Accurate IVIM model-based liver lesion characterisation can be achieved with only three b-value DWI
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The objective of this study was to evaluate a simplified intravoxel incoherent motion (IVIM) approach of diffusion-weighted imaging (DWI) with four b-values for liver lesion characterisation at 1.5 T.
DWI data from a respiratory-gated MRI sequence with b = 0, 50, 250, 800 s/mm2 were retrospectively analysed in 173 lesions and 40 healthy livers. The apparent diffusion coefficient ADC = ADC(0,800) and IVIM-based parameters D1′ = ADC(50,800), D2′ =ADC(250,800), f1′, f2′, D*′, ADClow = ADC(0,50), and ADCdiff=ADClow-D2′ were calculated voxel-wise without fitting procedures. Differences between lesion groups were investigated.
Focal nodular hyperplasias were best discriminated from all other lesions by f1′ with an area under the curve (AUC) of 0.989. Haemangiomas were best discriminated by D1′ (AUC of 0.994). For discrimination between malignant and benign lesions, ADC(0,800) and D1′ were best suited (AUC of 0.915 and 0.858, respectively). Discriminatory power was further increased by using a combination of D1′ and f1′.
IVIM parameters D and f approximated from three b-values provided more discriminatory power between liver lesions than ADC determined from two b-values. The use of b = 0, 50, 800 s/mm2 was superior to that of b = 0, 250, 800 s/mm2. The acquisition of four instead of three b-values has no further benefit for lesion characterisation.
• Diffusion and perfusion characteristics are assessable with only three b-values.
• Association of b = 0, 50, 800 s/mm2is superior to b = 0, 250, 800 s/mm2.
• A fourth acquired b-value has no benefit for differential diagnosis.
• For liver lesion characterisation, simplified IVIM analysis is superior to ADC determination.
• Simplified IVIM approach guarantees numerically stable, voxel-wise results and short acquisition times.
KeywordsDiffusion magnetic resonance imaging Carcinoma, hepatocellular Liver neoplasms Haemangioma Focal nodular hyperplasia
Apparent diffusion coefficient
Area under the curve
Focal nodular hyperplasia
Intravoxel incoherent motion
Region of interest
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Petra Mürtz.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• diagnostic study
• performed at one institution
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