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Diagnostic Efficacy and Correlation of Intravoxel Incoherent Motion (IVIM) and Contrast-Enhanced (CE) MRI Perfusion
Abhijith S1, Rajagopal Kadavigere2, Priya P S2
1Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
Background:
Intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) is a noncontrast technique estimating diffusion and perfusion parameters via multiple b-values, essential for oncology imaging. However, there is limited collective evidence regarding the efficacy of IVIM in oncology imaging compared to contrast-enhanced (CE) MRI perfusion techniques. This systematic review and meta-analysis compared IVIM's diagnostic accuracy and correlation with CE MRI perfusion techniques.
Methods:
Following PRISMA guidelines (PROSPERO-registered), a literature search across five databases (PubMed, Scopus, Embase, Web of Science, and Cochrane Library) was conducted. Diagnostic metrics, including AUC, sensitivity, specificity, and correlation coefficients, were analyzed using a random-effects model, with heterogeneity and publication bias assessed via I 2 statistics and Egger's test.
Results:
Eighteen studies on breast, rectal, and brain cancers were analyzed. For breast cancer, IVIM showed 83.50% sensitivity and 81.24% specificity compared to dynamic contrast-enhanced (DCE) MRI's 88.04% sensitivity and 65.98% specificity. In rectal cancer, IVIM achieved 70.9% sensitivity and 56.2% specificity, outperforming DCE MRI's 58.11% sensitivity and 72.49% specificity. For gliomas, IVIM demonstrated 92.27% sensitivity and 74.06% specificity compared to dynamic susceptibility contrast (DSC) MRI's 95.71% sensitivity and 92.91% specificity. Correlations between IVIM and CE parameters were weak to moderate.
Conclusion:
IVIM demonstrated equal or superior diagnostic performance to CE MRI in breast cancer, rectal cancer, and gliomas, offering a noncontrast alternative. However, unclear parameter correlations warrant future studies focusing on IVIM protocol optimization based on perfusion regimes.
Insights
Intravoxel incoherent motion (IVIM) MRI offers a noncontrast method for cancer imaging. This review found IVIM comparable or superior to contrast-enhanced MRI in diagnosing breast, rectal, and brain cancers.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) is a noncontrast technique for estimating diffusion and perfusion parameters, crucial in oncology.
- Limited evidence exists comparing IVIM's efficacy against contrast-enhanced (CE) MRI perfusion techniques in oncology.
Purpose of the Study:
- To systematically review and meta-analyze the diagnostic accuracy of IVIM compared to CE MRI perfusion techniques.
- To assess the correlation between IVIM parameters and CE MRI perfusion parameters.
Main Methods:
- A systematic literature search was conducted across five databases following PRISMA guidelines.
- Diagnostic metrics (AUC, sensitivity, specificity) and correlation coefficients were analyzed using a random-effects model.
- Heterogeneity and publication bias were assessed using I² statistics and Egger's test.
Main Results:
- Eighteen studies involving breast, rectal, and brain cancers were analyzed.
- IVIM showed comparable or superior sensitivity and specificity to CE MRI in breast, rectal, and glioma imaging.
- Correlations between IVIM and CE parameters were generally weak to moderate.
Conclusions:
- IVIM demonstrates promising diagnostic performance as a noncontrast alternative to CE MRI in various cancers.
- Further research is needed to optimize IVIM protocols and clarify parameter correlations for improved clinical application.
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