Traditional magnetic resonance (MR) diffusion-weighted imaging (DWI) uses a single exponential model to obtain the apparent diffusion coefficient to quantitatively reflect the diffusion motion of water molecules in living tissues, but it is affected by blood perfusion. Intravoxel incoherent motion (IVIM)-DWI utilizes a double-exponential model to obtain information on pure water molecule diffusion and microcirculatory perfusion-related diffusion, which compensates for the insufficiency of traditional DWI. In recent years, research on the application of IVIM-DWI in the diagnosis and treatment of hepatic diseases has gradually increased and has achieved considerable progress. This study mainly reviews the basic principles of IVIM-DWI and related research progress in the diagnosis and treatment of hepatic diseases.

Progress of intravoxel incoherent motion diffusion-weighted imaging in liver diseases

To design a b value and first‐order motion moment (M1) optimized data acquisition for repeatable intravoxel incoherent motion (IVIM) quantification in the liver.

b value and first‐order motion moment optimized data acquisition for repeatable quantitative intravoxel incoherent motion DWI

The purpose of this work was to obtain precise tri‐exponential intravoxel incoherent motion (IVIM) quantification in the liver using 2D (b‐value and first‐order motion moment [M1]) IVIM‐DWI acquisitions and region of interest (ROI)‐based fitting techniques.

Precision of region of interest‐based tri‐exponential intravoxel incoherent motion quantification and the role of the Intervoxel spatial distribution of flow velocities

Abstract Purpose To evaluate reproducibility and interlobar agreement of intravoxel incoherent motion (IVIM) quantification in the liver across field strengths and MR scanners with different gradient hardware. Methods Cramer‐Rao lower bound optimization was performed to determine optimized monopolar and motion‐robust 2D ( b ‐value and first‐order motion moment [ M 1 ]) IVIM‐DWI acquisitions. Eleven healthy volunteers underwent diffusion MRI of the liver, where each optimized acquisition was obtained five times across three MRI scanners. For each data set, IVIM estimates (diffusion coefficient ( D ), pseudo‐diffusion coefficients ( and ), blood velocity SDs ( V b1 and V b2 ), and perfusion fractions [ f 1 and f 2 ]) were obtained in the right and left liver lobes using two signal models (pseudo‐diffusion and M 1 ‐dependent physical) with and without T 2 correction ( f c1 and f c2 ) and three fitting techniques (tri‐exponential region of interest–based full and segmented fitting and blood velocity SD distribution fitting). Reproducibility and interlobar agreement were compared across methods using within‐subject and pairwise coefficients of variation ( CV w and CV p ), paired sample t‐tests, and Bland–Altman analysis. Results Using a combination of motion‐robust 2D ( b ‐ M 1 ) data acquisition, M 1 ‐dependent physical signal modeling with T 2 correction, and blood velocity SD distribution fitting, multiscanner reproducibility with median CV w = 5.09%, 11.3%, 9.20%, 14.2%, and 12.6% for D , V b1 , V b2 , f c1 , and f c2 , respectively, and interlobar agreement with CV p = 8.14%, 11.9%, 8.50%, 49.9%, and 42.0%, respectively, was achieved. Conclusion Recently proposed advanced IVIM acquisition, signal modeling, and fitting techniques may facilitate reproducible IVIM quantification in the liver, as needed for establishment of IVIM‐based quantitative biomarkers for detection, staging, and treatment monitoring of diseases. 

Reproducibility of intravoxel incoherent motion quantification in the liver across field strengths and gradient hardware

// Jinning Li 1, * , Caiyuan Zhang 1, * , Yanfen Cui 1 , Huanhuan Liu 1 , Weibo Chen 2 , Guilong Wang 2 and Dengbin Wang 1 1 Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China 2 Philips Healthcare, Shanghai 200233, China * These authors contributed equally to this work Correspondence to: Dengbin Wang, email: wangdengbin@xinhuamed.com.cn Keywords: intravoxel incoherent motion, diffusion-weighted imaging, liver, repeatability, respiratory-cardiac double triggering Received: August 02, 2017      Accepted: September 22, 2017      Published: October 11, 2017 ABSTRACT To investigate the influence of respiratory-cardiac double triggering (RCT) on intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for the liver, twelve healthy volunteers underwent liver DWI twice respectively with respiratory triggering (RT) and RCT schemes. Signal-to-noise ratios (SNRs) of the images, values, repeatability (evaluating with within-subject coefficient of variation), and variability of quantitative parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient ( D ), perfusion fraction ( f ), and perfusion-related diffusion coefficient ( D *), were evaluated for each DWI sequence. Results showed that the use of RCT scheme significantly enhanced SNRs ( P < 0.001), improved the measurement precision ( P ≤ 0.023) and repeatability ( P ≤ 0.009) of ADC, D , and f values, decreased the variability of ADC and D values ( P ≤ 0.015). Furthermore, this improvement was not completely confined to the left liver lobe, but also observed for the right liver lobe. Moreover, the precision of D * values in the right lobe ( P < 0.001) and its repeatability in the left lobe ( P = 0.002) were also significantly improved. Thus, our findings suggest that RCT is a more effective physiological scheme for improving SNRs, the precision, repeatability, and variability of quantitative parameters than RT for IVIM-DWI in the liver.

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Intravoxel incoherent motion diffusion-weighted MR imaging of the liver using respiratory-cardiac double triggering

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Intravoxel incoherent motion diffusion-weighted MR imaging of the liver using respiratory-cardiac double triggering