Abstract TP88: Usefulness of High and Standard B-value DWI for Analysis of Pathophysiology in Acute Stage Cerebral Infarction

Introduction: Standard b-value DWI (sDWI) and high b-value DWI (hDWI) and ADC calculation from each DWI have been widely used for diagnosis of (acute ischemic stroke) AIS. However, diagnosis of AIS subtypes by using hDWI and ADC have not been well investigated. Hypothesis: AIS has several pathophysiological subtypes such as lacunar infarction, cardio-embolism(CE), and atherothrombotic brain infarction (ATBI), and so on, and condtion of collateral circulations differ among those subtypes. Several studies have shown that hDWI is relatively dominant in intracellular diffusion, conversely, sDWI is comparatively dominant in extracellular diffusion. Therefore, our hypothesis is that calculation of ADC from sDWI and hDWI could give valuable information for differentiation among AIS subtypes. Methods: We evaluated 130 AIS patients from medical records. Pathophysiological diagnoses were made by experienced neurologists. We acquired sDWI and hDWI at 3T MRI in all patients. 321 ADC values were obtained by calculating 200 ischemic lesions sequentially. We used relative ADC (rADC) value to adjust the difference caused by location and age. The rADC values were measured by manually placing regions of interest on the ADC maps at the ischemic lesion defined by DWI high and divided by the ADC values on the contralateral normal brain. For assessment of the AIS (within 30hrs from the onset) relationship between ATBI and CE, we subtract high b-value rADC (hrADC) from standard b-value rADC (srADC) to focus on the extracellular diffusion. To analyze the subacute phase stroke relationship between ATBI and CE, we evaluated the each rADC. And at both phase we conducted Mann-Whitney U test. Results: In superacute phase, hDWI more clearly showed hyper-intense signal than sDWI. From the onset, rADC of CE was lower than that of ATBI (median srADC-hrADC: ATBI/CE =0.0699/0.0244) (P=0.0445), this might imply the poor collateral status in CE. Contrary, for subacute phase, CE rapidly underwent necrosis in the ischemic core, rADC was higher than ATBI rADC (median ATBI/CE:0.5939/0.6480) (P=0.0011). Conclusions: We found that quantitative assessment of hrADC and srADC could give valuable information for differential diagnoses of AIS subtypes.

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Signal Intensity Changes of Normal Brain at Varying High b-Value Diffusion-Weighted Images Using 3.0T MR Scanner

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2003.49.6.455 ◽

2003 ◽

Vol 49 (6) ◽

pp. 455 ◽

Cited By ~ 1

Author(s):

Jin Hee Lee ◽

Chul Ho Sohn ◽

Jin Soo Choi

Keyword(s):

Signal Intensity ◽

B Value ◽

Normal Brain ◽

Diffusion Weighted Images ◽

High B Value ◽

Diffusion Weighted ◽

Intensity Changes

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The utility of diffusion-weighted imaging and ADC values in the characterization of mumps orchitis and seminoma

Acta Radiologica ◽

10.1177/0284185121991980 ◽

2021 ◽

pp. 028418512199198

Author(s):

Renwei Liu ◽

Jianhua Li ◽

Yixiang Jiang ◽

Zhiqing Wu ◽

Jiayin Ji ◽

...

Keyword(s):

Diffusion Weighted Imaging ◽

Testicular Tissue ◽

B Value ◽

Youden Index ◽

Characteristic Analysis ◽

Adc Value ◽

High B Value ◽

Diffusion Weighted ◽

Hyperintense Signal ◽

Adc Values

Background Diffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and quantitative analysis of a disease. Purpose To characterize testicular lesions that present as a hypointense signal on magnetic resonance imaging (MRI) T2-weighted images using DWI. Material and Methods Study participants were divided into three groups. Group A were healthy controls (n = 35), group B included patients with mumps orchitis (n = 20), and group C included patients with seminoma (n = 15). DWI sequences used b-values of 0, 1000, and 2000 s/mm2. Apparent diffusion coefficient (ADC) values between 1000 and 2000 s/mm2 were calculated by MRI postprocessing software. The Kruskal–Wallis test and receiver operating characteristic analysis were performed to evaluate how well ADC values distinguished between mumps orchitis and seminoma. Results Normal testicular tissue showed a hyperintense signal on DWI and hypointensity on the ADC map: mean ADC value was 0.77 (0.69–0.85) ± 0.08 ×10−3 mm2/s. Mumps orchitis and seminoma showed slight hyperintensity on DWI: mean ADC values were 0.85 (0.71–0.99) ± 0.15 ×10−3 mm2/s and 0.43 (0.39–0.47) ± 0.04 × 10−3 mm2/s, respectively. There were statistically significant differences in mean ADC values between normal testicular tissue and seminoma and between mumps orchitis and seminoma. The cutoff ADC value for differentiating seminoma from mumps orchitis was 0.54 × 10−3 mm2/s. The sensitivity, specificity, and Youden Index for diagnosing seminoma were 99%, 31%, and 30%, respectively. Conclusion High b-value DWI has potential utility for differentiating mumps orchitis from seminoma in the clinical setting.

