• European radiology · Oct 2013

    Intravoxel incoherent motion model-based liver lesion characterisation from three b-value diffusion-weighted MRI.

    • A-H Penner, A M Sprinkart, G M Kukuk, I Gütgemann, J Gieseke, H H Schild, W A Willinek, and P Mürtz.
    • Department of Radiology, University of Bonn, Bonn, Germany.
    • Eur Radiol. 2013 Oct 1; 23 (10): 2773-83.

    ObjectiveTo evaluate intravoxel incoherent motion (IVIM) model-based liver lesion characterisation from three b-value diffusion-weighted imaging (DWI).MethodsThe 1.5-T DWI data from a respiratory gated spin-echo echo-planar magnetic resonance imaging sequence (b = 0, 50, 800 s/mm(2)) were retrospectively analysed in 38 patients with different liver lesions. Conventional apparent diffusion coefficient ADC = ADC(0,800) as well as IVIM-based parameters D' = ADC(50,800), ADC_low = ADC(0,50), and f' were calculated voxel-wise. Sixty-one regions of interest in hepatocellular carcinomas (HCCs, n = 24), haemangiomas (HEMs, n = 11), focal nodular hyperplasias (FNHs, n = 11), and healthy liver tissue (REFs, n = 15) were analysed. Group differences were investigated using Student's t-test and receiver-operating characteristic (ROC) analysis.ResultsMean values ± standard deviations of ADC, D', ADC_low (in 10(-5) mm(2)/s), and f' (in %) for REFs/FNHs/HEMs/HCCs were 130 ± 11/143 ± 27/168 ± 16/113 ± 25, 104 ± 12/123 ± 25/162 ± 18/102 ± 23, 518 ± 66/437 ± 97/268 ± 69/283 ± 120, and 18 ± 3/14 ± 4/6 ± 3/9 ± 5, respectively. Differences between lesions and REFs were more significant for IVIM-based parameters than for conventional ADC. ROC analysis showed the best discriminability between HCCs and FNHs for ADC_low and f' and between HEMs and FNHs or HCCs for D'.ConclusionThree instead of two b-value DWI enables a numerically stable and voxel-wise IVIM-based analysis for improved liver lesion characterisation with tolerable acquisition time.Key Points• Quantitative analysis of diffusion-weighted MRI helps liver lesion characterisation. • Analysis of intravoxel incoherent motion is superior to apparent diffusion coefficient determination. • Only three b-values enable separation of diffusion and microcirculation effects. • The method presented is numerically stable, with voxel-wise results and short acquisition times.

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