Evaluation of Hepatic Fibrosis Using Intravoxel Incoherent Motion in Diffusion-Weighted Liver MRI

Yoon, Jeong Hee; Lee, Jeong Min; Baek, Jeong‐Hwa; Shin, Cheong Il; Kiefer, Berthold; Han, Joon Koo; Choi, Byung Ihn

doi:10.1097/rct.0b013e3182a589be

Cited by 82 publications

(82 citation statements)

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“…The bi-exponential intravoxel incoherent motion (IVIM) DW model [11,12] allows separating the diffusion and perfusion effects by quantifying the pure diffusion coefficient (D), the pseudo-diffusion (D*), and vascular fraction (f) microperfusion parameters. Lower ADC values in liver with fibrosis were associated to both liver compartment restrictions [13][14][15][16]. Other authors found lower ADC values in fibrotic livers being only dependent on perfusion parameters changes [5,17,18].…”

mentioning

confidence: 81%

“…The IVIM model allows separating the liver signal intensity changes due to true molecular diffusion from those related to perfusion within the tissue. Recently, it has been proposed that the IVIM model, and particularly the perfusion-related parameters D* and f, would be more advantageous to evaluate liver fibrosis than conventional ADC measurements [5,[13][14][15][16][17][18][33][34][35]. However, the influence of liver inflammation, steatosis and siderosis on liver values has to be considered in this analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Categorical variables were evaluated by v 2 and Fisher's exact test. For statistical analysis, necro-inflammatory activity score was grouped as none (score 0), mild (scores 1-6), moderate (scores 7-12), and severe inflammation (scores [13][14][15][16][17][18]. The Ishak fibrosis staging was categorized into none (F0), mild to moderate fibrosis (F1-F3), and marked fibrosis/cirrhosis (F4-F6).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of fibrosis and inflammation in diffuse liver diseases using intravoxel incoherent motion diffusion-weighted MR imaging

et al. 2016

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Purpose: The purpose of the study was to evaluate the role of intravoxel incoherent motion (IVIM) diffusion model for the assessment of liver fibrosis and inflammation in diffuse liver disorders, also considering the presence of liver steatosis and iron deposits. Methods: Seventy-four patients were included, with liver biopsy and a 3 Tesla abdominal magnetic resonance imaging examination, with an IVIM diffusion-weighted sequence (single-shot spin-echo echo-planar sequence, with gradient reversal fat suppression; 6 b-values: 0, 50, 200, 400, 600, and 800 s/mm 2 ). Histological evaluation comprised the Ishak modified scale, for grading inflammation and fibrosis, plus steatosis and iron loading classification. The liver apparent diffusion coefficient (ADC) and IVIM parameters (D, D*, f) were calculated from the IVIM images. The relationship between IVIM parameters and histopathological scores were evaluated by ANOVA and Spearman correlation tests. A testretest experiment assessed reproducibility and repeatability in 10 healthy volunteers and 10 randomly selected patient studies. Results: ADC and f values were lower with higher fibrosis stages (p = 0.009, p = 0.006, respectively) and also with higher necro-inflammatory activity grades (p = 0.02, p = 0.017, respectively). Considered together, only fibrosis presented a significant effect on ADC and f measurements (p < 0.05), whereas inflammation had no significant effect (p > 0.05). A mild correlation was found between ADC and f with fibrosis (R S = -0.32 and R S = -0.38; p < 0.05) and inflammation (R S = -0.31 and R S = -0.32, p < 0.05; respectively). The AUROC for ADC and f measurements with the different dichotomizations between fibrosis or inflammation grades were only fair (0.670 to 0.749, p < 0.05). Neither D nor D* values were significantly different between liver fibrosis or inflammation grades. D measurements were significantly different across histologic grades of steatosis (p < 0.001) and iron overload (p < 0.001), whereas f measurements showed significant differences across histologic steatosis grades (p = 0.005).

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confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of fibrosis and inflammation in diffuse liver diseases using intravoxel incoherent motion diffusion-weighted MR imaging

et al. 2016

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“…Yoon et al compared IVIM diffusion versus conventional DWI for the staging of liver fibrosis and found IVIM performed better that conventional DWI [34]. Murphy et al demonstrated that liver steatosis and fibrosis have significant independent effects on both IVIM diffusivity (D) and perfusion fraction (PF) [75].…”

Section: Page 12mentioning

confidence: 99%

“…With good response to treatment, tumors can exhibit a decline of signal intensity at high b-value images or an increase in ADC value, which may be secondary to treatment-induced cystic or necrotic changes and cell death [31]. Page 3 Several studies have demonstrated the capability of DWI in early detection and classification of liver fibrosis and fatty liver diseases [32][33][34][35][36][37]. The common theory for studying liver fibrosis by DWI is that the interstitial space of fibrotic liver parenchyma may be narrower than normal, which is accompanied by restricted diffusion and declined ADC values.…”

Section: Introductionmentioning

confidence: 99%

Technical advancements and protocol optimization of diffusion-weighted imaging (DWI) in liver

Yang

Zhong

et al. 2016

Abdom Radiol

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Advances on Nanomedicines for Diagnosis and Theranostics of Hepatic Fibrosis

Dai

Zeng

Zhang

et al. 2021

Advanced NanoBiomed Research

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Hepatic fibrosis is induced by chronic hepatic injuries before it turns into hepatic cirrhosis/carcinoma. It is characterized by the formation of collagen and other extracellular matrices around damaged hepatic tissues; consequently, the normal architecture of liver would be disrupted and its function impaired. Diagnosis of hepatic fibrosis, especially at the early stage, is crucial because most fibrotic changes are reversible during the hepatic fibrosis stage. However, early and more accurate diagnosis of hepatic fibrosis still remains a great challenge. With their promising structural adjustability and targeting ability, nanomedicines have recently been introduced to improve diagnosis of hepatic fibrosis. By targeting fibrogenic cells, receptors, and extracellular matrix components, these nanomedicines can achieve detection of hepatic tissues with high sensitivity and specificity at the early stage. The use of nanomedicines can also enable theranostics of this chronic hepatic disease. This review aims to present an overview of recent advances of nanomedicines in diagnosis and theranostics of hepatic fibrosis.

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Evaluation of Hepatic Fibrosis Using Intravoxel Incoherent Motion in Diffusion-Weighted Liver MRI

Abstract: The IVIM-derived parameters and ADC(total) showed significant correlation with HF. The D p showed better diagnostic performance for differentiating significant HF than did ADC(total).

Cited by 82 publications

References 29 publications

Evaluation of fibrosis and inflammation in diffuse liver diseases using intravoxel incoherent motion diffusion-weighted MR imaging

Evaluation of fibrosis and inflammation in diffuse liver diseases using intravoxel incoherent motion diffusion-weighted MR imaging

Technical advancements and protocol optimization of diffusion-weighted imaging (DWI) in liver

Advances on Nanomedicines for Diagnosis and Theranostics of Hepatic Fibrosis

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