Simplified intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging for liver lesion discrimination

Abstract

Diffusion weighted imaging is one of the most promising non-invasive imaging techniques implemented in routine clinical practice and plays an important role in liver lesion characterization and discrimination. Using DWI-derived IVIM parameters, a reliable liver lesion discrimination into benign and malignant lesions is possible. For this purpose, using representative 2D-ROIs is sufficient in routine clinical practice. Centrally deviating areas such as central necrosis, cystic components or scars should be excluded from ROIs either by hand or by computing low percentiles of diffusion coefficients instead of mean values by histogram analysis. Furthermore, created voxel-wise combined index maps IDf and the ROI-based combination of D' and f' parameters provide concordant diagnostic accuracy for liver lesion discrimination. The described IDf index map used as two-color overlay to b-800 images can be considered as a new tool for visual assessment and liver lesion discrimination.