Influence of cardiac motion on diffusion-weighted magnetic resonance imaging of the liver

Kwee, Thomas C.; Takahara, Taro; Niwa, Tetsu; Ivancevic, Marko K.; Hérigault, Gwénaël; Cauteren, Marc Van; Luijten, Peter R.

doi:10.1007/s10334-009-0183-1

Cited by 101 publications

(116 citation statements)

References 14 publications

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“…In addition, some ROIs were chosen in the left liver lobe. Lesions located in the left lobe, especially close to the edge of the liver, are susceptible to be affected by cardiac or diaphragm motion and gastrointestinal peristalsis (47)(48)(49). It is recommended to select lesions located in the center of the right liver lobe because it is more stable and leads to less overestimation during measurements (50); adding echocardiography triggering could decrease parametric variability effectively (49).…”

Section: Discussionmentioning

confidence: 99%

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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A mong primary malignant hepatic tumors, hepatocellular carcinoma (HCC) is the most common disease and is highly associated with chronic hepatitis B and cirrhosis. Focal nodular hyperplasia (FNH) is the second most common benign focal liver lesion (1), and although it displays gentle biological behavior generally, it can cause abdominal pain or right upper quadrant discomfort occasionally. In terms of the extent of vascular supply during contrast enhancement, HCC and FNH both show a hyperarterialization pattern. HCC is characterized by rapid washout in portal and delayed phase compared with adjacent liver tissue, while FNH displays isointensity or mild hyperintensity in the venous phase because of its slower washout. Liver-specific contrast agents, such as gadoxetic acid, can provide unique information to diagnose these conditions more precisely; however, such agents increase the cost and time-consumption of diagnosis. Occasionally, HCC and FNH show confounding or atypical appearances on imaging, especially for high-or middle-grade differentiated HCC, leading to confusion, misdiagnosis ( Fig. 1), and even unnecessary interventions. Since the treatment of these two lesions is completely different, avoiding unnecessary invasive treatment or tests, such as biopsy, surgery, or interventional therapy, is vital for the prognosis and quality of life of the patient. Therefore, it is crucial to diagnose these conditions noninvasively and accurately before surgery.Diffusion-weighted imaging (DWI) is a functional technology to detect diffusion of water molecules and permits to capture more detailed disease information. For lesion detection, the signal intensity on diffusion-weighted image depends on several factors, particularly cell density. A B D O M I N A L I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to explore whether intravoxel incoherent motion (IVIM)-related parameters of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) demonstrate differences that could be used to differentiate and improve diagnostic efficiency. METHODSA total of 27 patients, including 22 with HCC and 5 with FNH, underwent liver 3.0 T magnetic resonance imaging for routine sequences. They were concurrently examined by IVIM diffusion-weighted imaging (DWI) scanning with 11 different b values (0-800 s/mm 2 ). IVIM-derived parameters, such as pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f ), and apparent diffusion coefficient (ADC total ), were quantified automatically by post-processing software and compared between HCC and FNH groups. A receiver operating characteristic (ROC) curve was then created to predict their diagnostic value. RESULTS

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Section: Discussionmentioning

confidence: 99%

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Luo

Jiang²,

Zhang³

2017

Diagn Interv Radiol

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“…Another limitation of DWI is that the evaluation of structures close to the heart, such as mediastinal lymph nodes and the left liver lobe, may be compromised because of signal loss and artifacts due to severe tissue motion (33,(44)(45)(46). Nevertheless, MRI is a versatile imaging modality, and the addition of other sequences may improve the evaluation of the mediastinal lymph nodes (24,47) (Fig.…”

Section: Limitationsmentioning

confidence: 99%

Complementary Roles of Whole-Body Diffusion-Weighted MRI and¹⁸F-FDG PET: The State of the Art and Potential Applications

