Age and gender differences of normative values of spleen diffusion MRI parameters

Abstract

Purpose

This study investigates age and gender differences of normative values of spleen diffusion MRI parameters.

Materials and Methods

We recruited 124 volunteers with MRI conducted at 1.5T. Diffusion imaging had b-values of 0, 2, 4, 7, 10, 15, 20, 30, 46, 60, 72, 100, 150, 200, 400, 600 s/mm². ADC, IVIM-Dslow, IVIM-PF, IVIM-Dfast, and DDVD (diffusion-derived vessel density) were computed. DDVD is the signal difference between the b=0 s/mm² image and b=2, 4 s/mm² image. Only images without apparent artifacts and with good curving fitting were included in the analysis. Finally, 34 females (age: 20–71 years) and 69 males (22–70 years) were measured with ADC; 20 females (20–71 years) and 48 males (22–67 years) were measured with IVIM; 32 females (20–71 years) and 65 males (22–70 years) were measured with DDVD parameter.

Results

An age-related decrease in ADC was noted for females, while such a trend was not noted for males. A very high level of heterogeneity was noted for the data for the males, with the highest ADC value being 1.710 × 10^–3mm ²/s and the lowest ADC value being 0.705 × 10^–3 mm²/s when b=0 and 600 s/mm ² were used for ADC calculation. A male-female data comparison did not show a statistically significant difference between the ADC median value. However, ADCs > 1.3 × 10^–3 mm²/s were only seen among males. A very high level of heterogeneity was also noted for males’ Dslow, with the highest value being 1.468 × 10^–3 mm²/s and the lowest value being 0.600 × 10^–3 mm²/s. Both PF and Dfast demonstrated a trend of age-related increase for older subjects. PF values were higher among males than females. However, no difference was noted for Dfast between males and females. DDVD did not show an age-related trend both for females and males. No difference was noted in DDVD values between males and females.

Conclusion

Interpreting normal spleen diffusion MRI parameters should consider age and gender factors.

Key Points

• An age-related decrease in spleen ADC and IVIM-Dslow was seen for healthy females.

• There is a high level of heterogeneity for spleen ADC and IVIM-Dslow data for healthy males.

• IVIM modelled perfusion fraction and Dfast demonstrate an artificial trend of age-related increase for older subjects.

• Vessel density measured on diffusion imaging does not show an age-related trend.

Citation Format

• Yu W, Ma FZ, Huang H et al. Age and gender differences of normative values of spleen diffusion MRI parameters. Rofo 2025; 197: 535–545

Zusammenfassung

Zweck

Diese Studie untersucht Alters- und Geschlechtsunterschiede der normativen Werte der Diffusions-MRT-Parameter der Milz.

Materialien und Methoden

Wir rekrutierten 124 Freiwillige für eine MRT-Untersuchung mit 1.5T. Die Diffusionsbildgebung hatte b-Werte von 0, 2, 4, 7, 10, 15, 20, 30, 46, 60, 72, 100, 150, 200, 400, 600 s/mm². ADC, IVIM-Dslow, IVIM-PF, IVIM-Dfast und DDVD (diffusionsabgeleitete Gefäßdichte) wurden berechnet. DDVD ist die Signaldifferenz zwischen dem Bild mit b=0 s/mm² und dem Bild mit b=2, 4 s/mm². In die Analyse wurden nur Bilder ohne erkennbare Artefakte und mit guter Kurvenanpassung einbezogen. Schließlich hatten 34 Frauen (Alter: 20-71 Jahre) und 69 Männer (22-70 Jahre) ADC; 20 Frauen (20-71 Jahre) und 48 Männer (22-67 Jahre) hatten IVIM; 32 Frauen (20-71 Jahre) und 65 Männer (22-70 Jahre) hatten DDVD.

