The Influence of Bowel Preparation on ADC Measurements: Comparison between Conventional DWI and DWIBS Sequences

Background and objectives: The aim of the study was to assess whether there were differences between apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) and diffusion-weighted imaging with background body signal suppression (DWIBS) sequences in non-prepared and prepared bowels before and after preparation with an enteric hyperosmolar agent, to assess whether ADC measurements have the potential to avoid bowel preparation and whether ADC-DWIBS has advantages over ADC-DWI. Materials and Methods: 106 adult patients without evidence of inflammatory bowel disease (IBD) underwent magnetic resonance (MR) enterography before and after bowel preparation. ADC-DWI and ADC-DWIBS values were measured in the intestinal and colonic walls demonstrating high signal intensity (SI) at DWI tracking images of b = 800 s/mm2 before and after preparation. Results: There were significant difference (p < 0.0001) in both ADC-DWI and ADC-DWIBS results between non-prepared and prepared jejunum for DWI being 1.09 × 10−3 mm2/s and 1.76 × 10−3 mm2/s, respectively, and for DWIBS being 0.91 × 10−3 mm2/s and 1.75 × 10−3 mm2/s, respectively. Both ADC-DWI and DWIBS also showed significant difference between non-prepared and prepared colon (p < 0.0001), with DWI values 1.41 × 10−3 mm2/s and 2.13 × 10−3 mm2/s, and DWIBS—1.01 × 10−3 mm2/s and 2.04 × 10−3 mm2/s, respectively. No significant difference between ADC-DWI and ADC-DWIBS was found in prepared jejunum (p = 0.84) and prepared colon (p = 0.58), whereas a significant difference was found in non-prepared jejunum and non-prepared colon (p = 0.0001 in both samples). Conclusions: ADC between DWI and DWIBS does not differ in prepared bowel walls but demonstrates a difference in non-prepared bowel. ADC in non-prepared bowel is lower than in prepared bowel and possible overlap with the ADC range of IBD is possible in non-prepared bowel. ADC-DWIBS has no advantage over ADC-DWI in regard to IBD assessment.

Download Full-text

Role of Quantitative Diffusion-Weighted Imaging in Differentiating Benign and Malignant Orbital Masses

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1730120 ◽

2021 ◽

Author(s):

Preeti Mundhada ◽

Sudarshan Rawat ◽

Ullas Acharya ◽

Dhananjay Raje

Keyword(s):

Roc Curve ◽

Diffusion Weighted Imaging ◽

Care Hospital ◽

Adc Value ◽

Diffusion Weighted ◽

Significant Difference ◽

Orbital Masses ◽

Adc Values ◽

Orbital Lesions

Abstract Aim To determine the role of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) values in differentiating benign and malignant orbital masses. Materials and Methods After obtaining institutional ethical board approval and informed consent from all patients, an observational study was done for a period of 24 months in the radiology department of a tertiary care hospital in South India. Conventional magnetic resonance imaging and DWI using a 3T scanner was done for all patients with suspected orbital mass lesion. ADC value and clinicohistopathological correlation were studied for every patient. Chi-square test was used to compare the signal characteristics of DWI and ADC maps between benign and malignant lesions. A comparison of mean ADC values for benign and malignant masses was performed using Student’s t-test for independent samples. The cut-off value for ADC was obtained using the receiver operating characteristic (ROC) curve. Results Of 44 patients with orbital lesions, 70% were benign and 30% were malignant. There was a significant difference in the mean ADC values of benign and malignant orbital masses. Using ROC curve analysis, an optimal ADC threshold of 1.26 × 10−3 mm2/s was calculated for the prediction of malignancy with 100% sensitivity, 80.65% specificity, and 86.36% accuracy (95% confidence interval: 0.872, 1.00, p < 0.0001). Two ADC thresholds were used to characterize the orbital masses with more than 90% confidence. Conclusion Quantitative assessment of ADC is a useful noninvasive diagnostic tool for differentiating benign and malignant orbital masses. Malignant orbital lesions demonstrate significantly lower ADC values as compared with benign lesions.

