A comparative study of apparent diffusion coefficient and intravoxel incoherent motion-derived parameters for the characterization of common solid hepatic tumors

Zhu, Liuhong; Cheng, Qian; Luo, Wenbin; Bao, Lijun; Guo, Gang

doi:10.1177/0284185114559426

Cited by 36 publications

(42 citation statements)

References 33 publications

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“…However, previous studies indicated that ADC could be used as a marker to differentiate disease entities because of its high efficacy and ease of calculation (24)(25)(26)(27). Our results also showed that ADC total slightly exceeded D in terms of maximum AUC values, with higher sensitivity and specificity, but there was no statistical difference between them (P = 0.61), which meant that ADC total and D had the same practical effectiveness.…”

Section: Discussionmentioning

confidence: 40%

“…A number of studies have pointed out that perfusion parameters between malignancy and benignity are absolutely different because of their microstructure disparities (11,12); however, the nature of these differences in specific lesions is still not completely understood (24)(25)(26). Images captured during routine work in hospitals or from the literature for HCC and FNH show that both of these lesions are characterized by abundant blood supply in the arterial phase.…”

Section: Discussionmentioning

confidence: 99%

“…ADC total has been proven to be superior to ADC 2b (11,25), because it contains more information. Although Klauss et al (27) considered that the AUC of D was slightly better than that of ADC, they only used two b values (0 and 800) to calculate their ADC 2b .…”

Section: Discussionmentioning

confidence: 99%

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Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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A mong primary malignant hepatic tumors, hepatocellular carcinoma (HCC) is the most common disease and is highly associated with chronic hepatitis B and cirrhosis. Focal nodular hyperplasia (FNH) is the second most common benign focal liver lesion (1), and although it displays gentle biological behavior generally, it can cause abdominal pain or right upper quadrant discomfort occasionally. In terms of the extent of vascular supply during contrast enhancement, HCC and FNH both show a hyperarterialization pattern. HCC is characterized by rapid washout in portal and delayed phase compared with adjacent liver tissue, while FNH displays isointensity or mild hyperintensity in the venous phase because of its slower washout. Liver-specific contrast agents, such as gadoxetic acid, can provide unique information to diagnose these conditions more precisely; however, such agents increase the cost and time-consumption of diagnosis. Occasionally, HCC and FNH show confounding or atypical appearances on imaging, especially for high-or middle-grade differentiated HCC, leading to confusion, misdiagnosis ( Fig. 1), and even unnecessary interventions. Since the treatment of these two lesions is completely different, avoiding unnecessary invasive treatment or tests, such as biopsy, surgery, or interventional therapy, is vital for the prognosis and quality of life of the patient. Therefore, it is crucial to diagnose these conditions noninvasively and accurately before surgery.Diffusion-weighted imaging (DWI) is a functional technology to detect diffusion of water molecules and permits to capture more detailed disease information. For lesion detection, the signal intensity on diffusion-weighted image depends on several factors, particularly cell density. A B D O M I N A L I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to explore whether intravoxel incoherent motion (IVIM)-related parameters of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) demonstrate differences that could be used to differentiate and improve diagnostic efficiency. METHODSA total of 27 patients, including 22 with HCC and 5 with FNH, underwent liver 3.0 T magnetic resonance imaging for routine sequences. They were concurrently examined by IVIM diffusion-weighted imaging (DWI) scanning with 11 different b values (0-800 s/mm 2 ). IVIM-derived parameters, such as pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f ), and apparent diffusion coefficient (ADC total ), were quantified automatically by post-processing software and compared between HCC and FNH groups. A receiver operating characteristic (ROC) curve was then created to predict their diagnostic value. RESULTS

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Section: Discussionmentioning

confidence: 40%

Section: Discussionmentioning

confidence: 99%

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Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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“…Various fitting algorithms have been used to determine IVIM parameters, including asymptotic fitting (9)(10)(11)(12)(19)(20)(21)24,41,45,46,48,51,53), nonlinear least square (usually Levenberg-Marquardt) fitting (23,42,47,52,54,55), and Bayesian fitting (15,22,40,43,50). Current review cannot draw conclusion which one is better than others, nor can the mean values be compared (Figure 8).…”

Section: Image Post-processing Methods For Ivim Parametersmentioning

confidence: 99%

“…Accumulation of collagen deposits and activated stellate cells contribute to increased hepatic resistance to portal blood flow, development of portal hypertension, and reduced portal blood perfusion. The decrease of blood perfusion can arise from a number of concomitant alterations in the tissue microenvironment, including collagen deposition, fatty (9)(10)(11)15,23,24,42,43,45,46,(48)(49)(50)(51)(53)(54)(55), free-breathing (FB) (19)(20)(21)40,41,47), and breath-hold (BH) (44). Solid line represents the median value of each group.…”

Section: Ivim For Liver Fibrosis Evaluationmentioning

confidence: 99%

Liver intravoxel incoherent motion (IVIM) magnetic resonance imaging: a comprehensive review of published data on normal values and applications for fibrosis and tumor evaluation

Lǐ¹,

Cercueil²,

Yuan³

et al. 2017

Quant. Imaging Med. Surg.

131

210

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Application of Intravoxel Incoherent Motion in Clinical Liver Imaging: A Literature Review

Wang,

Yu,

Qiu

et al. 2023

Magnetic Resonance Imaging

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Intravoxel incoherent motion (IVIM) modeling is a widely used double‐exponential model for describing diffusion‐weighted imaging (DWI) signal, with a slow component related to pure molecular diffusion and a fast component associated with microcirculatory perfusion, which compensates for the limitations of traditional DWI. IVIM is a noninvasive technique for obtaining liver pathological information and characterizing liver lesions, and has potential applications in the initial diagnosis and treatment monitoring of liver diseases. Recent studies have demonstrated that IVIM‐derived parameters are useful for evaluating liver lesions, including nonalcoholic fatty liver disease (NAFLD), liver fibrosis and liver tumors. However, the results are not stable. Therefore, it is necessary to summarize the current applications of IVIM in liver disease research, identify existing shortcomings, and point out the future development direction. In this review, we searched for studies related to hepatic IVIM‐DWI applications over the past two decades in the PubMed database. We first introduce the fundamental principles and influential factors of IVIM, and then discuss its application in NAFLD, liver fibrosis, and focal hepatic lesions. It has been found that IVIM is still unstable in ensuring the robustness and reproducibility of measurements in the assessment of liver fibrosis grade and liver tumors differentiation, due to inconsistent and substantial overlap in the range of IVIM‐derived parameters for different fibrotic stages. In the end, the future direction of IVIM‐DWI in the assessment of liver diseases is discussed, emphasizing the need for further research on the stability of IVIM‐derived parameters, particularly perfusion‐related parameters, in order to promote the clinical practice of IVIM‐DWI.Level of Evidence5Technical EfficacyStage 3

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A comparative study of apparent diffusion coefficient and intravoxel incoherent motion-derived parameters for the characterization of common solid hepatic tumors

Abstract: ADCs showed superior diagnostic performance compared to IVIM-derived parameters in detecting differences between the malignant group and hemangioma group.

Cited by 36 publications

References 33 publications

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Liver intravoxel incoherent motion (IVIM) magnetic resonance imaging: a comprehensive review of published data on normal values and applications for fibrosis and tumor evaluation

Application of Intravoxel Incoherent Motion in Clinical Liver Imaging: A Literature Review

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