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Conventional Diffusion Weighted Imaging In Acute Stroke Overestimates Apparent Diffusion Coefficient (ADC): Improved Accuracy of ADC Measurements of Brain Using Fluid-Inversion Prepared Diffusion (FLIPD) Imaging

Stroke ◽

10.1161/str.32.suppl_1.318-a ◽

2001 ◽

Vol 32 (suppl_1) ◽

pp. 318-318

Author(s):

Lawrence L Latour ◽

Steven Warach

Keyword(s):

B Value ◽

Inversion Pulse ◽

Normal Brain ◽

Perivascular Spaces ◽

Single Shot ◽

Acute Lesion ◽

Apparent Diffusion ◽

Adc Values ◽

Improved Accuracy ◽

Tissue Models

13 Background: The measurement of ADC of water in brains of stroke patients is used in developing tissue models of reversible from irreversible injury. Cerebrospinal fluid (CSF) has a higher ADC and T2 value than parenchyma and measurement of lesion ADC by conventional EPI methods may be overestimated by the presence of CSF in sulci and perivascular spaces. We investigated whether the suppression of signal from CSF using an inversion recovery MRI method would give different ADC values than with the conventional DWI technique. Methods: Thirteen consecutive patients with stroke onset of less than 6 hours and an acute lesion on conventional DWI were studied. Conventional isotropic DWI was a T2-weighted single shot EPI technique with a b value of 1000 s/mm2. CSF suppression was achieved by the addition of an inversion pulse (TI = 2200 ms) at the beginning of the DWI sequence. The method is termed Fluid-Inversion Prepared Diffusion (FLIPD), and it is a combination of FLAIR and DWI in a single sequence. The region of the acute lesion was identified on the conventional DWI and the ADC of that region was measured in both the conventional and FLIPD ADC images. Results: In all 13 patients, FLIPD ADC was lower than conventional ADC. The mean (SD) of the 13 patients’ lesion ADC was 0.587 (0.075) x 10 -3 mm/s with FLIPD and 0.696 (0.078) x 10 -3 mm/s with conventional DWI (p < 0.0001). The distribution of ADC values in all voxels pooled across all subjects indicated a narrower distribution of for FLIPD ADC (SD = 0.128 vs. 0.220 x 10 -3 mm/s for lesions and (SD = 0.151 vs. 0.514 x 10 -3 mm/s for normal brain). The reduced variance in FLIPD ADC improved the diagnostic conspicuity of FLIPD ADC lesions. Conclusions: Suppression of CSF leads to lesion ADC values more homogeneous and greater than 15% lower than with conventional EPI DWI techniques. We suggest that FLIPD ADC measurements are more accurate and give more diagnostically useful images than conventional ADC maps. Because FLIPD measures water diffusion within parenchyma only, it should be more sensitive to ischemic changes.

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High b-Value Diffusion-Weighted MRI of Normal Brain

Journal of Computer Assisted Tomography ◽

10.1097/00004728-200107000-00002 ◽

2001 ◽

Vol 25 (4) ◽

pp. 515-519 ◽

Cited By ~ 53

Author(s):

Jonathan H. Burdette ◽

David D. Durden ◽

Allen D. Elster ◽

Yi-Fen Yen

Keyword(s):

B Value ◽

Normal Brain ◽

Diffusion Weighted Mri ◽

High B Value ◽

Diffusion Weighted

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Reversible Ischemic Lesion Hypodensity in Acute Stroke CT Following Endovascular Reperfusion

Neurology ◽

10.1212/wnl.0000000000012484 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012484

Author(s):

Gabriel Broocks ◽

Rosalie McDonough ◽

Lukas Meyer ◽

Matthias Bechstein ◽

Helge Kniep Dipl.Ing ◽

...

