Liver fibrosis staging with diffusion-weighted imaging: a systematic review and meta-analysis

Jiang, Hanyu; Chen, Jie; Gao, Ronghui; Huang, Zixing; Wu, Mingpeng; Song, Bin

doi:10.1007/s00261-016-0913-6

Cited by 53 publications

(44 citation statements)

References 56 publications

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“…Considering pancreatic hardness is associated with fibrosis, a low ADC value due to a hard texture can be explained by the decreased diffusion of water and the high density of fibrin within the tissue. The usefulness of the ADC to evaluate for fibrosis or hardness of the tissue has already been proven in other organs such as the liver and kidney[19-21]. In our study, the minimal ADC value showed a higher degree of correlation than the mean ADC value.…”

Section: Discussionsupporting

confidence: 50%

Pancreatic hardness: Correlation of surgeon’s palpation, durometer measurement and preoperative magnetic resonance imaging features

Hong¹,

Choi²,

Park³

et al. 2017

WJG

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AIMTo evaluate the correlation between subjective assessments of pancreatic hardness based on the palpation, objective measurements using a durometer, and magnetic resonance imaging (MRI) findings for assessing pancreatic hardness.METHODSEighty-three patients undergoing pancreatectomies were enrolled. An experienced surgeon subjectively evaluated the pancreatic hardness in the surgical field by palpation. The pancreatic hardness was also objectively evaluated using a durometer. Preoperative MRI findings were evaluated by a radiologist in terms of the apparent diffusion coefficient (ADC) values, the relative signal intensity decrease (RSID) of the pancreatic parenchyma, and the diameter of the pancreatic parenchyma and duct. Durometer measurement results, ADC values, RSID, pancreatic duct and parenchyma diameters, and the ratio of the diameters of the duct and parenchyma were compared between pancreases judged to be soft or hard pancreas on the palpation. A correlation analysis was also performed between the durometer and MRI measurements.RESULTSThe palpation assessment classified 44 patients as having a soft pancreas and 39 patients as having a hard pancreas. ADC values were significantly lower in the hard pancreas group. The ductal diameter and duct-to-pancreas ratio were significantly higher in the hard pancreas group. For durometer measurements, a correlation analysis showed a positive correlation with the ductal diameter and the duct-to-pancreas ratio and a negative correlation with ADC values.CONCLUSIONHard pancreases showed lower ADC values, a wider pancreatic duct diameter and a higher duct-to-pancreas ratio than soft pancreases. Additionally, the ADC values, diameter of the pancreatic duct and duct-to-pancreas ratio were closely correlated with the durometer results.

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Section: Discussionsupporting

confidence: 50%

Pancreatic hardness: Correlation of surgeon’s palpation, durometer measurement and preoperative magnetic resonance imaging features

Hong¹,

Choi²,

Park³

et al. 2017

WJG

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“…An example DW-EPI data set (after averaging and before normalization) is shown in Figure 4. Red arrows point to regions with undesirable signal attenuation caused by cardiac motion, which becomes apparent in the left liver lobe when α is more than 1.5 s/mm 2 (e.g., when b = [200, 300 s/mm 2 ] for α 4 and b = 300 s/mm 2 for α 3 ). Moreover, bright vessels were apparent on images acquired with α 0 when b was less than 100 s/mm 2 , as highlighted by the blue arrows.…”

Section: In Vivo Imagingmentioning

confidence: 99%

“…IVIM was first investigated in the brain, but has recently seen growing interest in more highly perfused organs such as the liver, 3,4 pancreas, 5 kidney, 6 prostate, 7 and the heart. [8][9][10] The liver has a unique vasculature system due to 2 main blood supplies, namely, the hepatic artery and the portal vein.…”

Section: Introductionmentioning

confidence: 99%

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Effect of flow‐encoding strength on intravoxel incoherent motion in the liver

