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 value of multi-parameter diffusion and perfusion magnetic resonance imaging for evaluating epithelial-mesenchymal transition in rectal cancer.

The utility of diffusion kurtosis imaging (DKI) for assessing intra-tumor heterogeneity was evaluated in a rat model of glioblastoma multiforme. Longitudinal MRI including T2 -weighted and diffusion-weighted MRI (DWI) was performed on six female Fischer rats 8, 11 and 14 days after intracranial transplantation of F98 cells. T2 -weighted images were used to measure the tumor volumes and DWI images were used to compute diffusion tensor imaging (DTI) and DWI based parametric maps including mean diffusivity (MD), mean kurtosis (MK), axial diffusivity (AD), axial kurtosis, radial diffusivity, radial kurtosis, fractional anisotropy (FA) and kurtosis fractional anisotropy (KFA). Median values from the segmented normal contralateral cortex, tumor and edema from the diffusion parameters were compared at the three imaging time points to assess any changes in tumor heterogeneity over time. ex vivo DKI was also performed in a representative sample and compared with histology. Significant differences were observed between normal cortex, tumor and edema in both the DTI and DKI parameters. Notably, at the earliest time point MK and KFA were significantly different between normal cortex and tumor in comparison with MD or FA. Although a decreasing trend in MD, AD and FA values of the tumor were observed as the tumor grew, no significant changes in any of the DTI or DKI parameters were observed longitudinally. While DKI was equally sensitive to DTI in differentiating tumor from edema and normal brain, it was unable to detect longitudinal increases in intra-tumoral heterogeneity in the F98 model of glioblastoma multiforme.

Diffusion kurtosis imaging for characterizing tumor heterogeneity in an intracranial rat glioblastoma model.

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

Epithelial-mesenchymal transition (EMT) plays an important role in aggravating invasiveness and metastatic behavior of colorectal cancer (CRC). Identification of EMT is important for structuring treatment strategy, but has not yet been studied by using noninvasive imaging modality. Diffusion kurtosis imaging (DKI) is an advanced diffusion weighted model that could reflect tissue microstructural changes in vivo. In this study, EMT was induced in CRC cells (HCT116) by overexpressing Snail1 gene. We aimed to investigate the value of DKI in identifying EMT in CRC and decipher the correlations between DKI-derived parameters and EMT biomarker E-cadherin and cell proliferative index Ki-67 expression. Our results revealed that HCT116/Snail1 cells presented changes consistent with EMT resulting in significant increase in migration and invasion capacities. DKI could identify CRC with EMT, in which the DKI-derived parameter diffusivity was significantly lower, and kurtosis was significantly higher than those in the CRC/Control. Diffusivity was negatively and kurtosis was positively correlated with Ki-67 expression, whereas diffusivity was positively and kurtosis was negatively correlated with E-cadherin expression. Therefore, our study concluded that DKI can identify EMT in CRC xenograft tumors. EMT-contained CRC tumors with high Ki-67 and low E-cadherin expression were vulnerable to have lower diffusivity and higher kurtosis coefficients.

/pdf/diffusion-kurtosis-imaging-evaluating-epithelial-mesenchymal-4uf0ij9qok.pdf

Diffusion kurtosis imaging evaluating epithelial-mesenchymal transition in colorectal carcinoma xenografts model: a preliminary study.

// 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.

/pdf/intravoxel-incoherent-motion-diffusion-weighted-mr-imaging-43e3wdwkk9.pdf

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

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Diffusion kurtosis imaging evaluating epithelial-mesenchymal transition in colorectal carcinoma xenografts model: a preliminary study.

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