Download Full-text

Efficiency of diffusion-weighted MRI for differentiating radiologically similar simple and type I hydatid cysts of the liver

Acta Radiologica ◽

10.1177/0284185120988131 ◽

2021 ◽

pp. 028418512098813

Author(s):

Ilyas Dundar ◽

Mesut Ozgokce ◽

Fatma Durmaz ◽

Sercan Ozkacmaz ◽

Saim Turkoglu ◽

...

Keyword(s):

Treatment Options ◽

Type I ◽

Hydatid Cysts ◽

Liver Cysts ◽

Diffusion Weighted ◽

Significant Difference ◽

Mean Diameter ◽

Apparent Diffusion ◽

Adc Values ◽

Hepatic Lesions

Background Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications. Purpose To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances. Material and Methods This single-center prospective study was conducted during 2016–2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test. Results Of 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5–82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2–7.6 cm) and ADCmean value was 3.03 ± 0.47 (range 2.64–5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8–14 cm) and ADCmean value was 2.99 ± 0.29 (range 2.36–3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs Conclusion Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.

Download Full-text

The role of quantitative diffusion-weighted imaging in characterization of hypovascular liver lesions: A prospective comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient

PLoS ONE ◽

10.1371/journal.pone.0247301 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247301

Author(s):

Jelena Djokić Kovač ◽

Marko Daković ◽

Aleksandra Janković ◽

Milica Mitrović ◽

Vladimir Dugalić ◽

...

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Liver Metastases ◽

Diffusion Weighted Imaging ◽

Intraclass Correlation ◽

Intravoxel Incoherent Motion ◽

Liver Lesions ◽

Diffusion Weighted ◽

Significant Difference ◽

Apparent Diffusion

Background The utility of intravoxel incoherent motion (IVIM) related parameters in differentiation of hypovascular liver lesions is still unknown. Purpose The purpose of this study was to evaluate the value of IVIM related parameters in comparison to apparent diffusion coefficient (ADC) for differentiation among intrahepatic mass-forming cholangiocarcinoma (IMC), and hypovascular liver metastases (HLM). Methods Seventy-four prospectively enrolled patients (21 IMC, and 53 HLM) underwent 1.5T magnetic resonance examination with IVIM diffusion-weighted imaging using seven b values (0–800 s/mm2). Two independent readers performed quantitative analysis of IVIM-related parameters and ADC. Interobserver reliability was tested using a intraclass correlation coefficient. ADC, true diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (ƒ) were compared among the lesions using Kruskal-Wallis H test. The diagnostic accuracy of each parameter was assessed by receiver operating characteristic (ROC) curve analysis. Results The interobserver agreement was good for ADC (0.802), and excellent for D, D*, and ƒ (0.911, 0.927, and 0.942, respectively). ADC, and D values were significantly different among IMC and HLM (both p < 0.05), while there was no significant difference among these lesions for ƒ and D* (p = 0.101, and p = 0.612, respectively). ROC analysis showed higher diagnostic performance of D in comparison to ADC (AUC = 0.879 vs 0.821). Conclusion IVIM-derived parameters in particular D, in addition to ADC, could help in differentiation between most common hypovascular malignant liver lesions, intrahepatic mass—forming cholangiocarcinoma and hypovascular liver metastases.

