Nieun Seo1, Yong Eun Chung2,3, Yung Nyun Park4, Eunju Kim5, Jinwoo Hwang5, Myeong-Jin Kim1. 1. Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. 2. Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. yelv@yuhs.ac. 3. BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea. yelv@yuhs.ac. 4. Department of Pathology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. 5. Philips Healthcare Korea, Sowoel-ro 272, Seoul, 04342, Korea.
Abstract
OBJECTIVES: To compare the ability of diffusion-weighted imaging (DWI) parameters acquired from three different models for the diagnosis of hepatic fibrosis (HF). METHODS: Ninety-five patients underwent DWI using nine b values at 3 T magnetic resonance. The hepatic apparent diffusion coefficient (ADC) from a mono-exponential model, the true diffusion coefficient (D t ), pseudo-diffusion coefficient (D p ) and perfusion fraction (f) from a biexponential model, and the distributed diffusion coefficient (DDC) and intravoxel heterogeneity index (α) from a stretched exponential model were compared with the pathological HF stage. For the stretched exponential model, parameters were also obtained using a dataset of six b values (DDC#, α#). The diagnostic performances of the parameters for HF staging were evaluated with Obuchowski measures and receiver operating characteristics (ROC) analysis. The measurement variability of DWI parameters was evaluated using the coefficient of variation (CoV). RESULTS: Diagnostic accuracy for HF staging was highest for DDC# (Obuchowski measures, 0.770 ± 0.03), and it was significantly higher than that of ADC (0.597 ± 0.05, p < 0.001), D t (0.575 ± 0.05, p < 0.001) and f (0.669 ± 0.04, p = 0.035). The parameters from stretched exponential DWI and D p showed higher areas under the ROC curve (AUCs) for determining significant fibrosis (≥F2) and cirrhosis (F = 4) than other parameters. However, D p showed significantly higher measurement variability (CoV, 74.6%) than DDC# (16.1%, p < 0.001) and α# (15.1%, p < 0.001). CONCLUSIONS: Stretched exponential DWI is a promising method for HF staging with good diagnostic performance and fewer b-value acquisitions, allowing shorter acquisition time. KEY POINTS: • Stretched exponential DWI provides a precise and accurate model for HF staging. • Stretched exponential DWI parameters are more reliable than D p from bi-exponential DWI model • Acquisition of six b values is sufficient to obtain accurate DDC and α.
OBJECTIVES: To compare the ability of diffusion-weighted imaging (DWI) parameters acquired from three different models for the diagnosis of hepatic fibrosis (HF). METHODS: Ninety-five patients underwent DWI using nine b values at 3 T magnetic resonance. The hepatic apparent diffusion coefficient (ADC) from a mono-exponential model, the true diffusion coefficient (D t ), pseudo-diffusion coefficient (D p ) and perfusion fraction (f) from a biexponential model, and the distributed diffusion coefficient (DDC) and intravoxel heterogeneity index (α) from a stretched exponential model were compared with the pathological HF stage. For the stretched exponential model, parameters were also obtained using a dataset of six b values (DDC#, α#). The diagnostic performances of the parameters for HF staging were evaluated with Obuchowski measures and receiver operating characteristics (ROC) analysis. The measurement variability of DWI parameters was evaluated using the coefficient of variation (CoV). RESULTS: Diagnostic accuracy for HF staging was highest for DDC# (Obuchowski measures, 0.770 ± 0.03), and it was significantly higher than that of ADC (0.597 ± 0.05, p < 0.001), D t (0.575 ± 0.05, p < 0.001) and f (0.669 ± 0.04, p = 0.035). The parameters from stretched exponential DWI and D p showed higher areas under the ROC curve (AUCs) for determining significant fibrosis (≥F2) and cirrhosis (F = 4) than other parameters. However, D p showed significantly higher measurement variability (CoV, 74.6%) than DDC# (16.1%, p < 0.001) and α# (15.1%, p < 0.001). CONCLUSIONS: Stretched exponential DWI is a promising method for HF staging with good diagnostic performance and fewer b-value acquisitions, allowing shorter acquisition time. KEY POINTS: • Stretched exponential DWI provides a precise and accurate model for HF staging. • Stretched exponential DWI parameters are more reliable than D p from bi-exponential DWI model • Acquisition of six b values is sufficient to obtain accurate DDC and α.
Entities:
Keywords:
Diffusion magnetic resonance imaging; Fibrosis; Liver; Liver cirrhosis
Authors: Kevin M Bennett; Kathleen M Schmainda; Raoqiong Tong Bennett; Daniel B Rowe; Hanbing Lu; James S Hyde Journal: Magn Reson Med Date: 2003-10 Impact factor: 4.668
Authors: Helena S Leitão; Sabrina Doblas; Philippe Garteiser; Gaspard d'Assignies; Valérie Paradis; Feryel Mouri; Carlos F G C Geraldes; Maxime Ronot; Bernard E Van Beers Journal: Radiology Date: 2016-10-27 Impact factor: 11.105
Authors: Tiffany P Hennedige; Gang Wang; Fiona P Leung; Hind S Alsaif; Lynette Ls Teo; Seng Gee Lim; Aileen Wee; Sudhakar K Venkatesh Journal: Gut Liver Date: 2017-05-15 Impact factor: 4.519
Authors: David A Reiter; Fatemeh Adelnia; Donnie Cameron; Richard G Spencer; Luigi Ferrucci Journal: Magn Reson Med Date: 2021-03-16 Impact factor: 3.737