Ergebnisse

Bei Frauen wurde ein altersbedingter Rückgang des ADC festgestellt, während bei Männern kein solcher Trend zu beobachten war. Bei den Daten der Männer wurde ein sehr hohes Maß an Heterogenität festgestellt, wobei der höchste ADC-Wert 1.710 × 10^–3 mm²/s und der niedrigste ADC-Wert 0.705 × 10^–3 mm²/s betrug, wenn b=0 und 600 s/mm² für die ADC-Berechnung verwendet wurden. Ein Datenvergleich zwischen Männern und Frauen ergab keinen statistisch signifikanten Unterschied zwischen dem ADC-Medianwert. Allerdings wurden ADCs >1.3 × 10^–3 mm²/s nur bei Männern beobachtet. Ein sehr hohes Maß an Heterogenität wurde auch für den Dslow der Männer festgestellt, wobei der höchste Wert bei 1.468 × 10^–3 mm²/s und der niedrigste Wert bei 0.600 × 10^–3 mm²/s lag. Sowohl PF als auch Dfast zeigten einen Trend zu einem altersbedingten Anstieg bei älteren Probanden. Die PF-Werte waren bei Männern höher als bei Frauen. Für Dfast wurde jedoch kein Unterschied zwischen Männern und Frauen festgestellt. DDVD zeigte weder bei Frauen noch bei Männern einen altersbedingten Trend. Es wurde kein Unterschied bei den DDVD-Werten zwischen Männern und Frauen festgestellt.

Schlussfolgerung

Bei der Interpretation normaler Diffusions-MRT-Parameter für die Milz sollten Alters- und Geschlechtsfaktoren berücksichtigt werden.

Kernaussagen

• Bei gesunden Frauen besteht in der eine altersbedingte Abnahme von Milz-ADC und IVIM-Dslow.

• Es besteht ein hohes Maß an Heterogenität für die ADC- und IVIM-Dslow-Daten in der Milz gesunder Männer.

• Die von IVIM modellierte Perfusionsfraktion und Dfast zeigen einen artifiziellen Trend einer altersbedingten Zunahme bei älteren Probanden.

• Die mittels Diffusionsbildgebung gemessene Gefäßdichte zeigt keinen altersbedingten Trend.

Keywords

Apparent diffusion coefficient - Intravoxel incoherent motion (IVIM) - spleen - aging - normative value

