Low B-value Diffusion-weighted Imaging Research Articles

Reconstruction of intra- and extra-neurite conductivity tensors via conductivity at Larmor frequency and DWI data patterns

The developed magnetic resonance electrical properties tomography (MREPT) techniques visualize the internal conductivity distribution at Larmor frequency by measuring the B1 transceive phase data. In biological tissues, electrical conductivity is influenced by ion concentrations and mobility. To visualize the anisotropic conductivity tensor of biological tissues, we use the Einstein–Smoluchowski equation, which links the diffusion coefficient to particle mobility. By assuming a correlation between ion mobility and water diffusivity, we aim to decompose the internal isotropic conductivity at Larmor frequency into anisotropic conductivity tensors within the intra- and extra-neurite compartments. The multi-compartment spherical mean technique (MC-SMT), utilizing both high and low b-value diffusion-weighted imaging (DWI) data, characterizes the diffusion of water molecules within and across the intra- and extra-neurite compartments by analyzing the microstructural intricacies and the foundational architectural arrangement of the brain’s tissues. By analyzing the relationships between the measured DWI data, the microscopic diffusion signal, and the fiber orientation distribution function, we predict the DWI data for the intra- and extra-neurite compartments using spherical harmonic decomposition. Using the predicted DWI data for the intra- and extra-neurite compartments, we develop a conductivity tensor imaging method that operates specifically within the separated compartments. Human brain experiments, involving four healthy volunteers and a brain tumor patient, were performed to assess and confirm the reliability of the proposed method.

Evaluation of Weighted Diffusion Subtraction for Detection of Clinically Significant Prostate Cancer.

Diffusion-weighted imaging (DWI) is an important method for clinically significant prostate cancer (csPCa) diagnosis; however, the Prostate Imaging-Reporting and Data System (PI-RADS) requires the subjective assessment of "markedly hypointense or not" on apparent diffusion coefficient (ADC) map. We hypothesize that weighted diffusion subtraction (WDS) images, created by weighted subtraction of high and low b-value DWIs, might better show areas of ADC values below a set threshold, thus decreasing the subjectivity of the assessment. To evaluate the diagnostic ability of WDS for csPCa by comparing scores based on WDS images (DWI/WDS) with those based on PI-RADS DWI (DWI/ADC). Retrospective. Eighty-six PCa patients. 3.0 T; DWI. Four readers assessed the probability of csPCa in lesions (overall, in the peripheral zone [PZ] and transitional zone [TZ]) using 5-point DWI/ADC and DWI/WDS scores. Prostatectomy specimens were the reference standard. ADC values and contrast between csPCa and normal prostate tissue on ADC maps and WDS images were calculated with reference to the pathological map. Diagnostic ability was evaluated by Jackknife alternative free-response receiver-operating characteristic curve. Figure of merit (FOM), sensitivity, and positive predictive value (PPV) between the DWI/ADC and DWI/WDS scores were compared using paired t-test. Inter-reader agreement was analyzed using κ statistics, and the significance probability was calculated using the Z statistic. Wilcoxon signed-rank test was used to compare contrast between csPCa and normal prostate tissue on ADC maps and WDS images. A P value <0.05 was considered statistically significant. FOM and sensitivity of the DWI/WDS scores were significantly better than those of the DWI/ADC scores overall, in the PZ and TZ (FOM: overall, 0.715 vs. 0.783; PZ, 0.756 vs. 0.815; TZ, 0.653 vs. 0.738. Sensitivity: overall, 0.512 vs. 0.607; PZ, 0.485 vs. 0.573; TZ, 0.636 vs. 0.761). For PPV, a statistically significant difference was observed overall (0.727 vs. 0.777). The κ value of DWI/WDS score was significantly higher than that of DWI/ADC score overall and in the PZ (overall, 0.614 vs. 0.792; PZ, 0.609 vs. 0.797). Contrast was significantly higher overall in the PZ and TZ in WDS images (median, 1.26, 1.19, and 1.61) than in ADC maps (0.46, 0.47, and 0.41). WDS images performed better than ADC maps in the diagnosis of csPCa and in inter-reader agreement of the diagnosis. 4 Technical Efficacy Stage: 2.

