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Measurement and scan reproducibility of parameters of intravoxel incoherent motion in renal tumor and normal renal parenchyma: a preliminary research at 3.0 T MR

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Abstract

Purpose

To prospectively estimate measurement and scan reproducibility of parameters of intravoxel incoherent motion (IVIM) in renal tumors, normal renal cortex, and medulla.

Methods

Twenty-four consecutive patients (twelve males and twelve females; median age 56.7 years, range 32–71 years) with 25 renal tumors (20 renal cell carcinomas, one urothelium carcinoma, three angiomyolipomas, and one oncocytoma) were examined twice using IVIM1 and IVIM2 with 9 and 16 b values, respectively, at 3.0 T. All the patients were re-scanned in 24–48 h. Regions of interest (ROIs) were placed in solid part of tumor, normal cortex, and medulla to derive IVIM parameters D (true diffusion coefficient), D* (pseudodiffusion coefficient), and f (perfusion fraction of pseudodiffusion). Differences in parameters between two IVIM sets and intra-observer, inter-observer, and scan–rescan differences were assessed using paired t tests. Intra-observer, inter-observer, and scan–rescan reproducibility were assessed by measuring coefficient of variation and Bland–Altman limits of agreements.

Results

Intra-observer reproducibility of renal tumors, normal renal cortex, and medulla was excellent for apparent diffusion coefficient (ADC; CV: 3.45%–5.34%, BA-LA: −14% to 18%) and D (CV: 3.65% to 6.04%, BA-LA: −18% to 19%), good for f (CV: 11.96%–16.08%, BA-LA: −76.4% to 92.1% except f of medulla with CV of 32.59% and BA-LA of −76.4% to 92.1% in IVIM1), and poor for D* (CV: 25.0% to 75.4%, BA-LA: −111% to 150%). The same order was in inter-observer reproducibility analysis. Scan–rescan reproducibility was the worst of the three parameters. Renal medulla showed worse reproducibility than renal tumors and the normal cortex. The metrics of IVIM2 had better reproducibility than IVIM1.

Conclusion

Excellent reproducibility evaluation for ADC and D, good for f, and poor for D* derived from IVIM was performed in renal tumors, normal renal cortex, and medulla. D* has limited reliability and scan–rescan reproducibility should be improved.

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Acknowledgements

We thank Xu Zhang (Department of Urology) and Aitao Guo (Department of Pathology) from General Hospital of PLA for their thoughtful suggestions and technical support.

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Correspondence to Haiyi Wang or Huiyi Ye.

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Funding

This study was funded by the National Natural Science Foundation of China (Grant Number 81471641). The funders had no role in research design, data collection and analysis, decision to publish, or preparation of the manuscript.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Pan, J., Zhang, H., Man, F. et al. Measurement and scan reproducibility of parameters of intravoxel incoherent motion in renal tumor and normal renal parenchyma: a preliminary research at 3.0 T MR. Abdom Radiol 43, 1739–1748 (2018). https://doi.org/10.1007/s00261-017-1361-7

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  • DOI: https://doi.org/10.1007/s00261-017-1361-7

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