Publication History

Received: 12 April 2024

Accepted after revision: 28 June 2024

Article published online:
30 July 2024

• References

• 1 Jang KM, Kim SH, Hwang J. et al. Differentiation of malignant from benign focal splenic lesions: added value of diffusion-weighted MRI. AJR Am J Roentgenol 2014; 203: 803-812
• 2 Bian W, Huang Q, Zhang J. et al. Intravoxel incoherent motion diffusion-weighted MRI for the evaluation of early spleen involvement in acute leukemia. Quant Imaging Med Surg 2024; 14: 98-110
• 3 Klasen J, Lanzman RS, Wittsack HJ. et al. Diffusion-weighted imaging (DWI) of the spleen in patients with liver cirrhosis and portal hypertension. Magn Reson Imaging 2013; 31: 1092-1096
• 4 Do RK, Chandarana H, Felker E. et al. Diagnosis of liver fibrosis and cirrhosis with diffusion-weighted imaging: value of normalized apparent diffusion coefficient using the spleen as reference organ. AJR Am J Roentgenol 2010; 195: 671-676
• 5 Wang YX, Huang H, Zheng CJ. et al. Diffusion-weighted MRI of the liver: challenges and some solutions for the quantification of apparent diffusion coefficient and intravoxel incoherent motion. Am J Nucl Med Mol Imaging 2021; 11: 107-142
• 6 Chevallier O, Zhou N, He J. et al. Removal of evidential motion-contaminated and poorly fitted image data improves IVIM diffusion MRI parameter scan-rescan reproducibility. Acta Radiologica 2018; 59: 1157-1167
• 7 Yuan J, Wong OL, Lo GG. et al. Statistical assessment of bi-exponential diffusion weighted imaging signal characteristics induced by intravoxel incoherent motion in malignant breast tumors. Quant Imaging Med Surg 2016; 6: 418-429
• 8 Huang H, Zheng CJ, Wang LF. et al. Age and gender dependence of liver diffusion parameters and the possibility that intravoxel incoherent motion modelling of perfusion component is constrained by diffusion component. NMR Biomed 2021; 34: e4449
• 9 Wang YX. Living tissue intravoxel incoherent motion (IVIM) diffusion MR analysis without b = 0 image: an example for liver fibrosis evaluation. Quant Imaging Med Surg 2019; 9: 127-133
• 10 Zheng CJ, Xiao BH, Huang H. et al. Bi-exponential fitting excluding b=0 data improves the scan-rescan stability of liver IVIM parameter measures and particularly so for the perfusion fraction. Quant Imaging Med Surg 2022; 12: 3288-3299
• 11 Chevallier O, Zhou N, Cercueil JP. et al. Comparison of tri-exponential decay versus bi-exponential decay and full fitting versus segmented fitting for modeling liver intravoxel incoherent motion diffusion MRI. NMR Biomed 2019; 32: e4155
• 12 Li T, Che-Nordin N, Wáng YXJ. et al. Intravoxel incoherent motion derived liver perfusion/diffusion readouts can be reliable biomarker for the detection of viral hepatitis B induced liver fibrosis. Quant Imaging Med Surg 2019; 9: 371-385
• 13 Li XM, Ma FZ, Quan XY. et al. Repeatability and reproducibility comparisons of liver IVIM imaging with free-breathing or respiratory-triggered sequences. NMR Biomed 2023; e5080
• 14 Wáng YXJ. Gender-specific liver aging and magnetic resonance imaging. Quant Imaging Med Surg 2021; 11: 2893-2904
• 15 Metens T, Ferraresi KF, Farchione A. et al. Normal hepatic parenchyma visibility and ADC quantification on diffusion-weighted MRI at 3 T: influence of age, gender, and iron content. Eur Radiol 2014; 24: 3123-3133
• 16 Schwenzer NF, Machann J, Haap MM. et al. T2* relaxometry in liver, pancreas, and spleen in a healthy cohort of one hundred twenty-nine subjects-correlation with age, gender, and serum ferritin. Invest Radiol 2008; 43: 854-860
• 17 Zheng CJ, Huang H, Xiao BH. et al. Spleen in viral Hepatitis-B liver fibrosis patients may have a reduced level of per unit micro-circulation: non-invasive diffusion MRI evidence with a surrogate marker. SLAS Technol 2022; 27: 187-194
• 18 Xiao BH, Wáng YXJ. Different tissue types display different signal intensities on b = 0 images and the implications of this for intravoxel incoherent motion analysis: Examples from liver MRI. NMR Biomed 2021; 34: e4522
• 19 Herrmann J, Schoennagel BP, Roesch M. et al. Diffusion-weighted imaging of the healthy pancreas: ADC values are age and gender dependent. J Magn Reson Imaging 2013; 37: 886-891
• 20 Sorokin EP, Basty N, Whitcher B. et al. Analysis of MRI-derived spleen iron in the UK Biobank identifies genetic variation linked to iron homeostasis and hemolysis. Am J Hum Genet 2022; 109: 1092-1104
• 21 Zacharski LR, Ornstein DL, Woloshin S. et al. Association of age, sex, and race with body iron stores in adults: analysis of NHANES III data. Am Heart J 2000; 140: 98-104
• 22 Lavdas I, Rockall AG, Castelli F. et al. Apparent Diffusion Coefficient of Normal Abdominal Organs and Bone Marrow From Whole-Body DWI at 1.5 T: The Effect of Sex and Age. AJR Am J Roentgenol 2015; 205: 242-250
• 23 Nazarlou AK, Abdolmohammadi J. A study of the relationship between gender/age and apparent diffusion coefficient values in spleen of healthy adults using diffusion-weighted magnetic resonance imaging. Electron Physician 2015; 7: 1005-1009
• 24 Li G, Xu P, Pan X. et al. The effect of age on apparent diffusion coefficient values in normal spleen: A preliminary study. Clinical radiology 2014; 69: e165-e167
• 25 Chen Y, Yang P, Fu C. et al. Variabilities in apparent diffusion coefficient (ADC) measurements of the spleen and the paraspinal muscle: A single center large cohort study. Heliyon 2023; 9: e18166
• 26 Miquel ME, Scott AD, Macdougall ND. et al. In vitro and in vivo repeatability of abdominal diffusion-weighted MRI. Br J Radiol 2012; 85: 1507-1512
• 27 Ma FZ, Wáng YXJ. T2 relaxation time elongation of hepatocellular carcinoma relative to native liver tissue leads to an underestimation of perfusion fraction measured by standard intravoxel incoherent motion magnetic resonance imaging. Quant Imaging Med Surg 2024; 14: 1316-1322
• 28 Wáng YXJ. Mutual constraining of slow component and fast component measures: some observations in liver IVIM imaging. Quant Imaging Med Surg 2021; 11: 2879-2887
• 29 Wáng YXJ. A reduction of perfusion can lead to an artificial elevation of slow diffusion measure: examples in acute brain ischemia MRI intravoxel incoherent motion studies. Ann Transl Med 2021; 9: 895
• 30 Yu WL, Xiao BH, Ma FZ. et al. Underestimation of the spleen perfusion fraction by intravoxel incoherent motion MRI. NMR Biomed 2023; 36: e4987