The Role of Non-Gaussian Models of Diffusion Weighted MRI in Hepatocellular Carcinoma: A Systematic Review

Tramontano, Liberatore; Cavaliere, Carlo; Salvatore, Marco; Brancato, Valentina

doi:10.3390/jcm10122641

Cited by 10 publications

(18 citation statements)

References 95 publications

(182 reference statements)

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“…Factors including the number, distribution, and fitting methods of b values, other physiological activities (such as gland secretion and flow), ROI settings, scanning devices and field strength, imaging acquisition methods, and motion artifacts all affect data quality[ 23 , 25 , 34 , 41 ]. Increased standardization of data acquisition and analysis is imperative to facilitate the generation of reliable IVIM-DWI biomarker measures that are broadly applicable[ 74 , 77 , 78 ]. In addition, recent studies have shown that IVIM-DWI modeling of the perfusion component is constrained by the diffusion component, and a reduced D slow measure leads to artificially higher PF and D fast measures[ 75 , 76 ].…”

Section: Discussionmentioning

confidence: 99%

Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma

Zhou¹,

Zheng²,

Yang³

et al. 2022

WJG

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The morbidity and mortality of hepatocellular carcinoma (HCC) rank 6 th and 4 th , respectively, among malignant tumors worldwide. Traditional diffusion-weighted imaging (DWI) uses the apparent diffusion coefficient (ADC) obtained by applying the monoexponential model to reflect water molecule diffusion in active tissue; however, the value of ADC is affected by microcirculation perfusion. Using a biexponential model, intravoxel incoherent motion (IVIM)-DWI quantitatively measures information related to pure water molecule diffusion and microcirculation perfusion, thus compensating for the shortcomings of DWI. The number of studies examining the application of IVIM-DWI in patients with HCC has gradually increased over the last few years, and many results show that IVIM-DWI has vital value for HCC differentiation, pathological grading, and predicting and evaluating the treatment response. The present study principally reviews the principle of IVIM-DWI and its research progress in HCC differentiation, pathological grading, predicting and evaluating the treatment response, predicting postoperative recurrence and predicting gene expression prediction.

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Section: Discussionmentioning

confidence: 99%

Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma

Zhou¹,

Zheng²,

Yang³

et al. 2022

WJG

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“…( 13 ) in 2005 and applied to brain tissue, which is very sensitive to tissue microstructure. It is conducive to the early detection of lesions and can reflect the tissue microenvironment structure more accurately, so it is widely used in the diagnosis and treatment of tumors ( 14 ). The IVIM bi-exponential model is an advanced noninvasive functional imaging technology ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

“…It can quantitatively provide intralesional perfusion and diffusion information by functional calculations after multiple b-value scanning without contrast agent injection, which compensates for the shortcomings of the traditional DWI mono-exponential model. DKI and IVIM combined with histogram analysis have been applied to other parts of the body ( 14 , 16 ), but little research has been done on the lungs. Zheng et al.…”

Section: Introductionmentioning

confidence: 99%

Differential value of diffusion kurtosis imaging and intravoxel incoherent motion in benign and malignant solitary pulmonary lesions

Liu

Yang

et al. 2023

Front. Oncol.

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ObjectiveTo investigate the diagnostic value of diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) whole-lesion histogram parameters in differentiating benign and malignant solitary pulmonary lesions (SPLs).Materials and MethodsPatients with SPLs detected by chest CT examination and with further routine MRI, DKI and IVIM-DWI functional sequence scanning data were recruited. According to the pathological results, SPLs were divided into a benign group and a malignant group. Independent samples t tests (normal distribution) or Mann‒Whitney U tests (nonnormal distribution) were used to compare the differences in DKI (Dk, K), IVIM (D, D*, f) and ADC whole-lesion histogram parameters between the benign and malignant SPL groups. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of the histogram parameters and determine the optimal threshold. The area under the curve (AUC) of each histogram parameter was compared by the DeLong method. Spearman rank correlation was used to analyze the correlation between histogram parameters and malignant SPLs.ResultsMost of the histogram parameters for diffusion-related values (Dk, D, ADC) of malignant SPLs were significantly lower than those of benign SPLs, while most of the histogram parameters for the K value of malignant SPLs were significantly higher than those of benign SPLs. DKI (Dk, K), IVIM (D) and ADC were effective in differentiating benign and malignant SPLs and combined with multiple parameters of the whole-lesion histogram for the D value, had the highest diagnostic efficiency, with an AUC of 0.967, a sensitivity of 90.00% and a specificity of 94.03%. Most of the histogram parameters for the Dk, D and ADC values were negatively correlated with malignant SPLs, while most of the histogram parameters for the K value were positively correlated with malignant SPLs.ConclusionsDKI (Dk, K) and IVIM (D) whole-lesion histogram parameters can noninvasively distinguish benign and malignant SPLs, and the diagnostic performance is better than that of DWI. Moreover, they can provide additional information on SPL microstructure, which has important significance for guiding clinical individualized precision diagnosis and treatment and has potential clinical application value.

