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Diffusion-Weighted MR Imaging

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Functional Imaging in Oncology

Abstract

MRI is an attractive imaging modality in oncology owing to its lack of ionising radiation and exquisite soft tissue contrast. While conventional MRI provides invaluable morphological information, it gives little functional information. Diffusion-weighted MRI (DW-MRI) derives its contrast from the movement of water molecules in the tissue microenvironment and thus provides an insight into tissue cellularity and architecture.

Einstein formalised the mathematical description of Brownian motion in 1905, but it was not until 1965 that water diffusion in nuclear magnetic resonance (NMR) was studied and described by Stejskal and Tanner. It took another 20 years for DW-MRI to be employed clinically. Among the first clinical application, DW-MRI was used to evaluate ischaemic stroke. Its utility soon broadened to include brain tumours, and the technological advances in the last decade have enabled its use in extracranial malignancies. DW-MRI is quick to perform and non-invasive and can be applied for lesion detection, disease characterisation and assessment of treatment response. Quantitative measurements derived from DW-MRI are potential imaging biomarkers to predict likelihood of treatment response and prognosis in oncology.

In this chapter, we will review the principles of DW-MR imaging, its technical considerations, image interpretation and its broad application in oncology. Discussions related to DW-MRI in specific diseases will be reviewed in subsequent chapters.

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Abbreviations

ADC:

Apparent diffusion coefficient

AP:

Anterior-posterior

CT:

Computed tomography

D :

Tissue diffusivity

D*:

Pseudodiffusion coefficient

DDC:

Distributed diffusion coefficient

DWIBS:

Diffusion weighted imaging with body signal suppression

DW-MRI:

Diffusion weighted MRI

EPI:

Echo-planar imaging

18F:

18Fluorine

FDG:

Fluoro-2-deoxy-d-glucose

fDM:

Functional diffusion map

f V :

Fractional volume of flowing water molecules within the capillaries

GRAPPA:

Generalized Autocalibrating Partially Parallel Acquisition

IR:

Inversion recovery

IVIM:

Intravoxel incoherent motion

MPG:

Motion probing gradients

PET:

Positron emission tomography

ROI:

Region of interest

SENSE:

Sensitivity encoding

SNR:

Signal-to-noise ratio

SPAIR:

Spectral attenuated inversion recovery

TR:

Repetition time

α :

Stretching parameter

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Acknowledgements

The authors would like to thank Mr. David J. Collins (Institute of Cancer Research, London) for his insight and helpful comments on the physics and technical aspect of this chapter.

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Authors and Affiliations

  1. Department of Radiology, Royal Marsden Hospital, Surrey, UK

    Henry H. Tam MBBS, BSc (Hons), FRCR & Dow-Mu Koh MBBS, MD, MRCP, FRCR

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  1. Henry H. Tam MBBS, BSc (Hons), FRCR
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  2. Dow-Mu Koh MBBS, MD, MRCP, FRCR
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Correspondence to Henry H. Tam MBBS, BSc (Hons), FRCR .

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Editors and Affiliations

  1. Health Time Group, Jaén, Spain

    Antonio Luna

  2. Dept. of MRI, Clínica Girona, Girona, Spain

    Joan C. Vilanova

  3. Botafogo - Rio de Janeiro/RJ, Brazil

    L. Celso Hygino da Cruz Jr.

  4. Centro de Diagnóstico Dr. Enrique Rossi, Buenos Aires, Argentina

    Santiago E. Rossi

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Tam, H.H., Koh, DM. (2014). Diffusion-Weighted MR Imaging. In: Luna, A., Vilanova, J., Hygino da Cruz Jr., L., Rossi, S. (eds) Functional Imaging in Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40412-2_14

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