Detection of mural inflammation with low b-value diffusion-weighted imaging in patients with active Takayasu Arteritis.

To evaluate the performance of low b-value diffusion-weighted imaging (DWI) for detection of inflamed vessels in active Takayasu arteritis (TA). Forty patients with active TA involving the thoracic aorta and its super-aortic branches underwent low b-value (50 s/mm2) DWI, T2-weighted imaging (T2WI), and delayed enhancement T1-weighted imaging (DEI). Corresponding images on these 3 sequences at the same diseased level were evaluated qualitatively and quantitatively using Friedman and Kruskal-Wallis test, and the agreement between them in detection of inflamed vessels was assessed using Cochran's Q test. The overall image quality of DEI, DWI, and T2WI was scored 7.97 ± 1.15, 7.32 ± 1.73, and 6.51 ± 1.69 respectively. The score of DEI and DWI was higher than that of T2WI (p < 0.001). The quality of blood suppression was rated higher in DWI than T2WI and DEI (p < 0.001). Both the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the diseased vessel walls measured on DEI and DWI were significantly higher than those on T2WI (p < 0.001). However, there was no significant difference in SNR and CNR between DEI and DWI (p = 0.283 and 0.063). In detection of mural inflammation, significant advantage was observed when comparing the findings from DEI/DWI to those from T2WI (p < 0.001). But no significant difference was found between the findings of DWI and DEI (p > 0.99). Low b-value DWI may be used as a promising alternative to DEI for detecting inflamed vessels in active TA. • Currently, the most widely used imaging modality in detection of mural inflammation is contrast-enhanced MRI. • Low b-value DWI is shown comparable to contrast-enhanced MRI and superior to T2WI in identifying mural inflammation in patients with active Takayasu arteritis. • Low b-value DWI is a fast and unenhanced MRI technique which may potentially replace contrast-enhanced MRI in identifying disease activity of Takayasu arteritis.

Evaluating the Effect of Arterial Pulsation on Cerebrospinal Fluid Motion in the Sylvian Fissure of Patients with Middle Cerebral Artery Occlusion Using Low b-value Diffusion-weighted Imaging.

PurposeDecrease in signal of the cerebrospinal fluid (CSF) on low b-value diffusion weighted image (DWI) due to non-uniform flow can provide additional information regarding CSF motion. The purpose of the current study was to evaluate whether arterial pulsations constitute the driving force of CSF motion.MethodsWe evaluated the CSF signals within the Sylvian fissure on low b-value DWI in 19 patients with unilateral middle cerebral artery (MCA) occlusion. DWI with b-value of 500 s/mm2 was evaluated for a decrease in CSF signal within the Sylvian fissure including the Sylvian vallecula and lower, middle, and higher Sylvian fissures and graded as follows: the same as contralateral side; smaller signal decrease than that on contralateral side; and no signal decrease. MR angiography (MRA) findings of MCA were graded as follows: the same as contralateral, lower signal than contralateral signal, and no signal. In 15 patients, regional cerebral blood flow (rCBF) was evaluated using single-photon emission computed tomography (SPECT) studies and graded as > 90%, 90%–70%, and < 70% rCBF compared to contralateral. The correlations between the gradings were evaluated using G likelihood-ratio test.ResultsThere was no statistically significant correlation between the MRA and low b-value DWI gradings of CSF in all areas. There were statistically significant correlations between the decreases in CBF on SPECT and CSF signals in the middle Sylvian fissure.ConclusionThe driving force of CSF pulsation in the Sylvian sinus may be related to the pulsations of the cerebral hemisphere rather than direct arterial pulsations.

