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European Radiology
Published in: European Radiology 3/2021

01-03-2021 | Magnetic Resonance Imaging | Magnetic Resonance

Intravoxel incoherent motion diffusion-weighted MRI for the characterization of inflammation in chronic liver disease

Authors: Thierry Lefebvre, Mélanie Hébert, Laurent Bilodeau, Giada Sebastiani, Milena Cerny, Damien Olivié, Zu-Hua Gao, Marie-Pierre Sylvestre, Guy Cloutier, Bich N. Nguyen, Guillaume Gilbert, An Tang

Published in: European Radiology | Issue 3/2021

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Abstract

Objective

To evaluate the diagnostic performance of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for grading hepatic inflammation.

Methods

In this retrospective cross-sectional dual-center study, 91 patients with chronic liver disease were recruited between September 2014 and September 2018. Patients underwent 3.0-T MRI examinations within 6 weeks from a liver biopsy. IVIM parameters, perfusion fraction (f), diffusion coefficient (D), and pseudo-diffusion coefficient (D*), were estimated using a voxel-wise nonlinear regression on DWI series (10 b-values from 0 to 800 s/mm2). The reference standard was histopathological analysis of hepatic inflammation grade, steatosis grade, and fibrosis stage. Intraclass correlation coefficients (ICC), univariate and multivariate correlation analyses, and areas under receiver operating characteristic curves (AUC) were assessed.

Results

Parameters f, D, and D* had ICCs of 0.860, 0.839, and 0.916, respectively. Correlations of f, D, and D* with inflammation grade were ρ = − 0.70, p < 0.0001; ρ = 0.10, p = 0.35; and ρ = − 0.27, p = 0.010, respectively. When adjusting for fibrosis and steatosis, the correlation between f and inflammation (p < 0.0001) remained, and that between f and fibrosis was also significant to a lesser extent (p = 0.002). AUCs of f, D, and D* for distinguishing inflammation grades 0 vs. ≥ 1 were 0.84, 0.53, and 0.70; ≤ 1 vs. ≥ 2 were 0.88, 0.57, and 0.60; and ≤ 2 vs. 3 were 0.86, 0.54, and 0.65, respectively.

Conclusion

Perfusion fraction f strongly correlated, D very weakly correlated, and D* weakly correlated with inflammation. Among all IVIM parameters, f accurately graded inflammation and showed promise as a biomarker of hepatic inflammation.

Key Points

• IVIM parameters derived from DWI series with 10 b-values are reproducible for liver tissue characterization.
• This retrospective two-center study showed that perfusion fraction provided good diagnostic performance for distinguishing dichotomized grades of inflammation.
• Fibrosis is a significant confounder on the association between inflammation and perfusion fraction.
Appendix
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Metadata
Title
Intravoxel incoherent motion diffusion-weighted MRI for the characterization of inflammation in chronic liver disease
Authors
Thierry Lefebvre
Mélanie Hébert
Laurent Bilodeau
Giada Sebastiani
Milena Cerny
Damien Olivié
Zu-Hua Gao
Marie-Pierre Sylvestre
Guy Cloutier
Bich N. Nguyen
Guillaume Gilbert
An Tang
Publication date
01-03-2021
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07203-y

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