Evaluation of hepatic fibrosis using intravoxel incoherent motion in diffusion-weighted liver MRI

Area of Science:

• Radiology
• Medical Imaging
• Hepatology

Background:

• Hepatic fibrosis (HF) is a critical indicator of liver disease progression.
• Accurate non-invasive assessment of HF is essential for patient management.
• Current imaging techniques have limitations in differentiating HF stages.

Purpose of the Study:

• To compare the diagnostic performance of intravoxel incoherent motion (IVIM)-diffusion-weighted imaging (DWI) parameters against the apparent diffusion coefficient (ADC(total)) for hepatic fibrosis evaluation.
• To determine if IVIM-DWI parameters offer improved accuracy in staging hepatic fibrosis.

Main Methods:

• Retrospective analysis of 55 patients with chronic liver disease who underwent IVIM-DWI at 3 Tesla with 8 b-values.
• Calculation of IVIM-DWI parameters: true diffusion coefficient (Dt), pseudo-diffusion coefficient (Dp), perfusion fraction (f), and ADC(total).
• Receiver operating characteristic (ROC) analysis was employed for parameter evaluation in hepatic fibrosis staging.

Main Results:

• All assessed parameters (Dt, Dp, f, ADC(total)) showed significant correlations with hepatic fibrosis stages (P < 0.05).
• Parameters were significantly higher in patients with stages F0-F1 compared to F4 (P < 0.05).
• The pseudo-diffusion coefficient (Dp) demonstrated superior performance in differentiating significant hepatic fibrosis (≥F2) from early stages (F0-F1) compared to ADC(total).

Conclusions:

• Both IVIM-derived parameters and ADC(total) exhibit significant correlations with hepatic fibrosis stages.
• The pseudo-diffusion coefficient (Dp) derived from IVIM-DWI offers enhanced diagnostic performance for identifying significant hepatic fibrosis over ADC(total).
• IVIM-DWI shows promise as a more effective imaging biomarker for non-invasive hepatic fibrosis assessment.