Intravoxel incoherent motion diffusion weighted imaging for preoperative evaluation of liver regeneration after hepatectomy in hepatocellular carcinoma

Li, Qian; Zhang, Tong; Che, Feng; Yao, Shan; Gao, Feifei; Nie, Lisha; Tang, Hehan; Yi, Wei; Song, Bin

doi:10.1007/s00330-023-09496-1

Cited by 3 publications

(5 citation statements)

References 59 publications

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“…In our study, we found that the Alpha value is similar between SGA with and without adverse outcomes, which is consistent with previous reports about hepatic fibrosis [ 8 ]. We cautiously speculated that increased intraplacental infarction and decreased microcirculation perfusion might not contribute to the increased heterogeneity of placental tissue [ 8 , 33 ]. Despite no statistically difference in D values between the groups of SGA infants with and without adverse outcomes, the D values of SGA infants with adverse outcomes were slightly lower than those of SGA infants without adverse outcomes [1.55 ± 0.23 (10 −3 mm 2 /s) vs 1.62 ± 0.13 (10 −3 mm 2 /s), p = 0.186], which could be due to the small sample size.…”

Section: Discussionsupporting

confidence: 93%

“…The stretched exponential model is another new method to fit the apparent diffusion attenuation characteristics that reflect a continuous distribution. The DDC value reflects the diffusion motion of water molecules like the ADC value and was considered a surrogate marker of cellular density [ 8 , 31 ]. The dysfunctional placenta of SGA infants potentially leads to sparse villi compared with normal placental tissue, increased interstitial hyperplasia and necrosis, marked reduction of intravascular vessels within the villi, and narrowing or occlusion of the lumen [ 26 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…This might be related to the fact that the DDC and ADC values fail to exclude the effect of microcirculation perfusion [ 33 ]. Alpha reflects the complexity of the tissue microstructure [ 8 ]. In our study, we found that the Alpha value is similar between SGA with and without adverse outcomes, which is consistent with previous reports about hepatic fibrosis [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Alpha reflects the complexity of the tissue microstructure [ 8 ]. In our study, we found that the Alpha value is similar between SGA with and without adverse outcomes, which is consistent with previous reports about hepatic fibrosis [ 8 ]. We cautiously speculated that increased intraplacental infarction and decreased microcirculation perfusion might not contribute to the increased heterogeneity of placental tissue [ 8 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated that placental IVIM-based diffusion and perfusion parameters have a large potential for clinical application, but few studies have used IVIM-based functional parameters to comprehensively identify neonatal adverse outcomes of SGA infants [ 6 , 7 ]. IVIM-based stretch index models could reflect tissue heterogeneity using diffusion distribution coefficient ( DDC ) and diffusion heterogeneity index ( Alpha ), which had been described in several liver-related studies [ 8 ]. Certain SGA infants with placenta dysfunction may have severe pathologic changes in the placental tissue, resulting in changes in its elasticity and stiffness.…”

Section: Introductionmentioning

confidence: 99%

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Value of placental virtual magnetic resonance elastography and intravoxel incoherent motion-based diffusion and perfusion in predicting adverse outcomes of small-for-gestational-age infants

Deng,

Cao,

et al. 2023

Insights Imaging

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Objective It is critical to early monitor and manage small-for-gestational age (SGA) infants with truly adverse outcomes not detected by conventional methods. We aimed to explore the value of diffusion-weighted imaging (DWI)-based virtual magnetic resonance elastography (vMRE) and intravoxel incoherent motion (IVIM)-based biexponential and stretched exponential parameters in predicting adverse outcomes of SGA infants. Methods Twenty SGA infants with adverse outcomes and forty without adverse outcomes were included in this prospective study. One DWI-based vMRE parameter [the stiffness value (μdiff)], five IVIM–based parameters [true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), diffusion distribution coefficient (DDC), and diffusion heterogeneity index (Alpha)] and apparent diffusion coefficient (ADC) were calculated and compared between groups. The predictive efficiency was compared by the logistic regression analysis and receiver operating characteristic curve analysis. The relationship between the μdiff value with gestational age was also evaluated. Results The placental μdiff value was remarkably higher, and the f, DDC, and ADC values were considerably lower in the SGA infants with adverse outcomes compared with those without adverse outcomes. The μdiff and f value were predictive risk factors for SGA infants with adverse outcomes. A combined predictive model (μdiff and f) improved the predictive efficacy. Moreover, there was no statistically significant correlation between the placental stiffness value and gestational age. Conclusions Functional MRI parameters to quantify placenta elastography and microcirculation in SGA patients. This might be a useful tool to assess placental function and a vital non-invasive supplement for predicting adverse outcomes of SGA infants. Critical relevance statement This prospective study shows DWI-based virtual magnetic resonance elastography and intravoxel incoherent motion-based functional parameters to quantify placenta elastography and microcirculation in small-for-gestational-age patients, which could complement existing non-invasive methods for monitoring and predicting neonatal perinatal adverse outcome. Key points • vMRE is an emerging non-invasive imaging technique for evaluating placenta stiffness. • SGA infants with adverse outcome have stiffer placental elasticity and lower microcirculation. • Risk factors combination displayed better efficacy in predicting adverse outcomes of SGA. Graphical Abstract

