Intravoxel incoherent motion (IVIM) MR imaging of colorectal liver metastases: are we only looking at tumor necrosis?

J Magn Reson Imaging. 2014 Feb;39(2):317-25. doi: 10.1002/jmri.24172. Epub 2013 May 30.

Abstract

Purpose: To determine if intra-voxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters, including free molecular-based (D) and perfusion-related (D*, f) diffusion parameters, correlate with the degree of tumor necrosis and viable tumor in colo-rectal cancer (CRC) metastasis.

Materials and methods: Fifteen patients referred for resection of liver metastases from CRC were retrospectively included in this Institutional Review Board approved study. An IVIM-DWI sequence was performed on a 1.5 Tesla MR imaging system, with 10 b factors (0, 10, 20, 30, 50, 80, 100, 200, 400 and 800 s/mm(2) ). Mean D, D*, f and apparent diffusion coefficient (ADC) values were determined in metastases with a longest diameter above 10 mm. Correlations between the diffusion parameters and the degree of liver tumor necrosis and viable tissue were determined (Spearman).

Results: Correlation between diffusion parameters and histopathological findings was performed in 35 hepatic metastases with a diameter of more than 10 mm (mean size of 17.9 mm; range, 1-68 mm). Both D (r = 0.36; P = 0.035) and ADC (r = 0.4; P = 0.02) correlated with the degree of tumor necrosis but not with viable tumor.

Conclusion: ADC variation observed in CRC metastases following systemic chemotherapy reflects a specific increase in free-molecular diffusion (D), in itself correlated to the degree of metastasis necrosis.

Keywords: b values; colorectal liver metastases; diffusion weighted imaging; intra-voxel incoherent motion; tumor necrosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colon / pathology*
  • Colorectal Neoplasms / pathology*
  • Diagnosis, Differential
  • Humans
  • Image Enhancement / methods
  • Imaging, Three-Dimensional / methods*
  • Liver / pathology*
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / secondary*
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Motion
  • Necrosis
  • Reproducibility of Results
  • Sensitivity and Specificity