The assessment of mild encephalopathy with a reversible splenial lesion (MERS) using high b-value DWI

Introduction:Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) was shown to have a transient reduction in diffusion. Such changes would be used as an early detection to reduce excessive treatments and promote recovery without sequelae. The current research evaluated the high b-value (b = 3000 s/mm2) diffusion-weighted imaging (DWI) assessment in MERS.Methods:Sixteen pediatric patients showed MERS used DWI (b = 1000 and 3000 s/mm2). To record number of lesions, the signal intensities, signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), contrast ratios (CRs), the apparent diffusion coefficients (ADCs) were measured in the normal parenchyma and lesions.Results:Lesions were more apparent with high b-value. The ADC values and CNR in the lesions and surrounding normal brain parenchyma were relatively low at a high compared to standard b-value DWI (SNR: 144.67 ± 33.03, 85.72 ± 31.50; CNR: 20.82 ± 17.64, 49.62 ± 33.06; for b = 1000 and 3000 s/mm2). The CR was significantly higher at a high compared to low b-value DWI (CR: 0.06 ± 0.07 versus 0.40 ± 0.14).Conclusion:High b-value DWI could detect more lesions and could obviously improve the detection of lesions in pediatric patients with MERS.

Conspicuity of Malignant Liver Tumors on Diffusion-Weighted Imaging With Short tau Inversion Recovery After Gadolinium Ethoxybenzyl Diethylenetriaminepentaacetic Acid Administration.

Diffusion-weighted imaging (DWI) has been used for the detection and characterization of liver tumors because it has excellent contrast resolution. DWI using short tau inversion recovery (STIR) can improve tumor-to-liver contrast after gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) administration that shortens the T1 relaxation of liver parenchyma. To quantitatively and qualitatively compare the conspicuity of malignant liver tumors on DWI after Gd-EOB-DTPA administration between STIR and chemical shift selective (CHESS) sequences. Single-institution retrospective study. Fifty-seven patients with histologically confirmed malignant liver tumors were evaluated. Low b-value DWIs with STIR and CHESS sequences 18-20 minutes after Gd-EOB-DTPA administration were acquired at 1.5T. Tumor contrast-to-noise ratio (CNR) and visual grade of tumor conspicuity on DWI between STIR and CHESS sequences were compared. Paired Student's t-test and the Wilcoxon signed rank-test were applied. P < 0.05 was considered statistically significant. The mean tumor CNR and visual grade of tumor conspicuity on DWI were significantly higher for STIR than for CHESS (both P < 0.001). Regardless of the presence of chronic liver disease, the mean CNR (normal liver 33.5 ± 19.8 vs. 15.7 ± 12.2, P < 0.001; chronic liver disease 19.6 ± 11.0 vs. 9.2 ± 7.8, P < 0.001) and the visual conspicuity grade (normal liver 3.36 ± 0.64 vs. 2.56 ± 0.77, P < 0.001; chronic liver disease 2.94 ± 0.80 vs. 2.25 ± 0.84, P = 0.001) were significantly higher for STIR than for CHESS. Mean CNR and the visual conspicuity grade were also significantly higher for STIR than for CHESS in patients with hepatocellular carcinomas (CNR 18.1 ± 10.5 vs. 8.8 ± 7.2, P < 0.001; visual grade 2.88 ± 0.83 vs. 2.22 ± 0.87, P = 0.001) or metastases (CNR 35.0 ± 19.3 vs. 16.2 ± 13.1, P < 0.001; visual grade 3.45 ± 0.51 vs. 2.59 ± 0.73, P < 0.001). DWI using STIR may be more helpful for depicting malignant liver tumors after Gd-EOB-DTPA administration compared with DWI using CHESS. 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:565-573.