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“…Hepatocellular carcinoma (HCC) is the most common malignant tumor in the world and also one of the main causes of cancer-related death ( 1 ). Considering the specific pathogenic mechanism and epidemiological and pathological basis of the occurrence and development of HCC, early diagnosis of HCC is difficult ( 2 ). Previous studies ( 3 , 4 ) have indicated that the pathological grade of HCC is closely related to patients’ prognosis; specifically, the postoperative survival rate of patients with well- and moderately differentiated HCC is significantly higher than that of patients with poorly differentiated HCC, and the 5-year postoperative recurrence rate of poorly differentiated HCC is as high as 70%.…”

Section: Introductionmentioning

confidence: 99%

The Roles of Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion Diffusion-Weighted Imaging Parameters in Preoperative Evaluation of Pathological Grades and Microvascular Invasion in Hepatocellular Carcinoma

Wang

Yan²,

Wang

et al. 2022

Front. Oncol.

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BackgroundCurrently, there are disputes about the parameters of diffusion kurtosis imaging (DKI), intravoxel incoherent motion (IVIM), and diffusion-weighted imaging (DWI) in predicting pathological grades and microvascular invasion (MVI) in hepatocellular carcinoma (HCC). The aim of our study was to investigate and compare the predictive power of DKI and IVIM-DWI parameters for preoperative evaluation of pathological grades and MVI in HCC.MethodsPubMed, Web of Science, and Embase databases were searched for relevant studies published from inception to October 2021. Review Manager 5.3 was used to summarize standardized mean differences (SMDs) of mean kurtosis (MK), mean diffusivity (MD), tissue diffusivity (D), pseudo diffusivity (D*), perfusion fraction (f), mean apparent diffusion coefficient (ADCmean), and minimum apparent diffusion coefficient (ADCmin). Stata12.0 was used to pool the sensitivity, specificity, and area under the curve (AUC). Overall, 42 up-to-standard studies with 3,807 cases of HCC were included in the meta-analysis.ResultsThe SMDs of ADCmean, ADCmin, and D values, but not those of D* and f values, significantly differed between well, moderately, and poorly differentiated HCC (P < 0.01). The sensitivity, specificity, and AUC of the MK, D, ADCmean, and ADCmin for preoperative prediction of poorly differentiated HCC were 69%/94%/0.89, 87%/80%/0.89, 82%/75%/0.86, and 83%/64%/0.81, respectively. In addition, the sensitivity, specificity, and AUC of the D and ADCmean for preoperative prediction of well-differentiated HCC were 87%/83%/0.92 and 82%/88%/0.90, respectively. The SMDs of ADCmean, ADCmin, D, MD, and MK values, but not f values, showed significant differences (P < 0.01) between MVI-positive (MVI+) and MVI-negative (MVI-) HCC. The sensitivity and specificity of D and ADCmean for preoperative prediction of MVI+ were 80%/80% and 74%/71%, respectively; the AUC of the D (0.87) was significantly higher than that of ADCmean (0.78) (Z = −2.208, P = 0.027). Sensitivity analysis showed that the results of the above parameters were stable and reliable, and subgroup analysis confirmed a good prediction effect.ConclusionDKI parameters (MD and MK) and IVIM-DWI parameters (D value, ADCmean, and ADCmin) can be used as a noninvasive and simple preoperative examination method to predict the grade and MVI in HCC. Compared with ADCmean and ADCmin, MD and D values have higher diagnostic efficacy in predicting the grades of HCC, and D value has superior diagnostic efficacy to ADCmean in predicting MVI+ in HCC. However, f value cannot predict the grade or MVI in HCC.

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The Role of Non-Gaussian Models of Diffusion Weighted MRI in Hepatocellular Carcinoma: A Systematic Review

Cited by 10 publications

References 95 publications

Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma

Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma

Differential value of diffusion kurtosis imaging and intravoxel incoherent motion in benign and malignant solitary pulmonary lesions

The Roles of Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion Diffusion-Weighted Imaging Parameters in Preoperative Evaluation of Pathological Grades and Microvascular Invasion in Hepatocellular Carcinoma

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