Abstract
To investigate the influence of respiratory-cardiac double triggering (RCT) on intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for the liver, twelve healthy volunteers underwent liver DWI twice respectively with respiratory triggering (RT) and RCT schemes. Signal-to-noise ratios (SNRs) of the images, values, repeatability (evaluating with within-subject coefficient of variation), and variability of quantitative parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), perfusion fraction (f), and perfusion-related diffusion coefficient (D*), were evaluated for each DWI sequence. Results showed that the use of RCT scheme significantly enhanced SNRs (P < 0.001), improved the measurement precision (P ≤ 0.023) and repeatability (P ≤ 0.009) of ADC, D, and f values, decreased the variability of ADC and D values (P ≤ 0.015). Furthermore, this improvement was not completely confined to the left liver lobe, but also observed for the right liver lobe. Moreover, the precision of D* values in the right lobe (P < 0.001) and its repeatability in the left lobe (P = 0.002) were also significantly improved. Thus, our findings suggest that RCT is a more effective physiological scheme for improving SNRs, the precision, repeatability, and variability of quantitative parameters than RT for IVIM-DWI in the liver.
Highlights
As a rapidly developing functional sequence, diffusion-weighted (DW) magnetic resonance (MR) imaging could provide the overall diffusion and microperfusion information in biological tissues, the apparent diffusion coefficient (ADC), and separated pure diffusion coefficient (D), perfusion fraction (f), and perfusion-related diffusion coefficient (D*), which based on the theory of intravoxel incoherent motion (IVIM) [1, 2]
For respiratory triggering (RT) diffusion-weighted imaging (DWI), the Signal-to-noise ratios (SNRs) was 16.71–24.75 in the left liver lobe and 22.69–33.49 in the right liver lobe
DW MR imaging is susceptible to various kinds of motions, from microscopic diffusion of water molecules to macroscopic physiological motions, and the latter www.impactjournals.com/oncotarget could lead to low SNRs, measurement error, enhanced variability, and decreased repeatability of ADC and IVIM parameters [7, 13]
Summary
As a rapidly developing functional sequence, diffusion-weighted (DW) magnetic resonance (MR) imaging could provide the overall diffusion and microperfusion information in biological tissues, the apparent diffusion coefficient (ADC), and separated pure diffusion coefficient (D), perfusion fraction (f), and perfusion-related diffusion coefficient (D*), which based on the theory of intravoxel incoherent motion (IVIM) [1, 2] These quantitative parameters have been increasingly reported as promising tools for diagnostic work-up of the cranial and extracranial diseases [3,4,5,6]. It is well known that the MR imaging of the liver is susceptive to physiology motions, such as respiratory and cardiac motion, which leads to signal loss, motion artifacts, blurring images, and the variability of quantitative parameters. The necessity to employ additional cardiac triggering has not reached a consensus
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