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Hepatic metastases: use of diffusion-weighted echo-planar imaging

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Abstract

Diffusion-weighted MR imaging is increasingly applied to detect and characterize focal hepatic lesions. In this update article, technical aspects regarding diffusion-weighted echo-planar imaging (DW-EPI) of the liver will be addressed, and concepts for image interpretation will be provided. The value of DW-EPI for the detection of hepatic metastases is illustrated on the basis of a review of the literature and our personal experience. In this respect, special emphasis is given to the comparison of DW-EPI with well-established MR imaging techniques such as T2-weighted and contrast-enhanced MR imaging, and advantages and limitations of DW-EPI will be described. Based on the review, it is concluded that DW-EPI is more sensitive than T2-weighted MR imaging and at least as accurate as superparamagnetic iron oxide-enhanced or gadolinium-enhanced MR imaging for the detection of hepatic metastases. Although difficulties occasionally arise in further characterizing small lesions detected with DW-EPI, substantial improvements in the preoperative evaluation of liver metastases in candidates for hepatic resection may be expected.

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References

  1. Ward J (2006) New MR techniques for the detection of liver metastases. Cancer Imaging 6:33-42.

    Article  CAS  PubMed  Google Scholar 

  2. Rappeport ED, Loft A (2007) Liver metastases from colorectal cancer: imaging with superparamagnetic iron oxide (SPIO)-enhanced MR imaging, computed tomography and positron emission tomography. Abdom Imaging 32:624-634.

    Article  PubMed  Google Scholar 

  3. Ichikawa T, Haradome H, Hachiya J, Nitatori T, Araki T (1998) Diffusion-weighted MR imaging with a single-shot echoplanar sequence: detection and characterization of focal hepatic lesions. AJR Am J Roentgenol 170:397-402.

    CAS  PubMed  Google Scholar 

  4. Kim T, Murakami T, Takahashi S et al. (1999) Diffusion-weighted single-shot echoplanar MR imaging for liver disease. AJR Am J Roentgenol 173:393-398.

    CAS  PubMed  Google Scholar 

  5. Namimoto T, Yamashita Y, Sumi S, Tang Y, Takahashi M (1997) Focal liver masses: characterization with diffusion-weighted echo-planar MR imaging. Radiology 204:739-744.

    CAS  PubMed  Google Scholar 

  6. Okada Y, Ohtomo K, Kiryu S, Sasaki Y (1998) Breath-hold T2-weighted MRI of hepatic tumors: value of echo planar imaging with diffusion-sensitizing gradient. J Comput Assist Tomogr 22:364-371.

    Article  CAS  PubMed  Google Scholar 

  7. Yamada I, Aung W, Himeno Y, Nakagawa T, Shibuya H (1999) Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging. Radiology 210:617-623.

    CAS  PubMed  Google Scholar 

  8. Le Bihan D, Breton E, Lallemand D et al. (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 168:497-505.

    PubMed  Google Scholar 

  9. Bammer R (2003) Basic principles of diffusion-weighted imaging. Eur J Radiol 45:169-184.

    Article  PubMed  Google Scholar 

  10. Turner R, Le Bihan D, Maier J et al. (1990) Echo-planar imaging of intravoxel incoherent motion. Radiology 177:407-414.

    CAS  PubMed  Google Scholar 

  11. Thoeny HC, De KF (2007) Extracranial applications of diffusion-weighted magnetic resonance imaging. Eur Radiol 17:1385-1393.

    Article  PubMed  Google Scholar 

  12. Stejskal EO, Tanner JE (1965) Spin diffusion measurements: spin echoes in the presence of a time-dependent field gradient. J Chem Phys 42:288-292.

    Article  CAS  Google Scholar 

  13. Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622-1635.

    Article  PubMed  Google Scholar 

  14. Koh DM, Scurr E, Collins DJ et al. (2006) Colorectal hepatic metastases: quantitative measurements using single-shot echo-planar diffusion-weighted MR imaging. Eur Radiol 16:1898-1905.

    Article  CAS  PubMed  Google Scholar 

  15. Taouli B, Martin AJ, Qayyum A et al. (2004) Parallel imaging and diffusion tensor imaging for diffusion-weighted MRI of the liver: preliminary experience in healthy volunteers. AJR Am J Roentgenol 183:677-680.

    PubMed  Google Scholar 

  16. Yoshikawa T, Kawamitsu H, Mitchell DG et al. (2006) ADC measurement of abdominal organs and lesions using parallel imaging technique. AJR Am J Roentgenol 187:1521-1530.