Kwee¹,

Takahara²,

Ochiai³

et al. 2010

J Nucl Med

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18 F-FDG PET is an established functional imaging modality for the evaluation of human disease. Diffusion-weighted MRI (DWI) is another rapidly evolving functional imaging modality that can be used to evaluate oncologic and nononcologic lesions throughout the body. The information provided by 18 F-FDG PET and DWI can be complementary, because the 2 methods are based on completely different biophysical underpinnings. This article will describe the basic principles, clinical applications, and limitations of DWI. In addition, the available evidence that correlates and compares 18 F-FDG PET and DWI will be reviewed. PET,usi ng the radiotracer 18 F-FDG, is an established functional imaging modality for a variety of oncologic and nononcologic (e.g., inflammatory and infectious) applications (1-3). The contribution of 18 F-FDG PET to medicine has been unmatched by any other functional imaging modality (4). At present, there is also growing interest in the application of diffusion-weighted MRI (DWI) in the body (5-7). DWI allows visualization and quantification of the mobility of water molecules and has many potential clinical applications. Importantly, although 18 F-FDG PET and DWI are both functional imaging modalities and provide a high lesion-to-background contrast, they are based on completely different biophysical and biochemical underpinnings. Therefore, the information provided by the 2 imaging modalities may be regarded as complementary. Given the developing applications of DWI, the increasing use of multimodality imaging (8), and the expected advent of fully integrated PET/MRI systems (9), knowledge of the characteristics, possibilities, and limitations of DWI technique is becoming increasingly important. This is true for both the imaging specialists and the clinicians who use these modalities. This article will review the basic principles, clinical applications, and limitations of DWI. Furthermore, the available evidence that correlates and compares 18 F-FDG PET with DWI will be reviewed.

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“…Thus, the ADC measurements in the right liver lobe may be lower than in the left lobe, because of the addition of heart motion (17). Other authors have shown that cardiac motion may affect the signal intensity of both the left and right lobes (18), which may explain why the differences between the two lobes were of no importance in our study. As demonstrated in our study, an interobserver variability also exists.…”

Section: Discussionmentioning

confidence: 64%

Interobserver and intraobserver variability of the apparent diffusion coefficient in treated malignant hepatic lesions on a 3.0T machine: Measurements in the whole lesion versus in the area with the most restricted diffusion

Meuli

Marques‐Vidal

et al. 2010

Magnetic Resonance Imaging

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Purpose: To assess the inter/intraobserver variability of apparent diffusion coefficient (ADC) measurements in treated hepatic lesions and to compare ADC measurements in the whole lesion and in the area with the most restricted diffusion (MRDA). Materials and Methods:Twenty-five patients with treated malignant liver lesions were examined on a 3.0T machine. After agreeing on the best ADC image, two readers independently measured the ADC values in the whole lesion and in the MRDA. These measurements were repeated 1 month later. The Bland-Altman method, Spearman correlation coefficients, and the Wilcoxon signed-rank test were used to evaluate the measurements. Conclusion: A limited variability in ADC measurements does exist, and it should be considered when interpreting ADC values of hepatic malignancies. This is especially true for the measurements of the minimal ADC.

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Influence of cardiac motion on diffusion-weighted magnetic resonance imaging of the liver

Cited by 101 publications

References 14 publications

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Complementary Roles of Whole-Body Diffusion-Weighted MRI and¹⁸F-FDG PET: The State of the Art and Potential Applications

Interobserver and intraobserver variability of the apparent diffusion coefficient in treated malignant hepatic lesions on a 3.0T machine: Measurements in the whole lesion versus in the area with the most restricted diffusion

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Influence of cardiac motion on diffusion-weighted magnetic resonance imaging of the liver

Cited by 101 publications

References 14 publications

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia

Complementary Roles of Whole-Body Diffusion-Weighted MRI and18F-FDG PET: The State of the Art and Potential Applications

Interobserver and intraobserver variability of the apparent diffusion coefficient in treated malignant hepatic lesions on a 3.0T machine: Measurements in the whole lesion versus in the area with the most restricted diffusion

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Product

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Complementary Roles of Whole-Body Diffusion-Weighted MRI and¹⁸F-FDG PET: The State of the Art and Potential Applications