Dataset Information

Clinical utility of mono-exponential model diffusion weighted imaging using two b-values compared to the bi- or stretched exponential model for the diagnosis of biliary atresia in infant liver MRI.

ABSTRACT:

Purpose

To investigate the clinical utility of mono-exponential model diffusion weighted imaging (DWI) using two b-values compared to the bi- or stretched exponential model to differentiate biliary atresia (BA) from non-BA in pediatric liver magnetic resonance imaging (MRI).

Methods

Patients who underwent liver MRI with DWI for suspected BA from November 2017 to September 2018 were retrospectively included and divided into BA and non-BA groups. Laboratory results including ?-glutamyl transferase (?GT) were compared between the two groups using the Mann-Whitney U test and Fisher's exact test. The hepatic apparent diffusion coefficient (ADC) 10 using ten b-values and ADC 2 using two b-values were obtained from the mono-exponential model. The slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion fraction (f) were obtained from the bi-exponential model. The distributed diffusion coefficient (DDC) and heterogeneity index (?) were measured from the stretched exponential model. Parameters were compared between the two groups using a linear mixed model and diagnostic performance was assessed using the area under the curve (AUC) analysis.

Results

For 12 patients in the BA and five patients in the non-BA group, the ADC 10 (median 0.985 ×10-3 mm2/s vs. 1.332 ×10-3 mm2/s, p = 0.008), ADC 2 (median 0.987 ×10-3 mm2/s vs. 1.335 ×10-3 mm2/s, p = 0.017), D* (median 33.2 ×10-3 mm2/s vs. 55.3 ×10-3 mm2/s, p = 0.021), f (median 13.4%, vs. 22.1%, p = 0.009), and DDC (median 0.889 ×10-3 mm2/s vs. 1.323 ×10-3 mm2/s, p = 0.009) values were lower and the ?GT (median 368.0 IU/L vs. 93.5 IU/L, p = 0.02) and ? (median 0.699 vs. 0.556, p = 0.023) values were higher in the BA group. The AUC values for ?GT (AUC 0.867 95% confidence interval [CI] 0.616-0.984), ADC 10 (AUC 0.963, 95% CI 0.834-0.998), ADC 2 (AUC 0.925, 95% CI 0.781-0.987), f (AUC 0.850, 95% CI 0.686-0.949), and DDC (AUC 0.925, 95% CI 0.781-0.987) were not significantly different, except for the D* and ? values.

Conclusion

Patients with BA had lower ADC 10, ADC 2, D*, f, and DDC values and higher ?GT and ? values than those in the non-BA group. The diagnostic performance of ADC 2 using only two b-values showed excellent diagnostic performance and was not significantly different from that of ?GT, ADC 10, f, and DDC for diagnosing BA.

SUBMITTER: Kim J

PROVIDER: S-EPMC6920030 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Clinical utility of mono-exponential model diffusion weighted imaging using two b-values compared to the bi- or stretched exponential model for the diagnosis of biliary atresia in infant liver MRI.

Kim Jisoo J Yoon Haesung H Lee Mi-Jung MJ Kim Myung-Joon MJ Han Kyunghwa K Han Seok Joo SJ Koh Hong H Kim Seung S Shin Hyun Joo HJ

PloS one 20191218 12

<h4>Purpose</h4>To investigate the clinical utility of mono-exponential model diffusion weighted imaging (DWI) using two b-values compared to the bi- or stretched exponential model to differentiate biliary atresia (BA) from non-BA in pediatric liver magnetic resonance imaging (MRI).<h4>Methods</h4>Patients who underwent liver MRI with DWI for suspected BA from November 2017 to September 2018 were retrospectively included and divided into BA and non-BA groups. Laboratory results including γ-gluta ...[more]

PMID: 31852012

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Project description:PURPOSE:Diffusion-weighted imaging (DWI) plays an important role in the preoperative assessment of gliomas; however, the diagnostic performance of histogram-derived parameters from mono-, bi-, and stretched-exponential DWI models in the grading of gliomas has not been fully investigated. Therefore, we compared these models' ability to differentiate between high-grade and low-grade gliomas. METHODS:This retrospective study included 22 patients with diffuse gliomas (age, 23-74 years; 12 males; 11 high-grade and 11 low-grade gliomas) who underwent preoperative 3 T-magnetic resonance imaging from October 2014 to August 2019. The apparent diffusion coefficient was calculated from the mono-exponential model. Using 13 b-values, the true-diffusion coefficient, pseudo-diffusion coefficient, and perfusion fraction were obtained from the bi-exponential model, and the distributed-diffusion coefficient and heterogeneity index were obtained from the stretched-exponential model. Region-of-interests were drawn on each imaging parameter map for subsequent histogram analyses. RESULTS:The skewness of the apparent diffusion, true-diffusion, and distributed-diffusion coefficients was significantly higher in high-grade than in low-grade gliomas (0.67?±?0.67 vs. -?0.18?±?0.63, 0.68?±?0.74 vs. -?0.08?±?0.66, 0.63?±?0.72 vs. -?0.15?±?0.73; P?=?0.0066, 0.0192, and 0.0128, respectively). The 10th percentile of the heterogeneity index was significantly lower (0.77?±?0.08 vs. 0.88?±?0.04; P?=?0.0004), and the 90th percentile of the perfusion fraction was significantly higher (12.64?±?3.44 vs. 7.14?±?1.70%: P?<?0.0001), in high-grade than in low-grade gliomas. The combination of the 10th percentile of the true-diffusion coefficient and 90th percentile of the perfusion fraction showed the best area under the receiver operating characteristic curve (0.96). CONCLUSION:The bi-exponential model exhibited the best diagnostic performance for differentiating high-grade from low-grade gliomas.

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Dataset Information

Clinical utility of mono-exponential model diffusion weighted imaging using two b-values compared to the bi- or stretched exponential model for the diagnosis of biliary atresia in infant liver MRI.

Purpose

Methods

Results

Conclusion

Publications

Clinical utility of mono-exponential model diffusion weighted imaging using two b-values compared to the bi- or stretched exponential model for the diagnosis of biliary atresia in infant liver MRI.

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