Precision of liver and pancreas apparent diffusion coefficients using motion-compensated gradient waveforms in DWI

Jitka Starekova; Ruiqi Geng; Zihan Wang; Yuxin Zhang; Nataliya V Uboha; Ali Pirasteh; Diego Hernando

doi:10.1016/j.mri.2024.04.026

Precision of liver and pancreas apparent diffusion coefficients using motion-compensated gradient waveforms in DWI

Magn Reson Imaging. 2024 Apr 18:110:161-169. doi: 10.1016/j.mri.2024.04.026. Online ahead of print.

Authors

Jitka Starekova¹, Ruiqi Geng², Zihan Wang³, Yuxin Zhang⁴, Nataliya V Uboha⁵, Ali Pirasteh⁶, Diego Hernando⁷

Affiliations

¹ Department of Radiology, University of Wisconsin, Madison, WI, USA. Electronic address: starekova@wisc.edu.
² Department of Radiology, University of Wisconsin, Madison, WI, USA; Department of Medical Physics, University of Wisconsin, Madison, WI, USA. Electronic address: rgeng5@wisc.edu.
³ Department of Radiology, University of Wisconsin, Madison, WI, USA. Electronic address: zwang379@jhmi.edu.
⁴ Department of Radiology, University of Wisconsin, Madison, WI, USA; Department of Medical Physics, University of Wisconsin, Madison, WI, USA. Electronic address: annie.yx.zhang1994@gmail.com.
⁵ Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, University of Wisconsin, School of Medcine and Public Health, Madison, WI, USA; Carbone Cancer Center, University of Wisconsin, Madison, WI, USA. Electronic address: nvuboha@medicine.wisc.edu.
⁶ Department of Radiology, University of Wisconsin, Madison, WI, USA; Department of Medical Physics, University of Wisconsin, Madison, WI, USA. Electronic address: pirasteh@wisc.edu.
⁷ Department of Radiology, University of Wisconsin, Madison, WI, USA; Department of Medical Physics, University of Wisconsin, Madison, WI, USA. Electronic address: dhernando@wisc.edu.

PMID: 38641212
DOI: 10.1016/j.mri.2024.04.026

Abstract

Background: Diffusion weighted imaging (DWI) with optimized motion-compensated gradient waveforms reduces signal dropouts in the liver and pancreas caused by cardiovascular-associated motion, however its precision is unknown. We hypothesized that DWI with motion-compensated DW gradient waveforms would improve apparent diffusion coefficient (ADC)-repeatability and inter-reader reproducibility compared to conventional DWI in these organs.

Methods: In this IRB-approved, prospective, single center study, subjects recruited between October 2019 and March 2020 were scanned twice on a 3 T scanner, with repositioning between test and retest. Each scan included two respiratory-triggered DWI series with comparable acquisition time: 1) conventional (monopolar) 2) motion- compensated diffusion gradients. Three readers measured ADC values. One-way ANOVA, Bland-Altman analysis were used for statistical analysis.

Results: Eight healthy participants (4 male/4 female), with a mean age of 29 ± 4 years, underwent the liver and pancreas MRI protocol. Four patients with liver metastases (2 male/2 female) with a mean age of 58 ± 5 years underwent the liver MRI protocol. In healthy participants, motion-compensated DWI outperformed conventional DWI with mean repeatability coefficient of 0.14 × 10^-3 (CI:0.12-0.17) vs. 0.31 × 10^-3 (CI:0.27-0.37) mm²/s for liver, and 0.11 × 10^-3 (CI:0.08-0.15) vs. 0.34 × 10^-3 (CI:0.27-0.49) mm²/s for pancreas; and with mean reproducibility coefficient of 0.20 × 10^-3 (CI:0.18-0.23) vs. 0.51 × 10^-3 (CI:0.46-0.58) mm²/s for liver, and 0.16 × 10^-3 (CI:0.13-0.20) vs. 0.42 × 10^-3 (CI:0.34-0.52) mm²/s for pancreas. In patients, improved repeatability was observed for motion-compensated DWI in comparison to conventional with repeatability coefficient of 0.51 × 10^{- 3} mm²/s (CI:0.35-0.89) vs. 0.70 × 10^-3 mm²/s (CI:0.49-1.20).

Conclusion: Motion-compensated DWI enhances the precision of ADC measurements in the liver and pancreas compared to conventional DWI.

Keywords: ADC; DWI; Liver; Pancreas; Repeatability.