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Accurate IVIM model-based liver lesion characterisation can be achieved with only three b-value DWI

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

The objective of this study was to evaluate a simplified intravoxel incoherent motion (IVIM) approach of diffusion-weighted imaging (DWI) with four b-values for liver lesion characterisation at 1.5 T.

Methods

DWI data from a respiratory-gated MRI sequence with b = 0, 50, 250, 800 s/mm2 were retrospectively analysed in 173 lesions and 40 healthy livers. The apparent diffusion coefficient ADC = ADC(0,800) and IVIM-based parameters D1′ = ADC(50,800), D2′ =ADC(250,800), f1′, f2′, D*′, ADClow = ADC(0,50), and ADCdiff=ADClow-D2′ were calculated voxel-wise without fitting procedures. Differences between lesion groups were investigated.

Results

Focal nodular hyperplasias were best discriminated from all other lesions by f1′ with an area under the curve (AUC) of 0.989. Haemangiomas were best discriminated by D1′ (AUC of 0.994). For discrimination between malignant and benign lesions, ADC(0,800) and D1′ were best suited (AUC of 0.915 and 0.858, respectively). Discriminatory power was further increased by using a combination of D1′ and f1′.

Conclusion

IVIM parameters D and f approximated from three b-values provided more discriminatory power between liver lesions than ADC determined from two b-values. The use of b = 0, 50, 800 s/mm2 was superior to that of b = 0, 250, 800 s/mm2. The acquisition of four instead of three b-values has no further benefit for lesion characterisation.

Key Points

• Diffusion and perfusion characteristics are assessable with only three b-values.

• Association of b = 0, 50, 800 s/mm2is superior to b = 0, 250, 800 s/mm2.

• A fourth acquired b-value has no benefit for differential diagnosis.

• For liver lesion characterisation, simplified IVIM analysis is superior to ADC determination.

• Simplified IVIM approach guarantees numerically stable, voxel-wise results and short acquisition times.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

CCC:

Cholangiocellular carcinoma

DWI:

Diffusion-weighted imaging

FNH:

Focal nodular hyperplasia

HCC:

Hepatocellular carcinoma

IVIM:

Intravoxel incoherent motion

REF:

Reference tissue

ROI:

Region of interest

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The authors state that this work has not received any funding.

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Author notes

  1. P. Mürtz and A. M. Sprinkart contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, University of Bonn, Bonn, Germany

    P. Mürtz, A. M. Sprinkart, M. Reick, C. C. Pieper, A.-H. Schievelkamp, R. König, H. H. Schild, W. A. Willinek & G. M. Kukuk

  2. Radiologische Klinik der Universität Bonn, Sigmund-Freud-Straße 25, 53105, Bonn, Germany

    P. Mürtz

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Mürtz, P., Sprinkart, A.M., Reick, M. et al. Accurate IVIM model-based liver lesion characterisation can be achieved with only three b-value DWI. Eur Radiol 28, 4418–4428 (2018). https://doi.org/10.1007/s00330-018-5401-7

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