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Postmortem MR diffusion-weighted imaging of the liver: time-behavior of the hepatic apparent diffusion coefficient in
Sarah Keller1, Tony M Schmidt2, Anne Catherine Kim3
1Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany. s.keller@uke.de.
Objective:
The objective of this study is to assess postmortem changes of the hepatic apparent diffusion coefficient (ADC) at multiple time points in the time interval of 16 hours postmortem in comparison to in vivo controls and to literature data.
Material And Methods:
Hepatic diffusion-weighted imaging (DWI) was repeatedly performed at 1.5 Tesla (b values 50, 400, and 800 s/mm2) in 2-hourly steps within 16 hours postmortem in 19 cases (male to female 13:6, mean age 68.5 ± 12.2 years) and 5 in vivo controls. The core body temperature was measured rectally prior to every scan. Mean ADC values were calculated from regions of interest (ROIs) and compared to in vivo healthy controls and to literature data of normal liver parenchyma. Spearman rank correlation and Levenberg-Marquardt algorithm were used to assess a relationship between postmortem core body temperature and ADC values.
Results:
Mean hepatic ADC values were significantly lower in postmortem cases than in in vivo controls (52.0 ± 15.0 · 10-5 mm2/s vs. 111.0 ± 15.7 · 10-5 mm2/s, p < 0.0001). The ex vivo liver ADC correlated inversely to calculated liver temperature (-3.5 ± 0.8) · 10-5 mm2/s/°C, r = -0.44, p < 0.0001. At low calculated liver temperature (< 30 °C), the ADC described an average increase of (22 ± 10) · 10-5 mm2/s/°C.
Conclusion:
Hepatic ADC values show a characteristic change in the immediate 16 hours postmortem, which is influenced by the postmortem liver temperature change. With the knowledge of characteristic postmortem liver changes, diffusion-weighted imaging could be added to conventional postmortem MRI for virtual autopsy.
Insights
Postmortem liver apparent diffusion coefficient (ADC) changes significantly within 16 hours, influenced by temperature. Diffusion-weighted imaging (DWI) can aid virtual autopsy by characterizing these hepatic ADC alterations.
Area of Science:
- Radiology
- Forensic Medicine
- Medical Imaging
Background:
- Apparent diffusion coefficient (ADC) is a key MRI parameter reflecting tissue water mobility.
- Understanding postmortem changes in ADC is crucial for interpreting forensic and clinical imaging.
- Hepatic ADC values in vivo are well-established, but postmortem changes require further characterization.
Purpose of the Study:
- To evaluate the temporal changes in hepatic apparent diffusion coefficient (ADC) up to 16 hours postmortem.
- To compare postmortem hepatic ADC values with in vivo controls and existing literature data.
- To investigate the influence of postmortem core body temperature on hepatic ADC.
Main Methods:
- Diffusion-weighted imaging (DWI) was performed at 1.5 Tesla in 19 postmortem cases and 5 in vivo controls.
- Scans were conducted in 2-hour intervals within 16 hours postmortem, with rectal temperature monitoring.
- Mean hepatic ADC values were calculated and correlated with liver temperature using statistical analysis.
Main Results:
- Mean hepatic ADC values were significantly lower in postmortem cases compared to in vivo controls (52.0 vs. 111.0 × 10⁻⁵ mm²/s).
- Ex vivo liver ADC showed an inverse correlation with liver temperature (r = -0.44, p < 0.0001).
- At liver temperatures below 30°C, ADC increased by approximately 22 × 10⁻⁵ mm²/s per degree Celsius.
Conclusions:
- Hepatic ADC values undergo characteristic changes within 16 hours postmortem, significantly influenced by temperature.
- These findings suggest that DWI can be a valuable addition to postmortem MRI for virtual autopsy.
- Characterizing postmortem hepatic ADC changes enhances the utility of MRI in forensic investigations.