Low b-value diffusion weighted imaging is promising in the diagnosis of brain death and hypoxic-ischemic injury secondary to cardiopulmonary arrest

BackgroundCardiorespiratory arrest can result in a spectrum of hypoxic ischemic brain injury leading to global hypoperfusion and brain death (BD). Because up to 40% of patients with BD are viable organ donors, avoiding delayed diagnosis of this condition is critical. High b-value diffusion weighted imaging (DWI) measures primarily molecular self-diffusion; however, low b-values are sensitive to perfusion. We investigated the feasibility of low b-value DWI in discriminating the global hypoperfusion of BD and hypoxic ischemic encephalopathy (HIE).MethodsWe retrospectively reviewed cardiorespiratory arrest subjects with a diagnosis of HIE or BD. Inclusion criteria included brain DWI acquired at both low (50 s/mm2) and high (1000–2000 s/mm2) b-values. Automated segmentation was used to determine mean b50 apparent diffusion coefficient (ADC) values in gray and white matter regions. Normal subjects with DWI at both values were used as age- and sex-matched controls.ResultsWe evaluated 64 patients (45 with cardiorespiratory arrest and 19 normal). Cardiorespiratory arrest patients with BD had markedly lower mean b50 ADC in gray matter regions compared with HIE (0.70 ± 0.18 vs. 1.95 ± 0.25 × 10−3 mm2/s, p < 0.001) and normal subjects (vs. 1.79 ± 0.12 × 10−3 mm2/s, p < 0.001). HIE had higher mean b50 ADC compared with normal (1.95 ± 0.25 vs. 1.79 ± 0.12 × 10−3 mm2/s, p = 0.016). There was wide separation of gray matter ADC values in BD subjects compared with age matched normal and HIE subjects. White matter values were also markedly decreased in the BD population, although they were less predictive than gray matter.ConclusionLow b-value DWI is promising for the discrimination of HIE with maintained perfusion and brain death in cardiorespiratory arrest.

Low b‐value diffusion‐weighted imaging: Emerging applications in the body

Thanks to recent advances in magnetic resonance imaging technology, it has become possible to perform intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) in any part of the body. Extracranial applications of DWI are currently under active investigation, especially for oncological imaging. However, the use of non-quantitative low b-value (10-100 s/mm(2)) DWI in the body is still a relatively unexplored field, and its potential is not fully recognized. Non-quantitative low b-value DWI may especially be useful for the evaluation of structures that have an inherently low signal at high b-value DWI, including (but not limited to) the liver, heart, and small bowel. This article will review and discuss the basic principles and potential applications of nonquantitative low b-value DWI in the body.

Application of high b-value MR diffusion weighted imaging for malignant and benign breast lesions

Objective To evaluate the application of high b-value diffusion weighted imaging (DWI) and ADC values for malignant and benign breast lesions.Methods There were 165 patients with 171 suspicious malignant breast lesions received low and high b-value ( 500 and 1500 s/mm2 ) DWI scan before dynamic contrast-enhanced MRI (DEC-MRI).Using normal breast as the reference base,the signal intensity and ADC values of the 171 lesions on high-b-value ( b = 1500 s/mm2 ) DWI were retrospectively analyzed If a lesion showed abnormal enhancement on DCE-MRI and high signal intensity on high-b-value (b = 1500 s/mm2 ) DWI,that lesion was defined as positive result on behalf of malignant lesion; the otherwise was defined as negative result on behalf of benign lesion.ADC values were calculated for the 111 lesions with positive results on DWI.And all lesions received a biopsy after MR scan.References to the histopatholngical results,the amounts of positive and negative results on high-b value DWI were recorded.Using 1.13 × 10 -3mm2/s as the cutoff value,the sensitivity and specificity of ADC value for the diagnosis of malignant breast lesion were calculated.Fisher exact tests and Wilcoxon rank sum tests were used for statistical analyses.Results There are 91 malignant and 80 benign lesions the 171 lesions confirmed by histopathology.On high-b value DWI,139 lesions were visually positive results,including 83 malignant and 56 benign lesions.Other 32 lesions were visually negative results,including 24 benign lesions and 8 malignant lesions (non-mass ductal carcinoma in situ).There are statistically significant difference between malignant and benign lesions ( P ＜ 0.01 ).All invasive carcinoma and mass-forming DCIS were visually positive results,whereas eight non-mass DCIs lesions were visually negative results,the overall sensitivity and specificity were 91.2％ (83/91)and 30.0％ (24/80),respectively.In the 111 lesions with DWI positive result ( 110 mass lesions and one focal lesion),the mean ADC value of the 63 malignant lesions was (0.73 ±0.24) × 10-3 mm2/s,whereas the mean ADC value of the 48 benign lesions was( 1.19 ±0.42) ×10-3 mm2/s.There was statistically significant difference between benign and malignant lesions (Z =5.818,P ＜0.01 ).When ADC value of 1.13 × 10-3 mm2/s was chosen as the cutoff value,61 malignant lesions were true positive results,2 mucinous carcinoma were false-negative results,27 benign lesions were true negative results,21 benign lesions were false-positive results,the sensitivity and specificity was 96.8％(61/63) and 56.2％ (27/48),respectively.Conclusions High b-value DWI and ADC values were useful for distinguishing of malignant and benign breast lesions,but it should be cautious when it was used for the diagnosis of non-mass breast lesions. Key words: Breast neoplasms; Magnetic resonance imaging; Comparative study

