Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 5, August, p. 811–816
Publication type: original article
Which organ should be considered a reference in diffusion weighted imaging of the abdomen?: The reproducibility of ADC measurements of the spleen and the renal cortex on a 1.5T MR
1 Department of General and Pediatric Radiology, Independent Public Clinical Hospital No. 1, Wrocław, Poland
2 Department of Radiology, Wroclaw Medical University, Poland
3 Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Poland
4 Medical University of Silesia, Katowice, Poland
5 Faculty of Natural Sciences and Technology, Karkonosze College, Jelenia Góra, Poland
Background. Diffusion weighted imaging (DWI) is a useful tool for the evaluation of focal lesions in the liver or kidneys, as well as for the diagnosis and assessment of the liver fibrosis process. Some reports show that the spleen and kidneys may serve as reference organs in the staging of liver fibrosis or the evaluation of focal liver lesions.
Objectives. The aim of the study was to determine whether the spleen and renal cortex can be used as reference organs in the DWI technique.
Material and Methods. The study group included 36 patients with no liver, spleen or renal pathologies and without any infections or hematologic disease. All the examinations were performed using a 1.5T MR unit with a conventional phased array body coil. Image interpretation and apparent diffusion coefficient (ADC) measurements were done by 3 experienced radiologists.
Results. There was a statistically significant difference between the ADC values noted by 2 of the examiners in the upper/middle and lower part of the spleen parenchyma. There were no statistically significant differences between the ADC values obtained by all 3 examiners in all the parts of each kidney. There were no statistically significant differences between the examiners’ ADC values for the spleen and kidneys. The mean ADC values for the left kidney showed the highest measurement reproducibility.
Conclusion. The study showed that the renal cortex seems to be an appropriate region for performing reference ADC measurements. Further studies on a larger group of patients and using various DWI protocols should be performed to ascertain the best conditions for maximizing the reproducibility of ADC measurements.
magnetic resonance imaging (MRI), diffusion weighted MRI, apparent diffusion coefficient, spleen, renal cortex
- Bilgili, MYK. Reproductibility of apparent diffusion coefficients measurements in diffusion-weighted MRI of the abdomen with different b values. Eur J Radiol. 2012; 81(9):2066–2068.
- Johnston KC, Wagner DP, Wang XQ, et al. Validation of an acute ischemic stroke model does diffusion-weighted imaging lesion volume offer a clinically significant improvement in prediction of outcome? Stroke. 2007;38(6):1820–1825.
- Roethke M, Blondin D, Schlemmer HP, Franiel T. PI-RADS classification: Structured reporting for MRI of the prostate. Rofo. 2013;185(3):253–261.
- Partridge SC, McDonald ES. Diffusion weighted MRI of the breast: Protocol optimization, guidelines for interpretation, and potential clinical applications. MRI Clinics of North America 2013. In press. [PMC free article][PubMed].
- Taouli B, Koh DM. Diffusion-weighted MR Imaging of the Liver 1. Radiology. 2009; 254(1):47–66.
- Lassel EA, Rao R, Schwenke C, Schoenberg SO, Michaely HJ. Diffusion-weighted imaging of focal renal lesions: A meta-analysis. Eur Radiol. 2014;24(1):241–249.
- Filipe JP, Curvo-Semedo L, Casalta-Lopes J, Marques MC, Caseiro-Alves F. Diffusion-weighted imaging of the liver: Usefulness of ADC values in the differential diagnosis of focal lesions and effect of ROI methods on ADC measurements. MAGMA. 2013;26(3):303–312.
- Taouli B, Vilgrain V, Dumont E, Daire JL, Fan B, Menu Y. 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. 2003;226:71–78.
- Aubé C, Racineux PX, Lebigot J, et al. Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: Preliminary results [in French]. J Radiol. 2004;85:301–306.
- El-Hariri M, Ali TFT, Hussien HI. Apparent diffusion coefficient (ADC) in liver fibrosis: Usefulness of normalized ADC using the spleen as reference organ. The Egyptian Journal of Radiology and Nuclear Medicine. 2013;44(3):441–451.
- Hong Y, Shi Y, Liao W, et al. Relative ADC measurement for liver fibrosis diagnosis in chronic hepatitis B using spleen/renal cortex as the reference organs at 3 T. Clin Radiol. 2014:69(6):581–588.
- Klasen J, Lanzman RS, Wittsack HJ, et al. Diffusion-weighted imaging (DWI) of the spleen in patients with liver cirrhosis and portal hypertension. Magn Reson Imaging. 2013;31(7):1092–1096.
- Papanikolaou N, Gourtsoyianni S, Yarmenitis S, Maris T, Gourtsoyiannis N. Comparison between two-point and four-point methods for quantification of apparent diffusion coefficient of normal liver parenchyma and focal lesions. Value of normalization with spleen. Eur J Radiol. 2010;73(2):305–309.