Download Full-text

Pitfalls of diffusion-weighted imaging of the female pelvis

Radiologia Brasileira ◽

10.1590/0100-3984.2016.0208 ◽

2018 ◽

Vol 51 (1) ◽

pp. 37-44 ◽

Cited By ~ 7

Author(s):

Ana Luisa Duarte ◽

João Lopes Dias ◽

Teresa Margarida Cunha

Keyword(s):

Signal Intensity ◽

Diffusion Weighted Imaging ◽

Structural Information ◽

Biological Tissues ◽

High Signal ◽

Female Pelvis ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Mri Sequences ◽

Magnetic Resonance Imaging Mri

Abstract Diffusion-weighted imaging (DWI) is widely used in protocols for magnetic resonance imaging (MRI) of the female pelvis. It provides functional and structural information about biological tissues, without the use of ionizing radiation or intravenous administration of contrast medium. High signal intensity on DWI with simultaneous low signal intensity on apparent diffusion coefficient maps is usually associated with malignancy. However, that pattern can also be seen in many benign lesions, a fact that should be recognized by radiologists. Correlating DWI findings with those of conventional (T1- and T2-weighted) MRI sequences and those of contrast-enhanced MRI sequences is mandatory in order to avoid potential pitfalls. The aim of this review article is the description of the most relevant physiological and benign pathological conditions of the female pelvis that can show restricted diffusion on DWI.

Download Full-text

Effects of contrast-enhancement on diffusion weighted imaging and apparent diffusion coefficient measurements in 3-T magnetic resonance imaging of breast lesions

Acta Radiologica ◽

10.1177/0284185117740759 ◽

2017 ◽

Vol 59 (8) ◽

pp. 902-908

Author(s):

Valentina Cipolla ◽

Daniele Guerrieri ◽

Giacomo Bonito ◽

Simone Celsa ◽

Carlo de Felice

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Diffusion Weighted Imaging ◽

Breast Lesions ◽

Post Contrast ◽

Diffusion Weighted ◽

Signed Rank ◽

Apparent Diffusion ◽

Malignant Breast ◽

Adc Values

Background The effect of gadolinium-based contrast agents on diffusion-weighted imaging (DWI) measurements of breast lesions is still not clear. Purpose To investigate gadolinium effects on DWI and apparent diffusion coefficient (ADC) in breast lesions and normal parenchyma with 3 Tesla contrast-enhanced MRI. Material and Methods Pre- and post-contrast DWI (b = 0 and b = 1000 s/mm2) were acquired in 47 patients. Measured ADC values, pre- and post-contrast T2 signal intensity (T2 SI) and contrast-to-noise ratio (CNR) were compared with Wilcoxon signed-rank and rank-sum test ( P < 0.05). Results Post-contrast ADC was reduced only in malignant lesions (−34%), T2 SI was reduced both in malignant (−50%) and benign (−36%) lesions. Post-contrast CNR was reduced in all groups except for benign lesions. Conclusion Gadolinium-based contrast agent causes a significant reduction in ADC values of malignant breast lesions.

Download Full-text

The Correlation between Diffusion-Weighted Imaging and Histopathological Evaluation of 356 Prostate Biopsy Sites in Patients with Prostatic Diseases

ISRN Urology ◽

10.5402/2012/252846 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

R. Kilinç ◽

O. G. Doluoglu ◽

B. Sakman ◽

D. S. Ciliz ◽

E. Yüksel ◽

...

Keyword(s):

Prostate Biopsy ◽

Diffusion Weighted Imaging ◽

Definitive Treatment ◽

Apparent Diffusion Coefficients ◽

Prostate Biopsies ◽

Diffusion Weighted ◽

Significant Difference ◽

Adc Values ◽

The Difference ◽

Prostatic Diseases

Purpose. The aim of this study is to investigate the reliability of diffusion MRI for detection of cancer foci by comparing diffusion-weighted imaging (DWI) results and pathology results of prostate biopsy sites. Methods. Of the patients who applied with lower urinary tract symptoms, 36 patients who had suspected DRE and/or PSA ≥2.5 ng/mL were included in the study. Patients underwent DWI prior to 10 cores-prostate biopsy. 356 biopsy cores were obtained from the patients. Foci from the patients with prostate cancer were labeled as malignant or benign foci, likewise foci from the patients with benign pathology were grouped as BPH and inflammation foci. Apparent diffusion coefficients (ADCs) of biopsy groups were compared with each other in order to measure the reliability of DWI in detection of PCa foci. Results. When ADC values of adenocarcinoma foci and BPH foci were compared, a statistically significant difference was found (P<0.001). When ADC values obtained from adenocarcinoma foci and chronic inflammation foci are compared, the difference between two groups is statistically significant, too (P<0.001). Conclusions. Biopsies focused on suspected regions after formation of ADC maps by means of DWI would provide to start definitive treatment immediately as well as being beneficial to prevent morbidity related to repeated prostate biopsies.

