Abstract

ObjectivesTo evaluate repeatability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters in the orbit.MethodsFrom December 2015 to March 2016, 22 patients were scanned twice using an IVIM sequence with 15b values (0–2,000 s/mm2) at 3.0T. Two readers independently delineated regions of interest in an orbital mass and in different intra-orbital and extra-orbital structures. Short-term test-retest repeatability and inter-observer agreement were assessed using the intra-class correlation coefficient (ICC), the coefficient of variation (CV) and Bland-Altman limits of agreements (BA-LA).ResultsTest-retest repeatability of IVIM parameters in the orbital mass was satisfactory for ADC and D (mean CV 12% and 14%, ICC 95% and 93%), poor for f and D*(means CV 43% and 110%, ICC 90% and 65%). Inter-observer repeatability agreement was almost perfect in the orbital mass for all the IVIM parameters (ICC = 95%, 93%, 94% and 90% for ADC, D, f and D*, respectively).ConclusionsIVIM appeared to be a robust tool to measure D in orbital lesions with good repeatability, but this approach showed a poor repeatability of f and D*.Key Points• IVIM technique is feasible in the orbit.• IVIM has a good–acceptable repeatability of D (CV range 12–25 %).• IVIM interobserver repeatability agreement is excellent (ICC range 90–95 %).• f or D* provide higher test-retest and interobserver variabilities.

Highlights

  • Diffusion-weighted imaging (DWI) using magnetic resonance imaging (MRI) was described by Le Bihan in 1986 as beingEur Radiol (2017) 27:5094–5103 sensitive to displacement of water protons in tissues due to both random Brownian motion as well as capillary perfusion [1, 2]

  • The quality of apparent diffusion coefficient (ADC) and Intravoxel incoherent motion (IVIM) parametric maps was considered good for subsequent analysis for all patients, and no patient had to be secondarily excluded from the study because of artefacts masking or distorting orbital tumours

  • Test-retest repeatability of IVIM in the orbital tumours was good for ADC and D, but was poor for f and especially D*

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Summary

Introduction

Diffusion-weighted imaging (DWI) using magnetic resonance imaging (MRI) was described by Le Bihan in 1986 as beingEur Radiol (2017) 27:5094–5103 sensitive to displacement of water protons in tissues due to both random Brownian motion as well as capillary perfusion [1, 2]. Â SðbÞ 1⁄4 Sð0Þ f e−bD* þ ð1− f Þe−bDÃ This model has been shown to provide a pertinent description of the DW signal measured in highly vascular organs [3]. Due to both improvement of MR devices and post-treatment softwares, IVIM has become more available in clinical practice. It has been tested and proved useful in a variety of organs, such as prostate, liver, abdomen, kidney and pelvis, and in the head and neck [4,5,6,7,8], to diagnose liver diseases, characterise tumours, or assess and monitor tissue response to treatment [4,5,6,7,8]. One issue is repeatability, which has been evaluated over time in brain imaging [9, 10] or abdominal imaging [11,12,13,14,15]

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