Low b-Value Diffusion-Weighted Cardiac Magnetic Resonance Imaging

Diffusion-weighted imaging (DWI) using low b-values permits imaging of intravoxel incoherent motion in tissues. However, low b-value DWI of the human heart has been considered too challenging because of additional signal loss due to physiological motion, which reduces both signal intensity and the signal-to-noise ratio (SNR). We address these signal loss concerns by analyzing cardiac motion during a heartbeat to determine the time-window during which cardiac bulk motion is minimal. Using this information to optimize the acquisition of DWI data and combining it with a dedicated image processing approach has enabled us to develop a novel low b-value diffusion-weighted cardiac magnetic resonance imaging approach, which significantly reduces intravoxel incoherent motion measurement bias introduced by motion. Simulations from displacement encoded motion data sets permitted the delineation of an optimal time-window with minimal cardiac motion. A number of single-shot repetitions of low b-value DWI cardiac magnetic resonance imaging data were acquired during this time-window under free-breathing conditions with bulk physiological motion corrected for by using nonrigid registration. Principal component analysis (PCA) was performed on the registered images to improve the SNR, and temporal maximum intensity projection (TMIP) was applied to recover signal intensity from time-fluctuant motion-induced signal loss. This PCATMIP method was validated with experimental data, and its benefits were evaluated in volunteers before being applied to patients. Optimal time-window cardiac DWI in combination with PCATMIP postprocessing yielded significant benefits for signal recovery, contrast-to-noise ratio, and SNR in the presence of bulk motion for both numerical simulations and human volunteer studies. Analysis of mean apparent diffusion coefficient (ADC) maps showed homogeneous values among volunteers and good reproducibility between free-breathing and breath-hold acquisitions. The PCATMIP DWI approach also indicated its potential utility by detecting ADC variations in acute myocardial infarction patients. Studying cardiac motion may provide an appropriate strategy for minimizing the impact of bulk motion on cardiac DWI. Applying PCATMIP image processing improves low b-value DWI and enables reliable analysis of ADC in the myocardium. The use of a limited number of repetitions in a free-breathing mode also enables easier application in clinical conditions.

