Diffusion-weighted MRI in evaluating liver fibrosis: a feasibility study in cirrhotic patients

Girometti, Rossano; Furlan, Alessandro; Bazzocchi, Massimo; Soldano, Franca; Isola, Miriam; Toniutto, Pierluigi; Bitetto, Davide; Zuiani, Chiara

doi:10.1007/s11547-007-0149-1

Cited by 101 publications

(84 citation statements)

References 36 publications

(132 reference statements)

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“…Diffusing water spins within a voxel experience phase dispersion, causing signal attenuation that is dependent on the (12,17,18,47,50), and for liver tumor treatment response (6,11,14,20,(51)(52)(53)(54).…”

Section: Discussionmentioning

confidence: 99%

“…THERE IS A GROWING interest in using liver diffusionweighted imaging (DWI) for lesion detection and characterization, prediction of treatment response and assessment of chronic liver disease, by means of apparent diffusion coefficient (ADC) measurement (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The interest in DWI is motivated by the recently described risk of nephrogenic systemic fibrosis (21)(22)(23)(24), which makes DWI an attractive alternate method to Gadolinium-enhanced sequences.…”

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confidence: 99%

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Diffusion‐weighted imaging of the liver: Comparison of navigator triggered and breathhold acquisitions

Taouli

Sandberg

Stemmer

et al. 2009

Magnetic Resonance Imaging

147

122

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Purpose: To compare a free breathing navigator triggered single shot echoplanar imaging (SS EPI) diffusion-weighted imaging (DWI) sequence with prospective acquisition correction (PACE) with a breathhold (BH) DWI sequence for liver imaging. Materials and Methods:Thirty-four patients were evaluated with PACE-DWI and BH DWI of the liver using bvalues of 0, 50, and 500 s/mm 2 . There were 29 focal liver lesions in 18 patients. Qualitative evaluation was performed on a 3-point scale (1-3) by two independent observers (maximum score 9). Quantitative evaluation included estimated SNR (signal to noise ratio), lesion-to-liver contrast ratio, liver and lesion apparent diffusion coefficients (ADCs), and coefficient of variation (CV) of ADC in liver parenchyma and focal liver lesions (estimate of noise contamination in ADC).Results: PACE-DWI showed significantly better image quality, higher SNR and lesion-to-liver contrast ratio when compared with BH DWI. ADCs of liver and focal lesions with both sequences were significantly correlated (r ϭ 0.838 for liver parenchyma, and 0.904 for lesions, P Ͻ 0.0001), but lower with the BH sequence (P Ͻ 0.02). There was higher noise contamination in ADC measurement obtained with BH DWI (with a significantly higher SD and CV of ADC). Conclusion:The use of a navigator echo to trigger SS EPI DWI improves image quality and liver to lesion contrast, and enables a more precise ADC quantification compared with BH DWI acquisition. THERE IS A GROWING interest in using liver diffusionweighted imaging (DWI) for lesion detection and characterization, prediction of treatment response and assessment of chronic liver disease, by means of apparent diffusion coefficient (ADC) measurement (1-20). The interest in DWI is motivated by the recently described risk of nephrogenic systemic fibrosis (21-24), which makes DWI an attractive alternate method to Gadolinium-enhanced sequences. Most prior studies have used breathhold (BH) single shot echoplanar imaging (SS EPI) to acquire diffusion-weighted images, using various sets of b-values. SS EPI sequences are very fast, however, suffer from limited image quality, mostly related to limited signal to noise ratio (SNR) especially at higher b-values, and limited spatial resolution, which constitute an obstacle for its widespread use in clinical practice. Techniques such as parallel imaging (25,26) and pulse triggering (27) have been proposed to improve SS EPI image quality and precision of ADC measurement.There are several recent reports on the use of respiratory triggered acquisitions for liver DWI (15,16,[28][29][30][31]. However, only two studies have specifically compared different diffusion acquisition schemes for liver imaging (28,30). The first study (28) included a population of patients with liver lesions, and compared image quality and ADC of free breathing versus BH DWI. The second study included healthy volunteers, and compared BH, free breathing and respiratory triggered DWI (without navigator echoes) (30). There are, however, no reports on the use of a...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Diffusion‐weighted imaging of the liver: Comparison of navigator triggered and breathhold acquisitions

