Short-Term Measurement Repeatability of a Simplified Intravoxel Incoherent Motion (IVIM) Analysis for Routine Clinical Diffusion-Weighted Imaging in Malignant Liver Lesions and Liver Parenchyma at 1.5 T

Abstract

Objectives To evaluate measurement repeatability of parameters derived from simplified intravoxel incoherent motion (IVIM) analysis of diffusion-weighted imaging (DWI) using 3 b-values.

Materials and Methods 24 patients (16 male, 8 female, mean age: 67 years) with hepatic malignancy (HCC: 10, metastases: 14) underwent 29 liver MRI examinations at 1.5 T. Respiratory-triggered DWI (b = 0, 50, 800 s/mm²) was acquired twice. Parameter maps of the apparent diffusion coefficient ADC(0,800), estimated diffusion coefficient D' and perfusion fraction f' were calculated. Measurement repeatability for a region of interest (ROI) placed in one lesion and liver parenchyma per lobe was assessed by intra-session variation coefficients (CV).

Results 86 ROIs (43 lesions, 43 parenchymas) were analyzed. Parameters did not significantly differ between measurements. Repeatability was excellent for ADC(0,800) and D' and good for f' in parenchyma (CVs: 7.3 %, 9.8 %, 13.0 %) and lesions (CVs: 7.5 %, 8.5 %, 11.0 %). Differences in CV-values between liver and lesions were not significant. Repeatability was better for the right than for the left lobe by tendency, for parenchyma (CVs: 6.4 % vs 8.4 %, 8.8 % vs 10.9 %, 10.5 % vs 16.0 %) and for lesions (CVs: 6.9 % vs 8.1 %, 7.5 % vs 9.5 %, 9.5 % vs 12.7 %).

Conclusion Measurement repeatability is excellent for ADC(0,800) and D' values and good for f' values using the simplified IVIM approach, both in lesions and liver parenchyma. Repeatability was better for lesions in the right compared to the left liver lobe.

Key points: 

• Repeatability obtained by a simplified IVIM analysis approach is good to excellent.

• Repeatability is better for the right than for the left liver lobe.

• The simplified approach may be helpful in diagnosing and monitoring liver malignancies.

Citation Format

• Pieper CC, Sprinkart AM, Kukuk GM et al. Short-Term Measurement Repeatability of a Simplified Intravoxel Incoherent Motion (IVIM) Analysis for Routine Clinical Diffusion-Weighted Imaging in Malignant Liver Lesions and Liver Parenchyma at 1.5T. Fortschr Röntgenstr 2019; 191: 199 – 208

Zusammenfassung

Zielsetzung Evaluierung der Messwiederholbarkeit von Parametern, die auf einer vereinfachten Intravoxel-Incoherent-Motion (IVIM) -Analyse diffusionsgewichteter Bildgebung (DWI) mit 3b-Werten basieren.

Material und Methoden 24 Patienten (16 Männer, 8 Frauen, mittleres Alter 67 Jahre) mit malignen Lebertumoren (HCC: 10, Metastasen: 14) erhielten 29 Leber-MRTs bei 1,5 T. Eine Atem-getriggerte DWI (b = 0,50, 800 s/mm²) wurde zweimal akquiriert. Parameterkarten des scheinbaren Diffusionskoeffizienten ADC(0,800), des geschätzten Diffusionskoeffizienten D' und der geschätzten Perfusionsfraktion f' wurden berechnet. Die Messwiederholbarkeit der Messwerte für eine Region-of-Interest (ROI) (jeweils einer pro Leberlappen in einer malignen Läsion und in Lebergewebe) wurde mit dem Variationskoeffizienten (CV) untersucht.

Ergebnisse 86 ROIs (43 Läsionen, 43 Parenchym) wurden analysiert. Die gemessenen Parameter unterschieden sich nicht signifikant zwischen den Messungen. Die Messwiederholbarkeit war exzellent für ADC(0,800) und D' und gut für f' in Lebergewebe (CVs: 7,3 %, 9,8 %, 13,0 %) und Läsionen (CVs: 7,5 %, 8,5 %, 11,0 %). Die CV-Werte unterschieden sich nicht signifikant zwischen Lebergewebe und Läsionen. Die Wiederholbarkeit war tendenziell besser im rechten Leberlappen, für Lebergewebe (CVs: 6,4 % vs. 8,4 %, 8,8 % vs. 10,9 %, 10,5 % vs. 16,0 %) und für Läsionen (CVs: 6,9 % vs. 8,1 %, 7,5 % vs. 9,5 %, 9,5 % vs. 12,7 %).

Schlussfolgerung Messungen mit dem vereinfachten IVIM-Modell zeigten eine exzellente Messwiederholbarkeit für die ADC(0,800) und D'-Werte und eine gute Messwiederholbarkeit für die f'-Werte sowohl für Läsionen als auch für Lebergewebe. Die Messwiederholbarkeit war im rechten Leberlappen besser als im linken Leberlappen.

Kernaussagen: 

• Die vereinfachte IVIM-Analyse zeigt eine gute bis exzellente Messwiederholbarkeit der Parameter.

• Die Messwiederholbarkeit ist für den rechten Leberlappen besser als für den linken Leberlappen.

• Die vereinfachte IVIM-Analyse kann bei Diagnose und Monitoring maligner Lebertumoren helfen.

Key words

MR-diffusion/perfusion - liver tumors - technical aspects

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