Download Full-text

Diffusion weighted imaging of liver lesions suspect for metastases: Apparent diffusion coefficient (ADC) values and lesion contrast are independent from Gd-EOB-DTPA administration

European Journal of Radiology ◽

10.1016/j.ejrad.2012.03.027 ◽

2012 ◽

Vol 81 (8) ◽

pp. e849-e853 ◽

Cited By ~ 14

Author(s):

Matthias Benndorf ◽

Juliane Schelhorn ◽

Matthias Dietzel ◽

Werner A. Kaiser ◽

Pascal A.T. Baltzer

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Diffusion Weighted Imaging ◽

Liver Lesions ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Adc Values

Download Full-text

Diffusion-Weighted Imaging Reflects Tumor Grading and Microvascular Invasion in Hepatocellular Carcinoma

Liver Cancer ◽

10.1159/000511384 ◽

2021 ◽

Vol 10 (1) ◽

pp. 10-24

Author(s):

Alexey Surov ◽

Maciej Pech ◽

Jazan Omari ◽

Frank Fischbach ◽

Robert Damm ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Diffusion Coefficient ◽

Diffusion Weighted Imaging ◽

Microvascular Invasion ◽

Data Bases ◽

Tumor Grading ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Adc Values

Background: To date, there are inconsistent data about relationships between diffusion-weighted imaging (DWI) and tumor grading/microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Our purpose was to systematize the reported results regarding the role of DWI in prediction of tumor grading/MVI in HCC. Method: MEDLINE library, Scopus, and Embase data bases were screened up to December 2019. Overall, 29 studies with 2,715 tumors were included into the analysis. There were 20 studies regarding DWI and tumor grading, 8 studies about DWI and MVI, and 1 study investigated DWI, tumor grading, and MVI in HCC. Results: In 21 studies (1,799 tumors), mean apparent diffusion coefficient (ADC) values (ADCmean) were used for distinguishing HCCs. ADCmean of G1–3 lesions overlapped significantly. In 4 studies (461 lesions), minimum ADC (ADCmin) was used. ADCmin values in G1/2 lesions were over 0.80 × 10−3 mm2/s and in G3 tumors below 0.80 × 10−3 mm2/s. In 4 studies (241 tumors), true diffusion (D) was reported. A significant overlapping of D values between G1, G2, and G3 groups was found. ADCmean and MVI were analyzed in 9 studies (1,059 HCCs). ADCmean values of MIV+/MVI− lesions overlapped significantly. ADCmin was used in 4 studies (672 lesions). ADCmin values of MVI+ tumors were in the area under 1.00 × 10−3 mm2/s. In 3 studies (227 tumors), D was used. Also, D values of MVI+ lesions were predominantly in the area under 1.00 × 10−3 mm2/s. Conclusion: ADCmin reflects tumor grading, and ADCmin and D predict MVI in HCC. Therefore, these DWI parameters should be estimated for every HCC lesion for pretreatment tumor stratification. ADCmean cannot predict tumor grading/MVI in HCC.

Download Full-text

Quantitative Evaluation of apparent diffusion coefficient in a large multi-unit institution using the QIBA diffusion phantom.

10.1101/2020.09.09.20191403 ◽

2020 ◽

Author(s):

Joshua P Yung ◽

Yao Ding ◽

Ken-Pin Hwang ◽

Carlos E Cardenas ◽

Hua Ai ◽

...

