Comparison of monoexponential, intravoxel incoherent motion diffusion-weighted imaging and diffusion kurtosis imaging for assessment of hepatic fibrosis

Jeong Hee Yoon, Jeong Min Lee, Kyung Bun Lee, Dongeun Kim, Hiroyuki Kabasawa, Joon Koo Han

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Abstract

Background: Hepatic fibrosis is a dynamic, reversible process which can result in liver failure. Diagnosis and monitoring of hepatic fibrosis are clinically important. Purpose: To compare the diagnostic performance of diffusion kurtosis imaging (DKI), intravoxel incoherent motion (IVIM), and monoexponential diffusion-weighted imaging (DWI) to detect clinically significant fibrosis (≥ F2). Material and Methods: This retrospective study was approved by Institutional Review Board and the requirement of informed consent was waived. One hundred and six patients were included who underwent liver multiple b-value DWI (10 b-values at 0–1000 s/mm2) at 1.5 T and were histologically diagnosed with hepatic fibrosis. Apparent diffusion coefficient (ADC), DKI-derived apparent kurtosis (Kapp) and diffusivity (Dapp), and IVIM-derived true diffusion (Dt), pseudodiffusion (D*), and perfusion fraction (f) were compared between no or early fibrosis (F0–1, n = 19) and clinically significant fibrosis (≥ F2, n = 87). Diagnostic performance was evaluated with receiver operating characteristic (ROC) analysis. Results: F2–4 had a significantly lower D* (59.9±16.3 vs. 86.2±21.0 [×10−3 mm2/s]) and Dapp (3.46±0.79 vs. 4.07 ± 0.76 [×10−3 mm2/s]) but higher Kapp (1.10±0.18 vs. 0.98±0.12) than F0–1 (P < 0.01). ADC, Dt, and f did not show significant difference between two groups (P > 0.05). The area under the ROC curve for diagnosis of clinically significant fibrosis (≥ F2) was significantly larger in D* (0.89; 95% CI = 0.81–0.94) than Dapp (0.73; 95% CI = 0.63–0.81) and Kapp (0.75; 95% CI = 0.65–0.83) (P = 0.017 and 0.012, respectively). Conclusion: IVIM-DWI might be more suitable for detecting hepatic fibrosis than the monoexponential and kurtosis model, and D* showed a better diagnostic performance to detect clinically significant fibrosis than other parameters.

Original languageEnglish
Pages (from-to)1593-1601
Number of pages9
JournalActa Radiologica
Volume60
Issue number12
DOIs
StatePublished - 1 Dec 2019

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Keywords

  • Liver cirrhosis
  • diffusion-weighted imaging
  • hepatitis
  • intravoxel incoherent motion
  • kurtosis

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