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Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T 2 correction.
Journal of Magnetic Resonance Imaging : JMRI 2018 October
BACKGROUND: Diminished signal intensity of uterine fibroids in T2 -weighted images is routinely used as a qualitative marker of fibroid hypoperfusion. However, quantitative classification of fibroid perfusion with intravoxel incoherent motion (IVIM) model-based metrics is not yet clinically accepted.
PURPOSE: To investigate the influence of T2 correction on the estimation of IVIM model parameters for characterizing uterine fibroid tissue.
STUDY TYPE: Prospective.
POPULATION: Fourteen women with 41 fibroids (12 Type I and 29 Type II, per Funaki classification) underwent diffusion-weighted imaging and T2 mapping.
FIELD STRENGTH: Diffusion-weighted images (b values: 0, 20, 40, 60, 100, 200, 400, 600, 800, 1000 s/mm2 ) and T2 maps were obtained at 1.5T.
ASSESSMENT: The effect of uterine fibroid T2 variation on IVIM model parameters (diffusion coefficient, perfusion coefficient, and perfusion volume fraction) were numerically modeled and experimentally evaluated without (D, D*, f) and with (Dc , D c * , fc ) T2 correction. The relationship of T2 with D and the T2 -corrected perfusion volume fraction (fc ) was also examined.
STATISTICAL TEST: D-values and f-values estimated with and without T2 correction were compared by using a two-tailed Student's t-test.
RESULTS: Type II fibroids had higher D and f than Type I fibroids, but the differences were not significant (Type I vs. Type II, D: 0.83 ± 0.20 vs. 0.80 ± 0.25 mm2 /s, P = 0.78; f: 23.64 ± 4.87% vs. 25.27 ± 7.46%, P = 0.49). For Type I and Type II fibroids, fc was lower than f, and fc of Type II fibroids was significantly higher than that of Type I fibroids (Type I vs. Type II, fc : 7.80 ± 1.88% vs. 11.82 ± 4.13%, P = 0.003). Both D and fc exponentially increased with the increase of fibroid T2 as functions: D c ( T 2 ) = - 1.52 × 10 - 3 ⋅ e - 3.42 T 2 290 + 1.84 × 10 - 3 and f c ( T 2 ) = - 0.2336 ⋅ e - 3.217 T 2 290 + 0.2269 , respectively. D asymptotically approached 1.79 × 10-3 mm2 /s, and fc approached 21.74%.
DATA CONCLUSION: T2 correction is important when using IVIM-based models to characterize uterine fibroid tissue.
LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;48:994-1001.
PURPOSE: To investigate the influence of T2 correction on the estimation of IVIM model parameters for characterizing uterine fibroid tissue.
STUDY TYPE: Prospective.
POPULATION: Fourteen women with 41 fibroids (12 Type I and 29 Type II, per Funaki classification) underwent diffusion-weighted imaging and T2 mapping.
FIELD STRENGTH: Diffusion-weighted images (b values: 0, 20, 40, 60, 100, 200, 400, 600, 800, 1000 s/mm2 ) and T2 maps were obtained at 1.5T.
ASSESSMENT: The effect of uterine fibroid T2 variation on IVIM model parameters (diffusion coefficient, perfusion coefficient, and perfusion volume fraction) were numerically modeled and experimentally evaluated without (D, D*, f) and with (Dc , D c * , fc ) T2 correction. The relationship of T2 with D and the T2 -corrected perfusion volume fraction (fc ) was also examined.
STATISTICAL TEST: D-values and f-values estimated with and without T2 correction were compared by using a two-tailed Student's t-test.
RESULTS: Type II fibroids had higher D and f than Type I fibroids, but the differences were not significant (Type I vs. Type II, D: 0.83 ± 0.20 vs. 0.80 ± 0.25 mm2 /s, P = 0.78; f: 23.64 ± 4.87% vs. 25.27 ± 7.46%, P = 0.49). For Type I and Type II fibroids, fc was lower than f, and fc of Type II fibroids was significantly higher than that of Type I fibroids (Type I vs. Type II, fc : 7.80 ± 1.88% vs. 11.82 ± 4.13%, P = 0.003). Both D and fc exponentially increased with the increase of fibroid T2 as functions: D c ( T 2 ) = - 1.52 × 10 - 3 ⋅ e - 3.42 T 2 290 + 1.84 × 10 - 3 and f c ( T 2 ) = - 0.2336 ⋅ e - 3.217 T 2 290 + 0.2269 , respectively. D asymptotically approached 1.79 × 10-3 mm2 /s, and fc approached 21.74%.
DATA CONCLUSION: T2 correction is important when using IVIM-based models to characterize uterine fibroid tissue.
LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;48:994-1001.
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