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Relationship between diffusion parameters derived from intravoxel incoherent motion MRI and perfusion measured by
Simona Marzi1, Linda Stefanetti2, Francesca Sperati3
1Medical Physics Laboratory, Regina Elena National Cancer Institute, Rome, Italy.
Abstract:
Our aim was to evaluate the link between diffusion parameters measured by intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and the perfusion metrics obtained with dynamic contrast-enhanced (DCE) MRI in soft tissue tumors (STTs). Twenty-eight patients affected by histopathologically confirmed STT were included in a prospective study. All patients underwent both DCE MRI and IVIM DWI. The perfusion fraction f, diffusion coefficient D and perfusion-related diffusion coefficient D* were estimated using a bi-exponential function to fit the DWI data. DCE MRI was acquired with a temporal resolution of 3-5 s. Maps of the initial area under the gadolinium concentration curve (IAUGC), time to peak (TTP) and maximum slope of increase (MSI) were derived using commercial software. The relationships between the DCE MRI and IVIM DWI measurements were assessed by Spearman's test. To exclude false positive results under multiple testing, the false discovery rate (FDR) procedure was applied. The Mann-Whitney test was used to evaluate the differences between all variables in patients with non-myxoid and myxoid STT. No significant relationship was found between IVIM parameters and any DCE MRI parameters. Higher f and D*f values were found in non-myxoid tumors compared with myxoid tumors (p = 0.004 and p = 0.003, respectively). MSI was significantly higher in non-myxoid tumors than in myxoid tumors (p = 0.029). From the visual assessments of single clinical cases, both f and D*f maps were in satisfactory agreement with DCE maps in the extreme cases of an avascular mass and a highly vascularized mass, whereas, for tumors with slight vascularity or with a highly heterogeneous perfusion pattern, this association was not straightforward. Although IVIM DWI was demonstrated to be feasible in STT, our data did not support evident relationships between perfusion-related IVIM parameters and perfusion measured by DCE MRI.
Insights
This study found no direct link between intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters and dynamic contrast-enhanced (DCE) MRI perfusion metrics in soft tissue tumors (STTs). However, IVIM parameters showed differences between non-myxoid and myxoid tumors.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Soft tissue tumors (STTs) require accurate characterization for effective management.
- Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI are advanced imaging techniques used to assess tumor biology.
- Understanding the relationship between these techniques can potentially improve diagnostic capabilities.
Purpose of the Study:
- To evaluate the correlation between IVIM DWI parameters and DCE MRI perfusion metrics in patients with STTs.
- To explore potential differences in these parameters between myxoid and non-myxoid STTs.
Main Methods:
- Prospective study of 28 patients with histopathologically confirmed STTs.
- All patients underwent both DCE MRI and IVIM DWI.
- IVIM parameters (f, D, D*f) were derived using a bi-exponential fit; DCE parameters (IAUGC, TTP, MSI) were calculated using commercial software.
- Spearman's test and false discovery rate (FDR) were used for correlation analysis; Mann-Whitney test for group comparisons.
Main Results:
- No significant correlation was found between IVIM parameters and DCE MRI perfusion metrics.
- Higher perfusion fraction (f) and perfusion-related diffusion coefficient (D*f) values were observed in non-myxoid tumors compared to myxoid tumors (p=0.004 and p=0.003, respectively).
- Maximum slope of increase (MSI) was significantly higher in non-myxoid tumors (p=0.029).
- Visual assessment showed agreement in extreme cases (avascular/highly vascular) but not in heterogeneous tumors.
Conclusions:
- While IVIM DWI is feasible for STTs, this study did not establish a direct relationship between its perfusion-related parameters and DCE MRI perfusion metrics.
- IVIM parameters may help differentiate between non-myxoid and myxoid STTs.
- Further research is needed to clarify the role of IVIM DWI in characterizing STTs.
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