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Characterization of focal liver lesions using the stretched exponential model: comparison with monoexponential and biexponential diffusion-weighted magnetic resonance imaging

 Hyung Cheol Kim  ;  Nieun Seo  ;  Yong Eun Chung  ;  Mi-Suk Park  ;  Jin-Young Choi  ;  Myeong-Jin Kim 
 European Radiology, Vol.29(9) : 5111-5120, 2019 
Journal Title
 European Radiology 
Issue Date
Comparative study ; Diffusion magnetic resonance imaging ; Hepatocellular carcinoma ; Liver ; Metastasis
OBJECTIVE: To compare the stretched exponential model of diffusion-weighted imaging (DWI) with monoexponential and biexponential models in terms of the ability to characterize focal liver lesions (FLLs). METHODS: This retrospective study included 180 patients with FLLs who underwent magnetic resonance imaging including DWI with nine b values at 3.0 T. The distributed diffusion coefficient (DDC) and intravoxel diffusion heterogeneity index (α) from a stretched exponential model; true diffusion coefficient (Dt), pseudo-diffusion coefficient (Dp), and perfusion fraction (f) from a biexponential model; and apparent diffusion coefficient (ADC) were calculated for each lesion. Diagnostic performances of the parameters were assessed through receiver operating characteristic (ROC) analysis. For 20 patients with treated hepatic metastases, the correlation between the DWI parameters and the percentage of tumor necrosis on pathology was evaluated using the Spearman correlation coefficient. RESULTS: DDC had the highest area under the ROC curve (AUC, 0.905) for differentiating malignant from benign lesions, followed by Dt (0.903) and ADC (0.866), without significant differences among them (DDC vs. Dt, p = 0.946; DDC vs. ADC, p = 0.157). For distinguishing hypovascular from hypervascular lesions, and hepatocellular carcinoma from metastasis, f  had a significantly higher AUC than the other DWI parameters (p < 0.05). The α had the strongest correlation with the degree of tumor necrosis (ρ = 0.655, p = 0.002). CONCLUSION: The DDC from stretched exponential model of DWI demonstrated excellent diagnostic performance for differentiating malignant from benign FLLs. The α is promising for evaluating the degree of necrosis in treated metastases. KEY POINTS: • The stretched exponential DWI model is valuable for characterizing focal liver lesions. • The DDC from stretched exponential model shows excellent performance for differentiating malignant from benign focal liver lesions. • The α from stretched exponential model is promising for evaluating the degree of necrosis in hepatic metastases after chemotherapy.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Hyung Cheol(김형철)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Seo, Nieun(서니은) ORCID logo https://orcid.org/0000-0001-8745-6454
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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