Clinical applications of diffusion‐weighted magnetic resonance imaging in diagnosis of renal lesions – a systematic review

Abstract

Diffusion-weighted magnetic resonance imaging (DW-MRI) is an established technique to detect the changes of the diffusion of water in biological tissues and reflect the pathophysiological process on the molecular level. It is a promising non-invasive imaging modality in detection of microstructural and functional changes in pathologies of kidney. To systematically review the research advancement of the DW-MRI in diagnosis of renal lesions, a systematic literature search was performed up to 8 October 2014 using the MEDLINE/PubMed and Embase databases for articles reporting on DW-MRI in diagnosis of renal lesions. Only articles with full data about DW-MRI application with potential implication in solving usually encountered clinical challenges about renal lesions were finally examined. The clinical application of DW-MRI allows a better understanding of some pathologic conditions of the kidney including renal insufficiency, renal artery stenosis, ureteral obstruction, foetal kidney disease, hydronephrosis and pyonephrosis. In addition, DW-MRI can also provide clinicians with the information of function evaluation of renal allograft and curative effect assessment of renal tumour. In summary, performance of renal DW-MRI, presuming that measurements are high quality, will further boost this modality, particularly for early detection of diffusion renal conditions, as well as more accurate characterization of renal lesions.

Multiparametric MRI of Solid Renal Masses: Principles and Applications of Advanced Quantitative and Functional Methods for Tumor Diagnosis and Characterization

“…However, physiologic substances, such as collagen and smooth muscle, may also restrict diffusion. DWI/IVIM may thus potentially be used for distinguishing malignant vs. benign SRM, as well as in the grading and differentiation of specific tumor subtypes 25–27 …”

“…DWI/IVIM may thus potentially be used for distinguishing malignant vs. benign SRM, as well as in the grading and differentiation of specific tumor subtypes. [25][26][27] RESULTS IN HUMAN SUBJECTS. The ability of DWI/IVIM to discern microstructural changes to classify not only benign SRM vs. RCC but also specific subtypes and grades of RCCs is of immense potential clinical and prognostic value.…”

“…35 Other studies summarized in a systemic review by Ye et al have also demonstrated similarly decreased ADC values in AML relative to solid RCC. 27 Whereas the reduced ADC values for AML could be attributed to the muscular components of the SRM causing increased restricted diffusion, the relatively higher ADC values of ccRCC could reflect the intratumoral microcystic or necrotic features, which are challenging to avoid when delineating regions-of-interest (ROIs) at the time of imaging analysis. 34,36 A separate study found conflicting results, demonstrating higher mean ADC in AML compared to solid RCCs (1.83 AE 0.35 Â 10 À3 mm 2 /sec vs. 1.42 AE 0.16 Â 10 À3 mm 2 /sec, P = 0.000).…”

Extra-axonal contribution to double diffusion encoding-based pore size estimates in the corticospinal tract

“…Diffusion-weighted magnetic resonance imaging has evolved into a widely used tool for studying tissue microstructure [1][2][3][4][5]. In diffusion-weighted imaging, the magnetization preparation is most often based on the pulsed gradient spin echo [6].…”

Diffusion-Weighted Magnetic Resonance Imaging: Clinical Potential and Applications

“…DWI has been widely used in cancer imaging to detect, characterize, and stage malignant lesions, or even assess the response to therapy, in various anatomical districts besides the brain [ 11 ], such as the breast [ 12 , 13 ], lung [ 14 , 15 ], liver [ 16 ], pancreas [ 17 ], kidney [ 18 ], gallbladder [ 19 ], thyroid [ 20 ], head and neck [ 21 , 22 ], prostate [ 23 , 24 ], vertebral bone marrow [ 25 ], musculoskeletal soft tissue [ 26 ], nasopharynx [ 27 ], ovaries [ 28 ], cervix [ 29 ], and rectum [ 30 ], as well as in the whole body [ 31 ].…”