• Lesheng Huang, Qian Wei, Hui Peng, Wanchun Zhang, Jiahui Tang, and Tianzhu Liu.
• From the Department of Radiology (Huang, Wei, Zhang, Tang, Liu); and from the Department of Pathology (Peng), Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, China.
• Saudi Med J. 2024 Aug 1; 45 (9): 911918911-918.

ObjectivesTo determine the diagnostic efficiencies of multiple diffusion-weighted imaging (DWI) techniques for hepatic fibrosis (HF) staging under the premise of high inter-examiner reliability.MethodsParticipants with biopsy-confirmed HF were recruited and divided into the early HF (EHF) and advanced HF (AHF) groups; healthy volunteers (HVs) served as controls. Two examiners analyzed intravoxel incoherent motion (IVIM) using the IVIM-DWI and diffusion kurtosis imaging (DKI) models. Intravoxel incoherent motion-DWI, DKI, and diffusion tensor imaging parameters with intraclass correlation coefficients (ICCs) of ≥0.6 were used to create regression models: HVs vs. EHF and EHF vs. AHF.ResultsWe enrolled 48 HVs, 59 EHF patients, and 38 AHF patients. Mean, radial, and axial kurtosis; fractional anisotropy; mean, radial, and axial diffusivity; and α exhibited excellent reliability (ICCs: 0.80-0.98). Fractional anisotropy of kurtosis, f, and apparent diffusion coefficient showed good reliability (ICCs: 0.69-0.92). The real (0.58-0.67), pseudo- (0.27-0.76), and distributed diffusion coefficients (0.58-0.67) showed low reliability. In the HVs versus (vs.) EHF model, α (p=0.008) and ADC (p=0.011) presented statistical differences (area under curve [AUC]: 0.710). In the EHF vs. AHF model, α (p=0.04) and distributed diffusion coefficient (p=0.02) presented significant differences (AUC: 0.758).ConclusionUnder the premise of high inter-examiner reliability, DWI and IVIM-derived stretched-exponential model parameters may help stage HF.Copyright: © Saudi Medical Journal.

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