Intravoxel incoherent motion MRI of the healthy pancreas: Monoexponential and biexponential apparent diffusion parameters of the normal head, body and tail.

BACKGROUND: To investigate the monoexponential and biexponential apparent diffusion parameters in different anatomical regions of the healthy pancreas using intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI). METHODS: Fifty-seven healthy volunteers (age, 45.0 ± 10.8 years) were recruited. DWI of the pancreas was performed with 9 b-values (0, 20, 50, 100, 200, 400, 600, 800, and 1000 s/mm(2) , respectively). The ADC was calculated for all b-values using linear regression yielding ADCtotal . The ADCb value of the monoexponential DWI, slow component of diffusion (ADCslow ), incoherent microcirculation (ADCfast ) and perfusion fraction (f) of the biexponential DWI were calculated for the pancreas head, body and tail. Dependency of the parameters on the anatomical regions was analyzed using Friedman test. RESULTS: All of the mean ADC400 , ADC600 , ADC800 , ADC1000 , ADCtotal and f values differed significantly among the anatomical regions with the lowest values were observed in the tail of pancreas (P < 0.05). The Friedman test results demonstrated a significant decline of the mean ADC values of the monoexponential DWI from b20 to b1000 for the three anatomical regions respectively (P < 0.001). CONCLUSION: Multi-b-value DWI derived quantitative parameters including ADC400 , ADC600 , ADC800 , ADC1000 , ADCtotal , and f differed significantly among the pancreatic head, body and tail, with the lowest values obtained in the tail.

Intravoxel incoherent motion DWI of the pancreatic adenocarcinomas: monoexponential and biexponential apparent diffusion parameters and histopathological correlations.

BACKGROUND: To investigate the associations between the diffusion parameters obtained from multiple-b-values diffusion weighted imaging (DWI) of pancreatic ductal adenocarcinoma (PDAC) and the aggressiveness and local stage prediction, and assess the values of the quantitative parameters for the discrimination of tumors from healthy pancreas. METHODS: Fifty-one patients with surgical pathology-proven PDAC (size, 35 ± 12 mm) and fifty-seven healthy volunteers were enrolled. Diffusion parameters including monoexponential apparent diffusion coefficient (ADCb and ADCtotal) and biexponential intravoxel incoherent motion (IVIM) parameters (ADCslow, ADCfast and f) based on 9 b-values (0 to 1000s/mm2) DWI were calculated for the lesions and the healthy pancreas. These parameters were compared by grades of differentiation, lymph node status, tumor stage and location. The diagnostic performances were calculated and compared by using the receiver operating characteristic curves (ROC) analyses. RESULTS: There was no statistically significant difference in ADCb, ADCtotal, ADCslow, ADCfast or f between PDAC stage T1/T2 and stage T3/T4 or moderately differentiated versus poorly differentiated PDAC (p = 0.060-0.941). In addition, no significant differences were observed for the quantitative parameters between tumors located in the pancreatic head versus other pancreatic regions (p = 0.203-0.954) or between tumors with and without metastatic peri-pancreatic lymph nodes (p = 0.313-0.917). ADC25-600, ADC1000, ADCtotal and ADCfast were significantly lower for PDAC compared the healthy pancreas (all p < 0.05). ROC analyses showed the area under curve for ADC20 was the largest (0.911) to distinguish PDAC from normal pancreas (cut-off value, 5.58 × 10-3mm2/s) and had the highest combined sensitivity (89.5%) and specificity (82.4%). CONCLUSIONS: Multiple-b-values DWI derived monoexponential and biexponential parameters of PDAC do not exhibit significance dependence on tumor grade or tumor characteristics. ADC20 provided the best accuracy for differentiating PDAC from healthy pancreas in the study.

The diagnostic value of biexponential apparent diffusion coefficients in myopathy.

