Abstract
Objective
To determine the measurement reproducibility of perfusion fraction f, pseudodiffusion coefficient D * and diffusion coefficient D in colorectal liver metastases and normal liver.
Methods
Fourteen patients with known colorectal liver metastases were examined twice using respiratory-triggered echo-planar DW-MRI with eight b values (0 to 900 s/mm2) 1 h apart. Regions of interests were drawn around target metastasis and normal liver in each patient to derive ADC (all b values), ADChigh (b values ≥100 s/mm2) and intravoxel incoherent motion (IVIM) parameters f, D * and D by least squares data fitting. Short-term measurement reproducibility of median ADC, ADChigh, f, D * and D values were derived from Bland–Altman analysis.
Results
The measurement reproducibility for ADC, ADChigh and D was worst in colorectal liver metastases (−21 % to +25 %) compared with liver parenchyma (−6 % to +8 %). Poor measurement reproducibility was observed for the perfusion-sensitive parameters of f (−75 % to +241 %) and D * (−89 % to +2,120 %) in metastases, and to a lesser extent the f (−24 % to +25 %) and D* (−31 % to +59 %) of liver.
Conclusions
Estimates of f and D * derived from the widely used least squares IVIM fitting showed poor measurement reproducibility. Efforts should be made to improve the measurement reproducibility of perfusion-sensitive IVIM parameters.
Key Points
• Quantitative diffusion-weighted MRI parameters are increasingly used for clinical management decisions.
• However perfusion-sensitive intravoxel incoherent motion (IVIM) parameters showed poor measurement reproducibility.
• Measurement reproducibility of IVIM parameters was worse in metastases than normal liver.
• Efforts to improve measurement reproducibility of IVIM parameters should be explored.
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Acknowledgments
This work was supported by the Cancer Research UK and EPSRC Cancer Imaging Centre in association with the MRC and Department of Health (England) grant #C1060/A10334 and NHS funding to the NIHR Biomedical Research Centre.
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Andreou, A., Koh, D.M., Collins, D.J. et al. Measurement reproducibility of perfusion fraction and pseudodiffusion coefficient derived by intravoxel incoherent motion diffusion-weighted MR imaging in normal liver and metastases. Eur Radiol 23, 428–434 (2013). https://doi.org/10.1007/s00330-012-2604-1
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DOI: https://doi.org/10.1007/s00330-012-2604-1