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Value of placental virtual magnetic resonance elastography and intravoxel incoherent motion-based diffusion and perfusion in predicting adverse outcomes of small-for-gestational-age infants

Deng,

Cao,

et al. 2023

Insights Imaging

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Value of gadoxetic acid-enhanced MR imaging for preoperative prediction of future liver regeneration after hemihepatectomy

Fujita,

Ushijima,

Itoyama

et al. 2024

Jpn J Radiol

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Purpose Liver resection is currently considered the most effective treatment for patients with liver cancer. To the best of our knowledge, no study has investigated the association between gadoxetic acid-enhanced magnetic resonance imaging (MRI) findings and liver regeneration in patients who underwent hemihepatectomy. We aimed to clarify the relationship between the signal intensity (SI) of the liver parenchyma on gadoxetic acid-enhanced MRI and the degree of liver regeneration in patients who underwent hemihepatectomy. Materials and methods Forty-one patients who underwent gadoxetic acid-enhanced MRI before hemihepatectomy were enrolled. We calculated the liver-to-erector spinae muscle SI ratio (LMR) in the hepatobiliary phase and the precontrast images. ΔLMR was calculated using the following equation: ΔLMR = (LMR in the hepatobiliary phase−LMR in the precontrast image)/LMR in the precontrast image. The preoperative and postoperative remnant liver volumes (LVs) were calculated using CT volumetry. We calculated the resection rate (RR) and liver regeneration index (LRI) using the following formulas: RR = Resected LV/Total LV × 100 and LRI = (postoperative remnant LV−preoperative remnant LV)/preoperative remnant LV × 100. The relationships among LRI, imaging, and clinicopathological factors were analyzed. Results Univariate analysis showed RR and ΔLMR showed a positive correlation with LRI (ρ = 0.4133, p = 0.0072 and ρ = 0.7773, p < 0.001, respectively). Spleen volume showed a negative correlation with LRI (ρ = −0.3138, p = 0.0486). Stepwise multiple regression analysis showed ΔLMR and RR were independently correlated with LRI (β coefficient = 44.8771, p = 0.0198 and β coefficient = 1.9653, p < 0.001, respectively). Conclusion ΔLMR may serve as a preoperative predictor of liver regeneration in patients undergoing hemihepatectomy.

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Use of Intravoxel Incoherent Motion Diffusion-Weighted Imaging to Assess Mesenchymal Stromal Cells Promoting Liver Regeneration in a Rat Model

Wang,

Xie,

Qiu

et al. 2024

Academic Radiology

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Intravoxel incoherent motion diffusion weighted imaging for preoperative evaluation of liver regeneration after hepatectomy in hepatocellular carcinoma

Cited by 3 publications

References 59 publications

Value of placental virtual magnetic resonance elastography and intravoxel incoherent motion-based diffusion and perfusion in predicting adverse outcomes of small-for-gestational-age infants

Value of placental virtual magnetic resonance elastography and intravoxel incoherent motion-based diffusion and perfusion in predicting adverse outcomes of small-for-gestational-age infants

Value of gadoxetic acid-enhanced MR imaging for preoperative prediction of future liver regeneration after hemihepatectomy

Use of Intravoxel Incoherent Motion Diffusion-Weighted Imaging to Assess Mesenchymal Stromal Cells Promoting Liver Regeneration in a Rat Model

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