title: Intravoxel Incoherent Motion MR Imaging: Comparison of Diffusion and Perfusion Characteristics for Differential Diagnosis of Soft Tissue Tumors.
abstract: We used intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) to explore the possibility of preoperative diagnosis of soft tissue tumors (STTs). This prospective study enrolled 23 patients. Conventional MRI and IVIM examinations were performed on a 3.0T MR imager. Eight (35%) hemangiomas, 11 (47%) benign soft tissue tumors excluding hemangiomas (BSTTEHs) and 4 soft tissue sarcomas (STSs) were assessed. The mean tumor size was about 1652.36 ± 233.66  mm(2). Ten b values (0-800  s/mm(2)) were used to evaluate diffusion and perfusion characteristics of IVIM. IVIM parameters (ADC(standard), ADC(slow), ADC(fast), and f) of STTs were measured and evaluated for differentiating hemangiomas, BSTTEHs, and STSs. ADC(slow) and ADC(fast) value were different for hemangiomas, BSTTEHs, and STSs separately (P < 0.001, P < 0.001, and P = 0.001). ADC(slow), cut-off value smaller than 0.93 × 10(-3)  mm(2)/s, was the best parameter to differ STSs (0.689 ± 0.173 × 10 (-3)mm(2)/s) from hemangiomas (0.933 ± 0.237 × 10 (-3)mm(2)/s) and BSTTEHs (1.156 ± 0.120 × 10 (-3)mm(2)/s) (P = 0.001). ADC(slow) (0.93 × 10(-3)  mm(2)/s <cut-off value <0.96 × 10(-3)  mm(2)/s) was used to distinguish hemangiomas from BSTTs. There were significant difference among hemangiomas, BSTTEHs, and STSs (P = 0.014, P = 0.036, P < 0.001). The ADC(standard), ADC(fast), and f value were different (P < 0.05) for STSs (1.009 ± 0.177 × 10 (-3) mm(2)/s, 15.700 ± 1.992 × 10(-3)  mm(2)/s, 0.503 ± 0.068), hemangiomas (1.505 ± 0.226 × 10(-3)  mm(2)/s, 11.675 ± 0.456 × 10(-3)  mm(2)/s, 0.682 ± 0.060), and BSTTEHs (1.555 ± 0.176 × 10(-3)  mm(2)/s, 11.727 ± 0.686 × 10(-3)  mm(2)/s, 0.675 ± 0.054). And there was no significant difference for these 3 parameters between hemangiomas and BSTTEHs (P = 0.584, 0.907, and 0.798). IVIM may be of significant value for differential diagnosing hemangiomas, BSTTEHs, and STSs.
authors.affiliation: From the Department of Radiology, First Affiliated Hospital of Dalian Medical University (JD, WZ, QS, AL, YM, ZL, LZ, MZ); Department of Radiology, Second Affiliated Hospital of Dalian Medical University (SW); and Department of orthopedics, Second Affiliated Hospital of Dalian Medical University, Dalian, China (KL).
authors.forename: Jun
authors.initials: J
authors.lastname: Du
authors.forename: Kun
authors.initials: K
authors.lastname: Li
authors.forename: Weisheng
authors.initials: W
authors.lastname: Zhang
authors.forename: Shaowu
authors.initials: S
authors.lastname: Wang
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Song
authors.forename: Ailian
authors.initials: A
authors.lastname: Liu
authors.forename: Yanwei
authors.initials: Y
authors.lastname: Miao
authors.forename: Zhijin
authors.initials: Z
authors.lastname: Lang
authors.forename: Lina
authors.initials: L
authors.lastname: Zhang
authors.forename: Minting
authors.initials: M
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000175:diagnosis*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis*; D055815:Young Adult