Taouli

Sandberg

Stemmer

et al. 2009

Magnetic Resonance Imaging

147

122

View full text Add to dashboard Cite

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“…In this experience, a 93% sensitivity and 100% specificity for detecting cirrhosis was associated with a cutoff ADC value of 1.31 ϫ 10 -3 mm 2 /s. 39 Notably, the change in ADC with greater degrees of fibrosis may not be related to reductions in water diffusion. Recent data suggest that decreased ADC values in rodents with hepatic fibrosis were observed in vivo but not when DWI was performed in euthanized rats or fixated livers.…”

Section: Novel Mr Applications For In Vivo Detection Of Hepatic Fibrosismentioning

confidence: 99%

“…Previous experience with physiological motion artifacts and poor image resolution have been addressed by the use of faster pulse sequences, cardiac and respiratory triggering, and modifying the acquisition to allow data collection during suspended respiration. 38,39 Reported times for breath-holding are usually between 10 and 20 seconds per measurement. Typical examination time for both standard and diffusion-weighted MRI is approximately 45 to 60 minutes.…”

Section: Novel Mr Applications For In Vivo Detection Of Hepatic Fibrosismentioning

confidence: 99%

“…If two or more diffusion-weighted images are obtained, then it is possible to calculate the apparent diffusion coefficient (ADC) of water protons in tissues, which is determined by the slope of the log intensity versus b value. 39,40 The calculated ADC values can be displayed as an image and quantitative analysis can be performed by placing measuring the mean value within a region of interest, which is typically positioned in the right hepatic parenchyma to avoid major vascular structures.…”

Section: Novel Mr Applications For In Vivo Detection Of Hepatic Fibrosismentioning

confidence: 99%

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Magnetic resonance imaging of hepatic fibrosis: Emerging clinical applications

et al. 2007

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Chronic liver disease and cirrhosis remains a major public health problem worldwide. While the majority of complications from chronic liver disease result from progressive hepatic fibrosis, the available diagnostic tests used in clinical practice are not sensitive or specific enough to detect occult liver injury at early or intermediate stages. While liver biopsy can stage the extent of fibrosis at diagnosis, its utility as a tool for longitudinal monitoring will be limited at the population level. To date, a number of methods including serum marker panels and ultrasound-based transient elastrography have been proposed for the non-invasive identification of hepatic fibrosis. Novel techniques including magnetic resonance (MR) spectroscopy, diffusion weighted MR, and MR elastography have also emerged for detecting fibrosis. In contrast to other non-invasive methods, MR imaging holds the promise of providing functional and biological information about hepatic pathophysiology as it relates to the natural history and future treatment of hepatic fibrosis. (HEPATOLOGY 2008;47:332-342.)

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Imaging of NAFLD

Yokoo

Tang

Sirlin

2013

Non‐Alcoholic Fatty Liver Disease

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Diffusion-weighted MRI in evaluating liver fibrosis: a feasibility study in cirrhotic patients

Abstract: Diffusion-weighted MRI is an accurate tool in evaluating advanced liver fibrosis if an optimised single-shot spin-echo echo-planar sequence with maximum intermediate b value is used. The ADC threshold for liver fibrosis was 1.31.10(-3)mm(2)/s.

Cited by 101 publications

References 36 publications

Diffusion‐weighted imaging of the liver: Comparison of navigator triggered and breathhold acquisitions

Diffusion‐weighted imaging of the liver: Comparison of navigator triggered and breathhold acquisitions

Magnetic resonance imaging of hepatic fibrosis: Emerging clinical applications

Imaging of NAFLD

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