Moulin

Aliotta

Ennis

2018

Magnetic Resonance in Med

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Purpose To study the impact of variable flow‐encoding strength on intravoxel incoherent motion (IVIM) liver imaging of diffusion and perfusion. Theory Signal attenuation in DWI arises from (1) intravoxel microvascular blood flow, which depends on the flow‐encoding strength α (first gradient moment) of the diffusion‐encoding waveform, and (2) intravoxel spin diffusion, which depends on the b‐value of the diffusion‐encoding gradient waveforms α and b‐value. Both are linked to the diffusion‐encoding gradient waveform and conventionally are not independently controlled. Methods In this work a convex optimization framework was used to generate gradient waveforms with independent α and b‐value. Thirty‐six unique α and b‐value sample points from 5 different gradient waveforms were used to reconstruct perfusion fraction (f), coefficient of diffusion (D), and blood velocity standard deviation (Vb) maps using a recently proposed IVIM model. Faster acquisition strategies were evaluated with 1000 random subsampling strategies of 16, 8, and 4 α and b‐value. Among the subsampled reconstructions, the sampling schemes that minimized the difference with the fully sampled reconstruction were reported. Results Healthy volunteers (N = 9) were imaged on a 3T scanner. Liver perfusion and diffusion estimates using the fully sampled IVIM method were f = 0.19 ± 0.06, D = 1.15 ± 0.15 × 10–3 mm2/s, and Vb = 5.22 ± 3.86 mm/s. No statistical differences were found between the fully sampled and 2‐times undersampled reconstruction (f = 0.2 ± 0.07, D = 1.19 ± 0.15 × 10–3 mm2/s, Vb = 5.79 ± 3.43 mm/s); 4‐times undersampled (f = 0.2 ± 0.06, D = 1.15 ± 0.17 × 10–3 mm2/s, Vb = 4.66 ± 3.61 mm/s), or 8‐times undersampled ( f = 0.2 ± 0.06, D = 1.23 ± 0.22 × 10–3 mm2/s, Vb = 4.99 ± 3.82 mm/s) approaches. Conclusion We demonstrate the IVIM signal’s dependence on the b‐value, the diffusion‐encoding time and the flow‐encoding strength and observe in vivo the ballistic regime signature of microperfusion in the liver. This work also demonstrates that using an IVIM model and sampling scheme matched to the ballistic regime, pixel‐wise IVIM parameter maps are possible when sampling as few as 4 IVIM signals.

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“…A high b value for liver fibrosis imaging (between 800 and 1000 s/mm 2 ) could significantly increase the diagnostic accuracy of diffusion imaging in differentiating between significant and severe fibroses (>F2). For diagnosing liver cirrhosis (F4), the use of 3T MRI equipment has also proved to optimize the DWI diagnostic accuracy, compared to 2T MRI [45].…”

Section: Diffusion-weighted Mr Imagingmentioning

confidence: 99%

Current Noninvasive MR-Based Imaging Methods in Assessing NAFLD Patients

Feier¹,

Muntean²,

Bastati³

et al. 2019

Nonalcoholic Fatty Liver Disease - An Update

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The chapter will focus on the different aspects of nonalcoholic fatty liver disease (NAFLD). An update in noninvasive MR-based imaging will be offered in detail, pointing mainly to fat, iron, and fibrosis deposition and the accuracy of quantitative methods in disease grading and severity assessment. NAFLD is the most common cause of chronic liver disease (CLD) in Western countries. MRI is used to evaluate the disease, to assess the severity, and to quantify the amount of fat deposition, being also the method of choice to evaluate and quantify iron overload. Diagnosis and staging of liver fibrosis is one of the most challenging aspects of noninvasive imaging. "Virtual biopsy" refers to the possibility of imaging techniques to depict, map, and measure fibrosis minimizing the need for invasive liver biopsies in CLD. MRI allows an accurate determination of steatosis, iron overload, and fibrosis, even if they coexist.

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Liver fibrosis staging with diffusion-weighted imaging: a systematic review and meta-analysis

Abstract: DWI is a reliable noninvasive technique with good diagnostic accuracy for LF staging. Using b ≥ 800 s/mm, high-field strength (3.0 T) and IVIM-DWI can optimize the diagnostic performance of DWI.

Cited by 53 publications

References 56 publications

Pancreatic hardness: Correlation of surgeon’s palpation, durometer measurement and preoperative magnetic resonance imaging features

Pancreatic hardness: Correlation of surgeon’s palpation, durometer measurement and preoperative magnetic resonance imaging features

Effect of flow‐encoding strength on intravoxel incoherent motion in the liver

Current Noninvasive MR-Based Imaging Methods in Assessing NAFLD Patients

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