Intravoxel Incoherent Motion Diffusion-weighted Imaging: Evaluation of the Differentiation of Solid Hepatic Lesions

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Focal liver lesions (FLLs) require accurate differentiation between malignant and benign types.
• Conventional imaging techniques may have limitations in definitively characterizing FLLs.
• Intravoxel incoherent motion (IVIM) imaging offers advanced insights into tissue microstructural and microcirculatory properties.

Purpose of the Study:

• To assess the utility of IVIM-derived parameters in distinguishing malignant from benign FLLs.
• To evaluate the diagnostic efficiency improvement offered by IVIM parameters.
• To identify specific IVIM parameters with the highest diagnostic value for hepatic lesions.

Main Methods:

• Seventy-four patients with 75 FLLs (51 malignant, 24 benign) underwent 3.0-T liver MRI.
• IVIM diffusion-weighted imaging (DWI) with 11 b values (0-800 s/mm²) was performed.
• Apparent diffusion coefficient (ADCtotal) and IVIM parameters (D, D*, f) were calculated and compared between groups using ROC analysis.

Main Results:

• ADCtotal, pure diffusion coefficient (D), and perfusion fraction (f) were significantly lower in malignant FLLs compared to benign FLLs.
• The pseudodiffusion coefficient (D*) did not show a statistically significant difference between groups.
• The D value exhibited a high area under the curve (0.968) and sensitivity (92.30%) for differentiating malignant from benign lesions.

Conclusions:

• IVIM imaging is a valuable tool for differentiating malignant and benign FLLs.
• The D value derived from IVIM demonstrates superior efficacy in detecting and characterizing hepatic solid lesions.
• IVIM parameters enhance diagnostic accuracy for FLLs.