases could be obtained at 3.0 Tesla with the STIR method. In comparison with 1.5 Tesla, DWIBS images at 3.0 Tesla were judged to provide a better lesion-to-bone tissue contrast. However, larger susceptibility-induced image distortions and signal intensity losses, stronger blurring artifacts, and more pronounced motion artifacts degraded the image quality at 3.0 Tesla. A good correlation was found between the metastases as depicted by DWIBS and those as visualized by FDG-PET. DWIBS is feasible at 3.0 Tesla with diagnostic image quality.
Collapse
Affiliation(s)
- Petra Mürtz
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
| | | | | | | | | | | |
Collapse
|
|
50
|
Nasu K, Kuroki Y, Sekiguchi R, Nawano S. The effect of simultaneous use of respiratory triggering in diffusion-weighted imaging of the liver. Magn Reson Med Sci 2007; 5:129-36. [PMID: 17139138 DOI: 10.2463/mrms.5.129] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To determine the effect of simultaneous use of respiratory triggering in hepatic diffusion-weighted imaging (DWI), we compared DWI with respiratory triggering (RT-DWI) and DWI under free breathing (FB-DWI) in terms of relative contrast between hepatic tumor and surrounding liver parenchyma, apparent diffusion coefficient (ADC) measurement, and frequency of respiratory misregistration. MATERIALS AND METHODS Thirty patients (21 men, 9 women, aged 25 to 80 years) with liver metastasis or hepatocellular carcinoma in the right hepatic lobe were examined with RT- and FB-DWI. In patients having multiple tumors, up to 3 lesions were selected by mutual agreement of 2 diagnostic radiologists. Finally, 59 nodules were selected for evaluation. Relative contrast ratio (RCR) between the lesions and surrounding parenchyma and ADC were measured in each hepatic lesion in each sequence. The differences in RCR and ADC between RT- and FB-DWI were statistically analyzed using Wilcoxon's signed rank test. The frequency of respiratory misregistration advents in each sequence was visually evaluated by the 2 diagnostic radiologists and assessed using McNemar's test. RESULTS RCRs were significantly higher in RT- than in FB-DWI (P<0.001). The difference in ADC between the 2 sequences was not significant. However, ADCs tended to be more scattered in FB- than in RT-DWI. The frequency of respiratory misregistration advents was significantly higher in FB- than in RT-DWI. CONCLUSION FB- was inferior to RT-DWI in both contrast between tumors and surrounding liver parenchyma and in accuracy of ADC measurement as far as the numbers of excitation in each sequence were the same. For preoperative examination of hepatic resection, RT- is more suitable than FB-DWI.
Collapse
Affiliation(s)
- Katsuhiro Nasu
- Department of Diagnostic Radiology, National Cancer Center Hospital East, Chiba, Japan.
| | | | | | | |
Collapse
|