title: Assessment of the link between quantitative biexponential diffusion-weighted imaging and contrast-enhanced MRI in the liver.
abstract: To investigate if intravoxel incoherent motion (IVIM) modeled diffusion-weighted imaging (DWI) can be linked to contrast-enhanced (CE-)MRI in liver parenchyma and liver lesions.
  
  
  
  Twenty-five patients underwent IVIM-DWI followed by multiphase CE-MRI using Gd-EOB-DTPA (n=20) or Gd-DOTA (n=5) concluded with IVIM-DWI. Diffusion (Dslow), microperfusion (Dfast), its fraction (ffast), wash-in-rate (Rearly) and late-enhancement-rate (Rlate) of Gd-EOB-DTPA were calculated voxel-wise for the liver. Parenchyma and lesions were segmented. Pre-contrast IVIM was compared 1) between low, medium and high Rearlyfor parenchyma 2) to post-contrast IVIM substantiated with simulations 3) between low and high Rlateper lesion type.
  
  
  
  Dfastand ffastincreased (P<0.001) with 25.6% and 33.8% between low and high Rearlyof Gd-EOB-DTPA. Dslowdecreased (-15.0%; P<0.001) with increasing Rearly. Gd-DOTA demonstrated similar observations. ffast(+10%; P<0.001) and Dfast(+6.6%; P<0.001) increased after Gd-EOB-DTPA, while decreasing after Gd-DOTA (-4.2% and -5.7%, P<0.001) and were confirmed by simulations. For focal nodular hyperplasia lesions (n=5) Dfastand ffastincreased (P<0.001) with increasing Rlate, whereas for hepatocellular carcinoma (n=4) and adenoma (n=7) no differences were found.
  
  
  
  Microperfusion measured by IVIM reflects perfusion in a way resembling CE-MRI. Also IVIM separated intra- and extracellular MR contrast media. This underlines the potential of IVIM in quantitative liver imaging.
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, EB44, PO Box 30001, 9700, RB, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Radiology, EB44, PO Box 30001, 9700, RB, Groningen, The Netherlands. Electronic address: h.dijkstra01@umcg.nl.
authors.forename: Hildebrand
authors.initials: H
authors.lastname: Dijkstra
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, EB44, PO Box 30001, 9700, RB, Groningen, The Netherlands.
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Radiology, EB44, PO Box 30001, 9700, RB, Groningen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Kappert
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Radiology, EB44, PO Box 30001, 9700, RB, Groningen, The Netherlands.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Sijens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D019786:Gadolinium DTPA; D006571:Heterocyclic Compounds; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C073590:gadolinium ethoxybenzyl DTPA; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate; D019786:Gadolinium DTPA
keywords: Contrast media; Diffusion magnetic resonance imaging; Liver; Perfusion; Pharmacokinetics