IVIM-diffusion-MRI for the differentiation of solid benign and malign hypervascular liver lesions—Evaluation with two different MR scanners

Klauß, Miriam; Mayer, Philipp; Maier‐Hein, Klaus H.; Laun, Frederik Bernd; Mehrabi, A.; Kauczor, Hans‐Ulrich; Stieltjes, Bram

doi:10.1016/j.ejrad.2016.04.011

Cited by 50 publications

(47 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: Discussionsupporting

confidence: 44%

“…Based on the above pathophysiologic feature, some studies have investigated useful ways to distinguish them, because it remains a challenge to make an accurate diagnosis in some complex cases. Klauss et al (27) found no significant differences between the D* values of HCCs and FNHs. Nevertheless, an obvious distinction in the D* values was observed in our study.…”

Section: Discussionmentioning

confidence: 99%

“…There are three possible explanations for the contradiction between the two datasets. First, the MRI platform is not uniform; we used GE 3.0 T MRI scanner only, while Klauss et al (27) used two different imagers, although both of them were Siemens 1.5 T (Aera and Magentom Avanto). Barbieri et al (28) compared different scanners and determined that the IVIM parameters across MRI imagers were substantially different, even between scanners from the Blood flow into the liver supplied by portal vein accounts for approximately 75%-80% in the normal state.…”

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: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

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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“…Though limited studies showed IVIM technique may be able to monitor liver tumor treatment response, its costeffectiveness and inter-sites consistency compared with other simpler approaches remains unknown. In fact, Klauss et al (67) suggested that ADC performed equally to IVIMderived parameters, a straightforward ADC measurement may be sufficient for DW imaging, which is possible if the acquisition protocol is fixed and that the different variables are managed in a coordinated way.…”

Section: Discussionmentioning

confidence: 99%

“…The longer the echo time, the greater the signal decays at low b values, which indicates the increase of estimated PF. This phenomenon is due to the faster transverse relaxation of the tissue compartment signal (i.e., the liver), which increases the signal fraction of Quant Imaging Med Surg 2017;7(1): [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] qims.amegroups.com Table S1. the vascular component.…”

Section: Ivim Parameters Of Healthy Liver In Published Literaturesmentioning

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.

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210

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Intravoxel incoherent motion diffusion‐weighted imaging for characterizing focal hepatic lesions: Correlation with lesion enhancement

Choi

Lee

Sung

et al. 2016

Magnetic Resonance Imaging

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IVIM-diffusion-MRI for the differentiation of solid benign and malign hypervascular liver lesions—Evaluation with two different MR scanners

Cited by 50 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

Intravoxel incoherent motion diffusion‐weighted imaging for characterizing focal hepatic lesions: Correlation with lesion enhancement

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