Measurement of the apparent diffusion coefficient in the liver: is it a reliable index for hepatic disease diagnosis?

Nasu, Katsuhiro; Kuroki, Yoshio; Sekiguchi, Ryuzo; Kazama, Toshiki; Nakajima, Hiroto

doi:10.1007/s11604-006-0053-y

Cited by 56 publications

(55 citation statements)

References 9 publications

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“…Several studies [5][6][7] have suggested that signal loss in DWI and artificially increased ADCs can be observed in the left liver lobe due to cardiac motion. In addition, localized signal loss in DWI of the right liver lobe was recently reported to occur in respiratory triggered DWI, depending on difference of directions of MPGs [8].…”

Section: Discussionmentioning

confidence: 99%

“…However, signal loss in DWI and artificially elevated ADCs have been reported to occur in the left liver lobe [5][6][7]. A possible explanation for this phenomenon is cardiac motion.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, regional deformation and/or acceleration may occur, which affects intravoxel incoherent motion imaging and measurements (i.e. DWI and ADC measurements, respectively) [5][6][7]. Thus, if no cardiac triggering is employed, both detectability of lesions, and reliability and reproducibility of ADC measurements in the left lobe of the liver may be impaired [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…DWI and ADC measurements, respectively) [5][6][7]. Thus, if no cardiac triggering is employed, both detectability of lesions, and reliability and reproducibility of ADC measurements in the left lobe of the liver may be impaired [5][6][7]. On the other hand, it has recently been reported that signal loss and artificially elevated ADCs may be encountered in the right liver lobe as well [8].…”

Section: Introductionmentioning

confidence: 99%

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

Kwee

Takahara

Niwa

et al. 2009

Magn Reson Mater Phy

101

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Purpose To assess cardiac motion-induced signal loss in diffusion-weighted magnetic resonance imaging (DWI) of the liver using dynamic DWI. Materials and methods Three volunteers underwent dynamic coronal DWI of the liver under breathholding, in the diastolic (DWI diast ) or systolic (DWI syst ) cardiac phase, and with motion probing gradients (MPGs) in phase encoding (P, left-right), frequency encoding (M, superior-inferior), or slice select (S, anterior-posterior) direction. Liver-to-background contrasts (LBCs) of DWI syst were compared to those of DWI diast , for both the left and right liver lobes, using nonparametric tests. Signal decrease ratios (SDRs) were calculated as (1 (median 3.35) were significantly lower (P < 0.0001) than those of DWI diast (median 4.84). In the right liver lobe, LBCs of DWI syst (median 4.17) were also significantly lower (P < 0.0001) than those of DWI diast (median 5.35). SDRs of the left and right liver lobes were 25.5% and 17.3%, respectively. In DWI syst , the significantly lowest (P < 0.05) LBCs were observed in the M direction (left liver lobe) and P direction (right liver lobe) of MPGs. Conclusion Signal intensity of both liver lobes are affected by cardiac motion in DWI. In the left liver lobe, signal loss especially occurs in the superior-inferior direction of MPGs, whereas in the right lobe, signal loss especially occurs in the left-right direction of MPGs.

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Section: Discussionmentioning

confidence: 99%

“…However, signal loss in DWI and artificially elevated ADCs have been reported to occur in the left liver lobe [5][6][7]. A possible explanation for this phenomenon is cardiac motion.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Kwee

Takahara

Niwa

et al. 2009

Magn Reson Mater Phy

101

View full text Add to dashboard Cite

show abstract

“…A difference may also exist between different anatomical locations. 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.…”

Section: Discussionmentioning

confidence: 60%

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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High‐b‐value diffusion‐weighted MR imaging of hepatocellular lesions: Estimation of grade of malignancy of hepatocellular carcinoma

Muhi

Ichikawa

Motosugi

et al. 2009

Magnetic Resonance Imaging

156

110

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Purpose: To evaluate the effectiveness of diffusionweighted magnetic resonance imaging (DWI) in estimating the grade of malignancy of hepatocellular carcinoma.Materials and Methods: Dynamic contrast-enhanced computed tomography (CE-CT) and DWI (b value, 1000 s/mm 2 ) were performed on 73 patients. Using DW images, the lesions were classified as ''visible'' or ''invisible.'' The apparent diffusion coefficient (ADC) of the lesions was measured. Furthermore, the lesions were classified as hypervascular or iso-hypovascular using arterial phase CE-CT images. The image findings for each lesion type were compared.Results: The 73 patients had 98 hepatocellular lesions, of which 12 were histologically diagnosed as dysplastic nodules; 39, well-differentiated HCCs; 33, moderately differentiated HCCs; and 14, poorly differentiated HCCs. The mean ADC values of moderately poorly-differentiated HCCs were significantly lower than well-differentiated HCCs and dysplastic nodules (P < 0.01). On DW images, >90% of moderately (30/33) and poorly differentiated HCCs (13/14) were visible, while 51% of well-differentiated HCCs (20/39) and all dysplastic nodules were invisible. Of 22 iso-hypovascular lesions, 4 were visible on DW images and were poorly differentiated HCCs, whereas 18 were invisible and were dysplastic nodules (12/18) or well-differentiated HCCs (6/18). Conclusion:A combination of hypovascularity and visibility on DW images can help distinguish poorly differentiated HCCs from low-grade hepatocellular lesions (dysplastic nodules and well-differentiated HCCs).

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Measurement of the apparent diffusion coefficient in the liver: is it a reliable index for hepatic disease diagnosis?

Abstract: ADC measurement of the left hepatic lobe was far more incorrect than that of the right lobe if cardiac gating was not employed. The administration of Buscopan worsened the image quality of the left lobe and made visual evaluation difficult.

Cited by 56 publications

References 9 publications

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

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

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

High‐b‐value diffusion‐weighted MR imaging of hepatocellular lesions: Estimation of grade of malignancy of hepatocellular carcinoma

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