Intravoxel incoherent motion diffusion-weighted imaging for characterizing focal hepatic lesions: Correlation with lesion enhancement.
To evaluate the value of intravoxel incoherent motion (IVIM) parameters for characterizing focal hepatic lesions, and to assess the correlation between IVIM parameters and arterial nodule enhancement.



We retrospectively evaluated 161 lesions (91 hepatocellular carcinomas [HCCs], 27 intrahepatic cholangiocarcinomas [IHCCs], 20 hemangiomas, 9 combined hepatocellular-cholangiocarcinomas, 9 metastases, and 5 other tumors) in 161 patients (105 men and 56 women; mean age, 56.4 years). Diffusion-weighted imaging was performed using nine b-values (0-900 s/mm2) at 1.5T. Apparent diffusion coefficient (ADC), molecular diffusion coefficient (Dslow), perfusion fraction (f), and perfusion-related diffusion coefficient (Dfast) were compared among the hepatic lesions using analysis of variance (ANOVA). Receiver-operating-characteristic analysis was performed to assess diagnostic performance. The enhancement fraction (EF) and the relative enhancement (RE) of the hepatic lesions on arterial phase gadoxetic acid-enhanced images were correlated with the IVIM parameters using Spearman's test.



For the differentiation of hemangiomas from malignant tumors, Dslowshowed the largest area under the curve (0.933) among all parameters. Although ADC did not show any difference among malignant lesions (P ≥ 0.28), HCCs showed a significantly lower Dslowthan IHCC (P < 0.001) and a higher f than did IHCC (P < 0.001) and metastasis (P = 0.027); f had a significant positive correlation with EF (r = 0.420, P < 0.001) and RE (r = 0.264, P = 0.001).



IVIM parameters are more helpful in characterizing malignant hepatic lesions than ADC; f may reflect the extent and degree of hepatic nodule enhancement in the arterial phase, and may allow for differentiation of HCC from IHCC and metastasis.



3 J. MAGN. RESON. IMAGING 2017;45:1589-1598.
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
In Young
IY
Choi
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Seung Soo
SS
Lee
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Yu Sub
YS
Sung
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Hyunhee
H
Cheong
University of Ulsan, College of Medicine, Seoul, Korea.
Hoyoung
H
Lee
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Jae Ho
JH
Byun
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
So Yeon
SY
Kim
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
So Jung
SJ
Lee
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Yong Moon
YM
Shin
Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Moon-Gyu
MG
Lee
D000465:Algorithms; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
D003287:Contrast Media
diffusion-weighted imaging; focal hepatic lesion; intravoxel incoherent motion; magnetic resonance imaging; quantitative imaging biomarker