Keyword(s):

Clinical Outcome ◽

Acute Stroke ◽

Water Uptake ◽

Vasogenic Edema ◽

Brain Infarction ◽

Future Research ◽

Anterior Circulation ◽

Ischemic Lesion ◽

Ischemic Brain Edema ◽

The Difference

Background and ObjectivesIn acute stroke, early ischemic lesion hypodensity in computed tomography (CT) is considered the imaging hallmark of brain infarction, representing a state of irreversible tissue damage with a continual increase of net water uptake. This dogma is however challenged by rare cases of apparently reversed early lesion hypodensity following complete reperfusion. The purpose of this study was to investigate the occurrence of reversible ischemic edema after endovascular treatment.Methods184 acute ischemic anterior circulation stroke patients were included after consecutive screening. Ischemic brain edema was determined using quantitative lesion net water uptake (NWU) in admission-CT and follow-up CT based on CT-densitometry and ΔNWU was calculated as the difference. The association of edema progression to imaging and clinical parameters was investigated. Clinical outcome was assessed using modified Ranking Scale (mRS) scores at day 90.Results27/184 patients (14.7%) showed edema arrest and 3 patients (1.6%) exhibited significant edema reversibility. Higher degree of recanalization (odds ratio (OR): 2.96, 95%CI: 1.46-6.01, p<0.01) and shorter time from imaging to recanalization (OR/hour: 0.32, 95%CI: 0.18-0.54, p<0.0001) were significantly associated with edema arrest or reversibility. Clinical outcome was significantly better in patients without edema progression (median mRS 2 versus mRS 5, p=0.004).DiscussionAlbeit rare, lesion hypodensity considered to be representative of early infarct in acute stroke CT may be reversible following complete recanalization. Arrest of edema progression of acute brain infarct lesions may occur after successful rapid vessel recanalization, resulting in improved functional outcome. Future research is needed to investigate conditions where early revascularization may halt or even reverse vasogenic edema of ischemic tissue.

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High b-value diffusion-weighted MR imaging of normal brain at 3T

European Journal of Radiology ◽

10.1016/j.ejrad.2007.11.023 ◽

2009 ◽

Vol 69 (3) ◽

pp. 454-458 ◽

Cited By ~ 14

Author(s):

Mutlu Cihangiroglu ◽

Aziz Müfit Uluğ ◽

Zeynep Firat ◽

Ali Bayram ◽

Arzu Kovanlikaya ◽

...

Keyword(s):

Mr Imaging ◽

B Value ◽

Normal Brain ◽

High B Value ◽

Diffusion Weighted

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Can the low and high b-value distribution influence the pseudodiffusion parameter derived from IVIM DWI in normal brain?

BMC Medical Imaging ◽

10.1186/s12880-020-0419-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yu-Chuan Hu ◽

Lin-Feng Yan ◽

Yu Han ◽

Shi-Jun Duan ◽

Qian Sun ◽

...

Keyword(s):

B Value ◽

Value Distribution ◽

Normal Brain ◽

High B Value

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The Primacy of High B-Value 3T-DWI Radiomics in the Prediction of Clinically Significant Prostate Cancer

Diagnostics ◽

10.3390/diagnostics11050739 ◽

2021 ◽

Vol 11 (5) ◽

pp. 739

Author(s):

Alessandro Bevilacqua ◽

Margherita Mottola ◽

Fabio Ferroni ◽

Alice Rossi ◽

Giampaolo Gavelli ◽

...

Keyword(s):

Prostate Cancer ◽

Quantitative Imaging ◽

B Value ◽

Support Vector ◽

Svm Classifier ◽

Primary Role ◽

High B Value ◽

Wilcoxon Rank Sum Test ◽

Apparent Diffusion ◽

Clinically Significant

Predicting clinically significant prostate cancer (csPCa) is crucial in PCa management. 3T-magnetic resonance (MR) systems may have a novel role in quantitative imaging and early csPCa prediction, accordingly. In this study, we develop a radiomic model for predicting csPCa based solely on native b2000 diffusion weighted imaging (DWIb2000) and debate the effectiveness of apparent diffusion coefficient (ADC) in the same task. In total, 105 patients were retrospectively enrolled between January–November 2020, with confirmed csPCa or ncsPCa based on biopsy. DWIb2000 and ADC images acquired with a 3T-MRI were analyzed by computing 84 local first-order radiomic features (RFs). Two predictive models were built based on DWIb2000 and ADC, separately. Relevant RFs were selected through LASSO, a support vector machine (SVM) classifier was trained using repeated 3-fold cross validation (CV) and validated on a holdout set. The SVM models rely on a single couple of uncorrelated RFs (ρ < 0.15) selected through Wilcoxon rank-sum test (p ≤ 0.05) with Holm–Bonferroni correction. On the holdout set, while the ADC model yielded AUC = 0.76 (95% CI, 0.63–0.96), the DWIb2000 model reached AUC = 0.84 (95% CI, 0.63–0.90), with specificity = 75%, sensitivity = 90%, and informedness = 0.65. This study establishes the primary role of 3T-DWIb2000 in PCa quantitative analyses, whilst ADC can remain the leading sequence for detection.

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