    Article  PubMed  Google Scholar 

  17. Kurihara Y, Yakushiji YK, Tani I, Nakajima Y, Van CM (2002) Coil sensitivity encoding in MR imaging: advantages and disadvantages in clinical practice. AJR Am J Roentgenol 178:1087-1091.

    PubMed  Google Scholar 

  18. Parikh T, Drew SJ, Lee VS et al. (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812-822.

    Article  PubMed  Google Scholar 

  19. Coenegrachts K, Delanote J, Ter BL et al. (2007) Improved focal liver lesion detection: comparison of single-shot diffusion-weighted echoplanar and single-shot T2 weighted turbo spin echo techniques. Br J Radiol 80:524-531.

    Article  CAS  PubMed  Google Scholar 

  20. Coenegrachts K, Orlent H, Ter BL et al. (2008) Improved focal liver lesion detection: comparison of single-shot spin-echo echo-planar and superparamagnetic iron oxide (SPIO)-enhanced MRI. J Magn Reson Imaging 27:117-124.

    Article  PubMed  Google Scholar 

  21. Chow LC, Bammer R, Moseley ME, Sommer FG (2003) Single breath-hold diffusion-weighted imaging of the abdomen. J Magn Reson Imaging 18:377-382.

    Article  PubMed  Google Scholar 

  22. Müller MF, Prasad P, Siewert B et al. (1994) Abdominal diffusion map** with use of a whole-body echo-planar system. Radiology 190:475-478.

    PubMed  Google Scholar 

  23. Mürtz P, Flacke S, Traber F et al. (2002) Abdomen: diffusion-weighted MR imaging with pulse-triggered single-shot sequences. Radiology 224:258-264.

    Article  PubMed  Google Scholar 

  24. Sun XJ, Quan XY, Huang FH, Xu YK (2005) Quantitative evaluation of diffusion-weighted magnetic resonance imaging of focal hepatic lesions. World J Gastroenterol 11:6535-6537.

    PubMed  Google Scholar 

  25. Taouli B, Vilgrain V, Dumont E et al. (2003) Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology 226:71-78.

    Article  PubMed  Google Scholar 

  26. Griswold MA, Jakob PM, Heidemann RM et al. (2002) Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 47:1202-1210.

    Article  PubMed  Google Scholar 

  27. Bruegel M, Gaa J, Waldt S et al. (2008) Diagnosis of hepatic metastasis: comparison of respiration-triggered diffusion-weighted echo-planar MRI and five t2-weighted turbo spin-echo sequences. AJR Am J Roentgenol 191:1421-1429.

    Article  PubMed  Google Scholar 

  28. Bruegel M, Holzapfel K, Gaa J et al. (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18:477-485.

    Article  PubMed  Google Scholar 

  29. Nasu K, Kuroki Y, Nawano S et al. (2006) Hepatic metastases: diffusion-weighted sensitivity-encoding versus SPIO-enhanced MR imaging. Radiology 239:122-130.

    Article  PubMed  Google Scholar 

  30. Low RN, Gurney J (2007) Diffusion-weighted MRI (DWI) in the oncology patient: value of breathhold DWI compared to unenhanced and gadolinium-enhanced MRI. J Magn Reson Imaging 25:848-858.

    Article  PubMed  Google Scholar 

  31. Bruegel M, Holzapfel K, Gaa J et al. (2008) Hepatic metastases: diffusion-weighted EPI versus dynamic gadolinium-enhanced MR imaging. In: 94th scientific assembly and annual meeting of the Radiological Society of North America: abstract number SSQ08-04.

  32. Cui Y, Zhang XP, Sun YS, Tang L, Shen L (2008) Apparent diffusion coefficient: potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases. Radiology 248:894-900.

    Article  PubMed  Google Scholar 

  33. Koh DM, Scurr E, Collins D et al. (2007) Predicting response of colorectal hepatic metastasis: value of pretreatment apparent diffusion coefficients. AJR Am J Roentgenol 188:1001-1008.

    Article  PubMed  Google Scholar 

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Correspondence to Melanie Bruegel.

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Bruegel, M., Rummeny, E.J. Hepatic metastases: use of diffusion-weighted echo-planar imaging. Abdom Imaging 35, 454–461 (2010). https://doi.org/10.1007/s00261-009-9541-8

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