Is liver lesion characterisation by simplified IVIM DWI also feasible at 3.0 T?

Mürtz, Petra; Pieper, C C; Reick, M; Sprinkart, A M; Schild, H H; Willinek, W A; Kukuk, G M · Eur Radiol · 2019

retrospective_cohort · Level III

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Abstract

To evaluate simplified intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for liver lesion characterisation at 3.0 T and to compare it with 1.5 T. 3.0-T DWI data from a respiratory-gated MRI sequence with b = 0, 50, 250, and 800 s/mm<sup>2</sup> were analysed in 116 lesions (78 patients) and 27 healthy livers. Apparent diffusion coefficient ADC = ADC(0,800) and IVIM-based parameters D<sub>1</sub>' = ADC(50,800), D<sub>2</sub>' = ADC(250,800), f<sub>1</sub>' = f(0,50,800), f<sub>2</sub>' = f(0,250,800), D*' = D*(0,50,250,800), ADC<sub>low</sub> = ADC(0,50), and ADC<sub>diff</sub> = ADC<sub>low</sub>-D<sub>2</sub>' were calculated voxel-wise and analysed on per-patient basis. Results were compared with those of 173 lesions (110 patients) and 40 healthy livers at 1.5 T. Focal nodular hyperplasias were best discriminated from all other lesions by f<sub>1</sub>' and haemangiomas by D<sub>1</sub>' with an area under the curve (AUC) of 0.993 and 1.000, respectively. For discrimination between malignant and benign lesions, ADC was best suited (AUC of 0.968). The combination of D<sub>1</sub>' and f<sub>1</sub>' correctly identified more lesions as malignant or benign than the ADC (99.1% vs 88.8%). Discriminatory power for differentiating malignant from benign lesions tended to be higher at 3.0 T than at 1.5 T. Simplified IVIM is suitable for lesion characterisation at 3.0 T with a trend of superior diagnostic accuracy for discriminating malignant from benign lesions compared with 1.5 T. • Simplified IVIM is also suitable for liver lesion characterisation at 3.0 T. • Excellent accuracy was reached for discriminating malignant from benign lesions. • The acquisition of only three b-values (0, 50, 800 s/mm <sup>2</sup> ) is required.

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