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European Radiology
Published in: European Radiology 7/2018

01-07-2018 | Magnetic Resonance

Liver fibrosis: stretched exponential model outperforms mono-exponential and bi-exponential models of diffusion-weighted MRI

Authors: Nieun Seo, Yong Eun Chung, Yung Nyun Park, Eunju Kim, Jinwoo Hwang, Myeong-Jin Kim

Published in: European Radiology | Issue 7/2018

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Abstract

Objectives

To compare the ability of diffusion-weighted imaging (DWI) parameters acquired from three different models for the diagnosis of hepatic fibrosis (HF).

Methods

Ninety-five patients underwent DWI using nine b values at 3 T magnetic resonance. The hepatic apparent diffusion coefficient (ADC) from a mono-exponential model, the true diffusion coefficient (D t ), pseudo-diffusion coefficient (D p ) and perfusion fraction (f) from a biexponential model, and the distributed diffusion coefficient (DDC) and intravoxel heterogeneity index (α) from a stretched exponential model were compared with the pathological HF stage. For the stretched exponential model, parameters were also obtained using a dataset of six b values (DDC#, α#). The diagnostic performances of the parameters for HF staging were evaluated with Obuchowski measures and receiver operating characteristics (ROC) analysis. The measurement variability of DWI parameters was evaluated using the coefficient of variation (CoV).

Results

Diagnostic accuracy for HF staging was highest for DDC# (Obuchowski measures, 0.770 ± 0.03), and it was significantly higher than that of ADC (0.597 ± 0.05, p < 0.001), D t (0.575 ± 0.05, p < 0.001) and f (0.669 ± 0.04, p = 0.035). The parameters from stretched exponential DWI and D p showed higher areas under the ROC curve (AUCs) for determining significant fibrosis (≥F2) and cirrhosis (F = 4) than other parameters. However, D p showed significantly higher measurement variability (CoV, 74.6%) than DDC# (16.1%, p < 0.001) and α# (15.1%, p < 0.001).

Conclusions

Stretched exponential DWI is a promising method for HF staging with good diagnostic performance and fewer b-value acquisitions, allowing shorter acquisition time.

Key Points

• Stretched exponential DWI provides a precise and accurate model for HF staging.
• Stretched exponential DWI parameters are more reliable than D p from bi-exponential DWI model
• Acquisition of six b values is sufficient to obtain accurate DDC and α
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Metadata
Title
Liver fibrosis: stretched exponential model outperforms mono-exponential and bi-exponential models of diffusion-weighted MRI
Authors
Nieun Seo
Yong Eun Chung
Yung Nyun Park
Eunju Kim
Jinwoo Hwang
Myeong-Jin Kim
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5292-z

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