Abstract
This study was aimed to determine the diagnostic performance of perfusion-related parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) by comparing them with quantitative parameters from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on differentiation grades of rectal cancer. We retrospectively analyzed 98 patients with rectal cancer. Perfusion-related IVIM parameters (D∗, f, and f·D∗) and quantitative DCE parameters (Ktrans, Kep, Ve, and Vp) were obtained by plotting the volume-of-interest on in-house software. Furthermore, we compared the difference and diagnostic performance of all well-moderately and poorly differentiated rectal cancer parameters. Finally, we analyzed the correlation between those DCE and IVIM parameters and pathological differentiation grade. The values of f, Ktrans, and Kep significantly differentiated poor and well-moderate rectal cancers. Ktrans achieved the highest area under the curve (AUC) value compared to perfusion-related IVIM and DCE parameters. Furthermore, Ktrans showed a better correlation with pathological differentiation grade than f. The diagnostic efficiency of DCE-MRI was greater than perfusion-related IVIM parameters. The f value derived from perfusion-related IVIM offered a diagnostic performance similar to DCE-MRI for patients with renal insufficiency.
Highlights
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a quantitative technique that measures the capillary blood perfusion parameters of the tissue using intravenous contrast media and evaluates tissue properties such as capillary permeability and extracellular volume fraction that indirectly reflect the microcirculation and hemodynamics in the tissue [1]
Quantitative parameters derived from IVIM-DWI can separate true molecular diffusion from the motion of water molecules [6], including pure diffusion coefficient (D), which represents the true tissue cellularity and diffusion; pseudo diffusion coefficient (D∗), which represents incoherent microcirculation; and perfusion fraction (f ), which represents the number of protons linked to microcirculation [7]
D values derived from IVIM-DWI demonstrated superior performance compared with ADC value, and perfusion-related IVIM parameters showed a correlation with quantitative parameters from DCE-MRI
Summary
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a quantitative technique that measures the capillary blood perfusion parameters of the tissue using intravenous contrast media and evaluates tissue properties such as capillary permeability and extracellular volume fraction that indirectly reflect the microcirculation and hemodynamics in the tissue [1]. DCEMRI is not suitable for patients with contraindication to contrast media. Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) collects multiple images containing low b values without using intravenous contrast media and Computational and Mathematical Methods in Medicine analyzes them using a biexponential model. D values derived from IVIM-DWI demonstrated superior performance compared with ADC value, and perfusion-related IVIM parameters showed a correlation with quantitative parameters from DCE-MRI. Further research is still needed to compare the diagnostic performance of perfusion-related IVIM parameters and quantitative parameters from DCE-MRI
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