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European Radiology
Published in: European Radiology 1/2017

01-01-2017 | Chest

Use of intravoxel incoherent motion diffusion-weighted MR imaging for assessment of treatment response to invasive fungal infection in the lung

Authors: Chenggong Yan, Jun Xu, Wei Xiong, Qi Wei, Ru Feng, Yuankui Wu, Qifa Liu, Caixia Li, Queenie Chan, Yikai Xu

Published in: European Radiology | Issue 1/2017

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Abstract

Objectives

The purpose of this study was to determine whether intravoxel incoherent motion (IVIM) –derived parameters and apparent diffusion coefficient (ADC) could act as imaging biomarkers for predicting antifungal treatment response.

Methods

Forty-six consecutive patients (mean age, 33.9 ± 13.0 y) with newly diagnosed invasive fungal infection (IFI) in the lung according to EORTC/MSG criteria were prospectively enrolled. All patients underwent diffusion-weighted magnetic resonance (MR) imaging at 3.0 T using 11 b values (0-1000 sec/mm2). ADC, pseudodiffusion coffiecient D*, perfusion fraction f, and the diffusion coefficient D were compared between patients with favourable (n=32) and unfavourable response (n=14).

Results

f values were significantly lower in the unfavourable response group (12.6%±4.4%) than in the favourable response group (30.2%±8.6%) (Z=4.989, P<0.001). However, the ADC, D, and D* were not significantly different between the two groups (P>0.05). Receiver operating characteristic curve analyses showed f to be a significant predictor for differentiation, with a sensitivity of 93.8% and a specificity of 92.9%.

Conclusions

IVIM-MRI is potentially useful in the prediction of antifungal treatment response to patients with IFI in the lung. Our results indicate that a low perfusion fraction f may be a noninvasive imaging biomarker for unfavourable response.

Key Points

• Recognition of IFI indicating clinical outcome is important for treatment decision-making.
• IVIM can reflect diffusion and perfusion information of IFI lesions separately.
• Perfusion characteristics of IFI lesions could help differentiate treatment response.
• An initial low f may predict unfavourable response in IFI.
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Metadata
Title
Use of intravoxel incoherent motion diffusion-weighted MR imaging for assessment of treatment response to invasive fungal infection in the lung
Authors
Chenggong Yan
Jun Xu
Wei Xiong
Qi Wei
Ru Feng
Yuankui Wu
Qifa Liu
Caixia Li
Queenie Chan
Yikai Xu
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4380-9

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