Hepatocellular carcinoma: short-term reproducibility of apparent diffusion coefficient and intravoxel incoherent motion parameters at 3.0T

J Magn Reson Imaging. 2015 Jan;41(1):149-56. doi: 10.1002/jmri.24538. Epub 2014 Jan 10.

Abstract

Purpose: To evaluate short-term test-retest and interobserver reproducibility of IVIM (intravoxel incoherent motion) diffusion parameters and ADC (apparent diffusion coefficient) of hepatocellular carcinoma (HCC) and liver parenchyma at 3.0T.

Materials and methods: In this prospective Institutional Review Board (IRB)-approved study, 11 patients were scanned twice using a free-breathing single-shot echo-planar-imaging, diffusion-weighted imaging (DWI) sequence using 4 b values (b = 0, 50, 500, 1000 s/mm(2)) and IVIM DWI using 16 b values (0-800 s/mm(2)) at 3.0T. IVIM parameters (D: true diffusion coefficient, D*: pseudodiffusion coefficient, PF: perfusion fraction) and ADC (using 4 b and 16 b) were calculated. Short-term test-retest and interobserver reproducibility of IVIM parameters and ADC were assessed by measuring correlation coefficient, coefficient of variation (CV), and Bland-Altman limits of agreements (BA-LA).

Results: Fifteen HCCs were assessed in 10 patients. Reproducibility of IVIM metrics in HCC was poor for D* and PF (mean CV 60.6% and 37.3%, BA-LA: -161.6% to 135.3% and -66.2% to 101.0%, for D* and PF, respectively), good for D and ADC (CV 19.7% and <16%, BA-LA -57.4% to 36.3% and -38.2 to 34.1%, for D and ADC, respectively). Interobserver reproducibility was on the same order of test-retest reproducibility except for PF in HCC. Reproducibility of diffusion parameters was better in liver parenchyma compared to HCC.

Conclusion: Poor reproducibility of D*/PF and good reproducibility for D/ADC were observed in HCC and liver parenchyma. These findings may have implications for trials using DWI in HCC.

Keywords: diffusion; hepatocellular carcinoma; perfusion; reproducibility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / diagnosis*
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging / methods*
  • Echo-Planar Imaging / methods*
  • Gadolinium DTPA
  • Humans
  • Image Enhancement
  • Image Interpretation, Computer-Assisted / methods*
  • Liver / pathology
  • Liver Neoplasms / diagnosis*
  • Male
  • Meglumine / analogs & derivatives
  • Middle Aged
  • Motion*
  • Observer Variation
  • Organometallic Compounds
  • Prospective Studies
  • Reproducibility of Results

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadolinium ethoxybenzyl DTPA
  • gadobenic acid
  • Meglumine
  • Gadolinium DTPA