Multi-b value diffusion-weighted magnetic resonance imaging and intravoxel incoherent motion modeling: Differentiation of aggressive lymphoma lesions on initial treatment and activity assessment after chemotherapy

Medicine (Baltimore). 2019 Feb;98(6):e14459. doi: 10.1097/MD.0000000000014459.

Abstract

The diagnostic efficiency of diffusion-weighted magnetic resonance imaging with different b-values and application of an intravoxel incoherent motion (IVIM) model for differentiating disease states of lymphoma was investigated.Thirty-six patients at initial diagnosis and 69 after chemotherapy underwent diffusion-weighted magnetic resonance imaging (DW-MRI) with multiple b-values. Analysis parameters included the apparent diffusion coefficient (ADC) for each b-value. Standard ADC, D, D*, and f were calculated using an IVIM model.For patients at initial diagnosis, compared with aggressive lymphomas, the benign lymph nodes exhibited higher mean ADC (2.34 vs 0.66 × 10 mm/s, P < .01) for b = 200 s/mm. The AUC, sensitivity, specificity, and the cutoff value were 0.992, 96%, 100%, and 1.09 ×10 mm/s, respectively. For patients who had finished chemotherapy, the f-values of IVIM for those with partial remission (PR) were higher than those of complete remission (CR) (56.22 vs 21.81%, P < .01). The AUC, sensitivity, specificity, and the cutoff value were 0.937, 94%, 82%, 42.10%, respectively.For b = 200 s/mm, ADC values are most helpful for characterizing benign lymph nodes and malignant lymphomas. The f-value of the IVIM is most valuable in the identification of residual lesions of lymphomas after chemotherapy.

MeSH terms

  • Adult
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Lymphoma / diagnosis
  • Lymphoma / diagnostic imaging*
  • Lymphoma / drug therapy
  • Lymphoma / pathology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • ROC Curve
  • Sensitivity and Specificity