Low b‐value diffusion‐weighted imaging for diagnosing strangulated small bowel obstruction: A feasibility study

To assess the feasibility of low b-value diffusion-weighted imaging (DWI) for diagnosing strangulated small bowel obstruction (SBO). Five volunteers and 14 patients with SBO underwent DWI at b-values of 0 and 50 s/mm(2). Apparent diffusion coefficients (ADCs) and signal preservation ratios (SPRs) were measured in the distal jejunum in the volunteers before and after butylscopolamine administration, and in the (strangulated) closed loop, near the obstructive site, and far from the obstructive site in the patients. Low b-value diffusion-weighted images in the patients were quantitatively evaluated for diagnosing strangulation. In the volunteers, mean ADC (10(-3) mm(2)/s) and SPR (%) before butylscopolamine administration (18.3 ± 5.9 and 41.4 ± 11.5) were significantly different (P < 0.05) from those after butylscopolamine administration (6.4 ± 3.6 and 73.7 ± 12.9). In the patients, mean ADCs and SPRs among the strangulated closed loop (3.8 ± 2.2 and 83.3 ± 9.3), near the obstructive site (12.1 ± 6.9 and 57.3 ± 18.5), and far from the obstructive site (26.8 ± 10.7 and 29.9 ± 16.4) were significantly different (P < 0.05). Areas under the receiver operating characteristic curve for the diagnosis of strangulation varied between 0.937 and 1.000. Low b-value DWI is a feasible technique to distinguish the strangulated closed loop from nonstrangulated loops in SBO, and show promise for diagnosing strangulated SBO.

A Comparison of Mean Displacement Values Using High b-Value Q-Space Diffusion-weighted MRI with Conventional Apparent Diffusion Coefficients in Patients with Stroke

Q-space analysis using high b-value diffusion-weighted magnetic resonance (MR) data provides information on tissue microstructure in contrast to conventional MR imaging (MRI) based on low b-value diffusion-weighted imaging (DWI). The purpose of this study was to evaluate the use of mean displacement (MDP) map in stroke patients using q-space diffusion-weighted MRI (QSI). Twenty-one patients presenting with a total of 22 acute or subacute cerebral infarctions were included. MR protocol consisted of conventional MR sequences, DWI (b-value; 1000 s/mm(2)) and QSI (b-value; maximum 12,000 s/mm(2)). Apparent diffusion coefficient (ADC) maps of conventional DWI and MDP maps of QSI data were obtained and compared in the ischemic lesions and corresponding normal tissues. Decreased ADC values were present in all lesions. There was no correlation between ADC and MDP values in the lesions (r = 0.21). MDP values of the lesions were 8.60 ± 1.26 μm (mean ± SD). Most of the lesions (16/22) had higher MDP values than normal brain tissue. Three lesions showed lower MDP values and three showed mixed MDP values. The MDP maps using QSI data provides additional information for stroke patients compared to conventional DWI.

Intravoxel partially coherent motion technique: Characterization of the anisotropy of skeletal muscle microvasculature

To propose a reformulation of the intravoxel incoherent motion (IVIM) technique exploiting the low b-value diffusion-weighted imaging regime that can characterize microcirculation of tissues perfused with partially coherent blood flow. The new methodology, termed intravoxel partially coherent motion (IVPCM) technique, is suitable for probing microcirculation in tissues with ordered microvasculature, such as skeletal muscle. We employ a subvoxel model utilizing a randomly oriented bundle of straight vessels whose orientation statistics are characterized by a Fisher axial distribution with concentration parameter K quantifying the anisotropy of the distribution (K = 0 indicates isotropic capillary orientation). The methodology is first validated with a proof-of-principle phantom experiment and is then applied to analyze the microvasculature of human calf muscle at rest. The microcirculatory part of the diffusion-weighted signal at b < 200 s/mm(2) is anisotropic. The variation of the diffusion-weighted signal with b-value exhibits stronger deviation from the expected monoexponential decay when the diffusion encoding gradient is applied parallel to the mean myofiber direction in the calf muscle of three healthy volunteers. The application of the model to data from the medial gastrocnemius and the soleus of the three volunteers gives results within the expected range for the mean microvascular volume fraction, the mean microflow velocity, and the parameter K. The proposed methodology has the capability of characterizing the anisotropy of the capillary network in vivo in a manner analogous to the capability of high b-value diffusion to characterize the anisotropy of muscle fibers.