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Application of diffusion kurtosis imaging in differential diagnosis of focal liver lesions
Joanna Podgórska1,2, Katarzyna Pasicz3, Witold Skrzyński3
12 Department of Clinical Radiology, Warsaw Medical University, Poland.
Purpose:
Diffusion kurtosis imaging (DKI) is an MRI method related to diffusion imaging (DWI) that is distinguished by a non-Gaussian calculation of water particles movements in tissues. The aim of the study was to assess DKI advantage over DWI in differentiating benign and malignant liver lesions.
Material And Methods:
Analysis included prospectively acquired group of 83 patients referred consecutively for 3T-MRI liver tumor examination, with 95 liver lesions (31 benign, 59 malignant). MRI assessments were performed with standard protocol and DKI sequence with seven b-values (0-2,000 s/mm2). Quantitative data were acquired by placing ROIs in liver tumors on all b-value images, ROI data extracted, and calculation of DWI and DKI parameters. ADC was calculated for all b-values (ADC0-2000) and for three values of b = 0, 500, and 750 (s/mm2) (ADC0-500-750). DKI and ADC parameters for benign and malignant lesions were compared, and ROC curves were plotted.
Results:
Significant differences were obtained for all DKI and ADC parameters. ROC analysis showed AUC of DK, K, ADC0-2000, and ADC0-500-750 was 0.74, 0.77, 0.77, and 0.75, respectively. The highest sensitivity (of 0.91) was obtained for ADC0-2000. The highest specificity (0.65) and accuracy (0.80) was obtained for K.
Conclusion:
DKI technique yields statistically comparable results with DWI technique.
Insights
Diffusion kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) show comparable results in differentiating liver lesions. Advanced DKI parameters, particularly kurtosis (K), offer high accuracy for lesion characterization.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Diffusion-weighted imaging (DWI) is a standard MRI technique.
- Diffusion kurtosis imaging (DKI) offers advanced analysis of water diffusion in tissues, potentially improving lesion characterization.
- Distinguishing benign from malignant liver lesions is crucial for patient management.
Purpose of the Study:
- To evaluate the diagnostic advantage of DKI compared to DWI in differentiating benign and malignant liver lesions.
- To assess the performance of DKI-derived parameters in liver tumor characterization.
Main Methods:
- Prospective analysis of 83 patients with 95 liver lesions (31 benign, 59 malignant) using 3T-MRI.
- Acquisition of standard DWI and DKI sequences with seven b-values (0-2,000 s/mm²).
- Quantitative analysis of apparent diffusion coefficient (ADC) and DKI parameters (e.g., D<0xE2><0x82><0x96>, K) using region of interest (ROI) measurements and receiver operating characteristic (ROC) curve analysis.
Main Results:
- All DKI and ADC parameters showed significant differences between benign and malignant lesions.
- ROC analysis yielded AUC values of 0.74 for D<0xE2><0x82><0x96>, 0.77 for K, 0.77 for ADC<0xE2><0x82><0x80><0xE2><0x80><0x93><0xE2><0x82><0x82><0xE2><0x82><0x80><0xE2><0x82><0x80>, and 0.75 for ADC<0xE2><0x82><0x80><0xE2><0x80><0x93><0xE2><0x82><0x85><0xE2><0x82><0x80><0xE2><0x82><0x80><0xE2><0x82><0x87><0xE2><0x82><0x85><0xE2><0x82><0x80>.
- ADC<0xE2><0x82><0x80><0xE2><0x80><0x93><0xE2><0x82><0x82><0xE2><0x82><0x80><0xE2><0x82><0x80> achieved the highest sensitivity (0.91), while kurtosis (K) demonstrated the highest specificity (0.65) and accuracy (0.80).
Conclusions:
- DKI technique provides statistically comparable results to DWI.
- DKI parameters, particularly kurtosis, show potential for improved differentiation of benign and malignant liver lesions.
- Further research may validate DKI's role in routine liver lesion assessment.
