Liver diffusion-weighted MR imaging: the tower of Babel?

Area of Science:

• Medical Imaging
• Radiology
• Biophysics

Background:

• Diffusion-weighted imaging (DWI) is increasingly used for liver assessment.
• The apparent diffusion coefficient (ADC) is a common metric, but its calculation is inconsistent.
• ADC values are influenced by both diffusion and perfusion, which can vary independently.

Discussion:

• DWI signal attenuation follows a bi-exponential pattern, enabling calculation of other diffusion/perfusion coefficients.
• These advanced metrics may offer more precise insights than standard ADC.
• Lack of standardized terminology and methodology hinders study comparability in liver DWI.

Key Insights:

• Current ADC calculation methods for liver DWI lack standardization, impacting reliability.
• Multi-parametric DWI provides a more comprehensive approach to liver tissue characterization.
• Standardized protocols and terminology are essential for advancing liver DWI research and clinical application.

Outlook:

• Future research should focus on developing standardized DWI protocols for the liver.
• Establishing a common language will facilitate multi-center studies and clinical translation.
• Multi-parametric DWI holds promise for improved diagnosis and monitoring of liver diseases.