To investigate the performance of a biexponential signal decay model using DWI in myopathies and to differentiate Polymyositis (PM)/Dermatomyositis (DM), Glycogen Storage Diseases (GSDs) and Muscular Dystrophies (MDs) utilizing diffusion-weighted imaging. 11 healthy volunteers (control group) and 46 patients with myopathy were enrolled in the retrospective study. 27 of 46 patients had PM/DM, 7 patients GSDs and 12 patients MDs. After conventional MR sequences, diffusion weighted imaging with a b-factor ranging from 0 to 1200 s/mm(2) was performed on both thighs. The intra-muscular signal-to-noise ratios (SNRs) on multiple-b DWI images were measured for 7 different muscles and compared among the different groups. The median T2 signal intensity and biexponential apparent diffusion coefficients (ADC), including standard ADC, fast ADC, and slow ADC values, were compared among the different groups. The intra-muscular SNRs were statistically significantly different depending on the b value, and also found among the 4 groups (p < 0.05). The median T2 signal intensity of the normal muscles in control group was statistically significantly lower than that of edematous muscles in the PM/DM, GSDs and MDs groups (p = 0.000), while there were no statistically significant differences among the PM/DM, GSDs, and MDs groups (p > 0.05). The median standard ADC value of the edematous muscles in GSDs was statistically significantly lower than that of normal muscles in the control group (p = 0.000) and the median ADC value of the edematous muscles in PM/DM patients was statistically significantly greater than that of the GSDs (p = 0.000) and MDs groups (p = 0.005). The median slow ADC value of the edematous muscles in MDs patients and PM/DM patients was statistically significantly greater than that of GSDs patients (p < 0.05). Intra-muscular SNR decay curves and biexponential ADC parameters are useful in distinguishing among PM/DM, GSDs, and MDs.

Differentiation of central gland prostate cancer from benign prostatic hyperplasia using monoexponential and biexponential diffusion-weighted imaging.

PURPOSE: To investigate biexponential apparent diffusion parameters of prostate central gland (CG) cancer, stromal hyperplasia (SH), and glandular hyperplasia (GH) and compare with monoexponential apparent diffusion coefficient (ADC) value for discriminating prostate cancer from benign hyperplasia. MATERIALS AND METHODS: Twenty-one CG cancer foci, 23 SH and 26 GH nodules in the CG were analyzed in 39 patients (19 with CG cancer, 20 with peripheral zone cancer but no CG cancer) who underwent preoperative conventional DWI (b-value 0, 1000s/mm(2)) and a 10 b-value (range 0 to 3000s/mm(2)) DWI. All of the cancer and hyperplastic foci on MR images were localized on the basis of histopathologic correlation. The ADC value of the monoexponential DWI, and the fast apparent diffusion coefficient (ADCf), slow apparent diffusion coefficient (ADCs) value and the fraction of ADCf (f) of the biexponential DWI were calculated for all of the lesions. Receiver operating characteristic (ROC) analysis was performed for the differentiation of CG cancer from SH and GH. RESULTS: The ADC values (×10(-3)mm(2)/s) were 0.87±0.11, 1.06±0.15, and 1.61±0.27 in CG cancer, SH and GH foci, respectively, and differed significantly, yielding areas under the ROC curve (AUCs) of 1.00 and 0.80 for the differentiation of carcinoma from GH and SH, respectively. The ADCf (×10(-3)mm(2)/s), ADCs (×10(-3)mm(2)/s) and f for cancer were 1.92±0.38, 0.53±0.17, and 47.7±6.1%, respectively, which were lower than the same values for GH (3.43 ±0.65, 1.12±0.21, 61.1±8.7%) (all p<0.01). The ADCf and ADCs for cancer were also lower than those for SH (3.11±0.30, 0.79±0.21) (all p<0.01). The ADCf yielded AUCs (1.00, p>0.01) that were comparable to those from ADC for the differentiation of cancer from GH, while ADCf yielded higher AUCs (0.92) compared with ADC (p<0.01) for the differentiation of cancer from SH. ADCs and f revealed AUCs of 0.97 and 0.90, respectively, for the differentiation of cancer from GH, and the ADCs offered relatively lower AUCs (0.68) for differentiating cancer from SH. CONCLUSION: Biexponential DWI could potentially improve the differentiation of prostate cancer in CG, and the ADCf of the biexponential model offers better accuracy than ADC.