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Coefficient Of Variation ◽

Diffusion Weighted Imaging ◽

Diffusion Weighted ◽

Apparent Diffusion Coefficient Values ◽

Wide Range ◽

Apparent Diffusion ◽

Adc Values ◽

The One

Purpose: The purpose of this study was to determine the quantitative variability of diffusion weighted imaging and apparent diffusion coefficient values across a large fleet of MR systems. Using a NIST traceable magnetic resonance imaging diffusion phantom, imaging was reproducible and the measurements were quantitatively compared to known values. Methods: A fleet of 23 clinical MRI scanners was investigated in this study. A NIST/QIBA DWI phantom was imaged with protocols provided with the phantom. The resulting images were analyzed and ADC maps were generated. User-directed region-of-interests on each of the different vials provided ADC measurements among a wide range of known ADC values. Results: Three diffusion phantoms were used in this study and compared to one another. From the one-way analysis of the variance, the mean and standard deviation of the percent errors from each phantom were not significantly different from one another. The low ADC vials showed larger errors and variation and appear directly related to SNR. Across all the MR systems and data, the coefficient of variation was calculated and Bland-Altman analysis was performed. ADC measurements were similar to one another except for the vials with the lower ADC values, which had a higher coefficient of variation. Conclusion: ADC values among the three phantoms showed good agreement and were not significantly different from one another. The large percent errors seen primarily at the low ADC values were shown to be a consequence of the SNR dependence and very little bias was observed between magnetic strengths and manufacturers. ADC values between diffusion phantoms were not statistically significant. Future investigations will be performed to study differences in magnetic field strength, vendor, MR system models, gradients, and bore size. More data across different MR platforms would facilitate quantitative measurements for multi-platform and multi-site imaging studies. With the increasing usage of diffusion weighted imaging in the clinic, the characterization of ADC variability for MR systems provides an improved quality control over the MR systems.

Download Full-text

Feasibility of Evaluating the Histologic and Genetic Subtypes of WHO Grade II-IV Gliomas by Diffusion-Weighted Imaging

10.21203/rs.3.rs-62323/v2 ◽

2021 ◽

Author(s):

Sirui Liu ◽

Yiwei Zhang ◽

Ziren Kong ◽

Chendan Jiang ◽

Yu Wang ◽

...

Keyword(s):

Diffusion Weighted Imaging ◽

Tumor Grade ◽

Low Grade ◽

Characteristic Analysis ◽

Who Grade ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Adc Values ◽

Grade Ii ◽

Tert Mutation

Abstract Background: To explore the feasibility of diffusion-weighted imaging (DWI) metrics to predict the histologic subtypes and genetic status of gliomas (e.g., IDH, MGMT, and TERT) noninvasively.Methods: One hundred and eleven patients with pathologically confirmed WHO grade II-IV gliomas were recruited retrospectively. Apparent diffusion coefficient (ADC) values were measured in solid parts of gliomas on co-registered T2-weighted images and were compared with each other in terms of WHO grading and genotypes using t-tests. Receiver operating characteristic analysis was performed to assess the diagnostic performances of ADC. Subsequently, multiple linear regression was used to find independent variables, which can directly affect ADC values. Results: The values of overall mean ADC (omADC) and normalized ADC (nADC) of high grade gliomas and IDH wildtype gliomas were lower than low grade gliomas and IDH mutated gliomas (P<0.05). nADC values showed better diagnostic performance than omADC in identifying tumor grade (AUC: 0.787 vs. 0.750) and IDH status (AUC: 0.836 vs. 0.777). ADC values had limited abilities in distinguishing TERT status (AUC=0.607 for nADC and 0.617 for omADC) and MGMT status (AUC=0.651 for nADC). Only tumor grade and IDH status were tightly associated with ADC values.Conclusion: DWI metrics can predict glioma grading and IDH mutation noninvasively, but have limited use in detecting TERT mutation and MGMT methylation.

Download Full-text