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30.01.2018 | Hepatobiliary-Pancreas | Ausgabe 7/2018

European Radiology 7/2018

Staging liver fibrosis with DWI: is there an added value for diffusion kurtosis imaging?

Zeitschrift:
European Radiology > Ausgabe 7/2018
Autoren:
Li Yang, Shengxiang Rao, Wentao Wang, Caizhong Chen, Ying Ding, Chun Yang, Robert Grimm, Xu Yan, Caixia Fu, Mengsu Zeng
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00330-017-5245-6) contains supplementary material, which is available to authorized users.

Abstract

Objectives

To assess liver fibrosis in patients with chronic liver disease using diffusion kurtosis imaging (DKI) in comparison with conventional diffusion-weighted imaging, with histology as reference standard.

Methods

This prospective study included 81 patients and DKI with b-values of 0, 200, 500, 1,000, 1,500, 2,000 s/mm2 were performed. Mean diffusivity (MD), mean kurtosis (MK) and apparent diffusion coefficient (ADC) maps were calculated. The diagnostic efficacy of MD, MK and ADC for predicting stage 2 fibrosis or greater, and stage 3 fibrosis or greater were compared.

Results

The MD (rho=-0.491, p<0.001), MK (rho=0.537, p<0.001) and ADC (rho=-0.496, p<0.001) correlated significantly with fibrosis stages, and ADC exhibited a strong negative correlation with MK (rho=-0.968; p<0.001) and a moderate association with MD (rho=0.601, p<0.001). Areas under the curves (AUCs) for predicting stage 2 fibrosis or greater were not significantly different (p>0.05) between MK (0.809) and ADC (0.797) as well as between MD (0.715) and ADC. AUCs were also similar for MD (0.710), MK (0.768) and ADC (0.747) for predicting stage 3 fibrosis or greater.

Conclusion

Although DKI is feasible for predicting liver fibrosis in patients with chronic liver disease, MD and MK offer similar diagnostic performance to ADC values.

Key Points

Diffusion kurtosis imaging is feasible for staging liver fibrosis.
Diffusion kurtosis and monoexponential model are highly correlated.
The kurtosis model offers no added value to the conventional, monoexponential model

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