Korean J Radiol.  2016 Oct;17(5):641-649. 10.3348/kjr.2016.17.5.641.

Intravoxel Incoherent Motion MR Imaging in the Head and Neck: Correlation with Dynamic Contrast-Enhanced MR Imaging and Diffusion-Weighted Imaging

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea. jeonghlee@amc.seoul.kr
  • 2Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
  • 3Department of Radiology, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon 22711, Korea.
  • 4Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Korea.

Abstract


OBJECTIVE
To investigate the correlation between perfusion- and diffusion-related parameters from intravoxel incoherent motion (IVIM) and those from dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted imaging in tumors and normal muscles of the head and neck.
MATERIALS AND METHODS
We retrospectively enrolled 20 consecutive patients with head and neck tumors with MR imaging performed using a 3T MR scanner. Tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were derived from bi-exponential fitting of IVIM data obtained with 14 different b-values in three orthogonal directions. We investigated the correlation between D, f, and D* and model-free parameters from the DCE-MRI (wash-in, Tmax, Emax, initial AUC60, whole AUC) and the apparent diffusion coefficient (ADC) value in the tumor and normal masseter muscle using a whole volume-of-interest approach. Pearson's correlation test was used for statistical analysis.
RESULTS
No correlation was found between f or D* and any of the parameters from the DCE-MRI in all patients or in patients with squamous cell carcinoma (p > 0.05). The ADC was significantly correlated with D values in the tumors (p < 0.001, r = 0.980) and muscles (p = 0.013, r = 0.542), despite its significantly higher value than D. The difference between ADC and D showed significant correlation with f values in the tumors (p = 0.017, r = 0.528) and muscles (p = 0.003, r = 0.630), but no correlation with D* (p > 0.05, respectively).
CONCLUSION
Intravoxel incoherent motion shows no significant correlation with model-free perfusion parameters derived from the DCE-MRI but is feasible for the analysis of diffusivity in both tumors and normal muscles of the head and neck.

Keyword

Head; Neck; Intravoxel incoherent motion; Dynamic contrast-enhanced MRI; Diffusion-weighted imaging; Correlation; IVIM; DCE-MRI; DWI

MeSH Terms

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell/diagnostic imaging
Contrast Media
Diffusion
Diffusion Magnetic Resonance Imaging/methods
Feasibility Studies
Female
Head and Neck Neoplasms/*diagnostic imaging
Humans
Image Interpretation, Computer-Assisted/methods
Magnetic Resonance Imaging/*methods
Male
Masseter Muscle/diagnostic imaging
Middle Aged
Perfusion
Retrospective Studies
Young Adult
Contrast Media

Figure

  • Fig. 1 Axial contrast-enhanced T1-weighted imaging, color coded AUC60, TSI curve, D, D*, and f map of 65-year-old male patient with squamous cell carcinoma of right palatine tonsil. Pre-contrast and contrast-enhanced T1-weighted MR imaging (A, B) showed mass in right palatine tonsil. Region of interest was drawn around entire tumor on dynamic contrast-enhanced source images (C). AUC60 (D) map derived from DCE-MRI showed fast visual increase in AUC in corresponding areas of contrast-enhancing lesion, and AUC60 value is 146.355. TSI curve (E) of entire enhancing lesion (blue curve) and normal muscle (red curve) showed wash out and plateau patterns, respectively. ROI was also drawn around entire tumor area on intravoxel incoherent motion MR source images (F), and D (G), D* (H), and f (I) maps demonstrated D, D*, and f values were 0.908 × 10-3 mm2/s, 184.075 × 10-3 mm2/s and 0.138, respectively. AUC60 = the initial 60-second area under curve, DCE-MRI = dynamic contrast-enhanced MR imaging, ROI = region of interest, SI = signal intensity, TSI = time-signal intensity

  • Fig. 2 Correlation of difference between ADC and D values with f value from IVIM. Difference between D and ADC values correlated significantly with f value from IVIM in tumors (A) and normal muscle (B) (tumor, p = 0.017, r = 0.528; muscle, p = 0.003, r = 0.630). ADC = apparent diffusion coefficient, IVIM = intravoxel incoherent motion


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