Diffusion-weighted images of the liver: comparison of tumor detection before and after contrast enhancement with superparamagnetic iron oxide.

PURPOSE: To study the recognition of malignant lesions of the liver on diffusion-weighted images (DWI) can be improved by the administration of superparamagnetic iron oxide (SPIO). MATERIALS AND METHODS: Pre- and post-SPIO mediated DWI of the liver was compared in six patients with suspected malignant liver lesions at 1.5 Tesla using a parallel imaging technique. RESULTS: Post-SPIO DWI showed improved contrast-to-noise ratio between malignant lesions and liver. Furthermore, the spleen signal was decreased on post-SPIO DWI, thus avoiding the overlap of the spleen and left lobe of the liver on maximum intensity projections (MIP). CONCLUSION: Recognition of malignant lesions of the liver was improved by SPIO on DWI. On MIP images of DWI, SPIO helped to decrease the overlap of spleen signal on the liver in some projection angles.

Differentiation of noncancerous tissue and cancer lesions by apparent diffusion coefficient values in transition and peripheral zones of the prostate.

PURPOSE: To compare the apparent diffusion coefficient (ADC) values of prostate cancer in both the peripheral zone (PZ) and the transition zone (TZ) with those of benign tissue in the same zone using echo-planar diffusion weighted imaging with a parallel imaging technique. MATERIALS AND METHODS: A total of 29 consecutive male patients (mean age 61.3 years, age range 53-88 years) with suspected prostate cancer were referred for MR imaging. All patients underwent transrectal ultrasound (TRUS)-guided biopsy of the prostate after MR imaging at 1.5 T, including ADC. For each patient, seven to 10 specimens were obtained from the prostate, and regions of interest (ROIs) were drawn on the ADC map by referring to the urologist's illustration of TRUS-guided biopsy sites. ADC values of cancerous tissue in both the PZ and TZ were compared to those of noncancerous tissue in the same zone. RESULTS: Out of 29 patients, 23 had cancer tissue. In the 23 patients with cancer, the mean ADC value of all cancer ROIs and that of all noncancer ROIs, respectively, were 1.11 +/- 0.41 x 10(-3) and 1.68 +/- 0.40 x 10(-3) mm(2)/second (values are mean +/- SD) (P < 0.01). The mean ADC value of TZ cancer ROIs and that of TZ noncancer ROIs, respectively, were 1.13 +/- 0.42 x 10(-3) and 1.58 +/- 0.37 x 10(-3) mm(2)/second (P < 0.01). CONCLUSIONS: ADC measurement with a parallel imaging technique showed that ADC values of prostate cancer in both the PZ and TZ were significantly lower than those of benign tissue in the PZ and TZ, respectively.

Diffusion-weighted imaging of the liver: technical challenges and prospects for the future.

Diffusion-weighted imaging (DWI) has recently been attempted in the abdominal region. We review diffusion-weighted images of the liver, especially from the technical point of view. We discuss selection of pulse sequence parameters, effects of anti-breathing motion technique, tips for measuring apparent diffusion coefficient (ADC), and utility of superparamagnetic iron oxide (SPIO), showing clinical cases, including those at 3T. Our current trial of new pulse sequencing, such as SPIO-mediated breath-holding black-blood fluid-attenuated inversion recovery (BH-BB-FLAIR), imaging is shown. Some prospects for the future in DWI of the liver are also stated.

Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix.

A relation between apparent diffusion coefficient (ADC) values and tumor cellular density has been reported. The purpose of this study was to measure the ADC values of cervical cancers in the uterus and compare them with those of normal cervical tissues, and to test whether ADC could differentiate between normal and malignant cervical tissues in the uterus. Twelve consecutive female patients with cervical cancer of the uterus and ten female patients with other pelvic abnormalities were included in this study. ADC was measured at 1.5 T with b-factors of 0, 300 and 600 s/mm2 using single-shot echo-planar diffusion-weighted imaging and a parallel imaging technique. The mean ADC value of cervical cancer lesions was 1.09+/-0.20 x 10(-3) mm2/s, and that of normal cervix tissue was 1.79+/-0.24 x 10(-3) mm2/s (P<0.0001). In nine patients treated by chemotherapy and/or radiation therapy, the mean ADC value of the cervical cancer lesion increased significantly after therapy (P<0.001). The present study showed, with a small number of patients, that ADC measurement has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix. Further study is necessary to determine the accuracy of ADC measurement in monitoring the treatment response.

Serial evaluation of diffusion tensor brain fiber tracking in a patient with severe diffuse axonal injury.

Serial evaluation of diffusion tensor brain fiber tracking was performed in a 27-year-old female patient with diffuse axonal injury after a traffic accident. Although the result of brain fiber tracking was not necessarily parallel to her clinical symptoms, it may have predicted the neurologic prognosis.

MR imaging of gastric cancer in vitro: accuracy of invasion depth diagnosis.

The purpose of this study was to evaluate the accuracy of grading cancerous invasion of the gastric wall in vitro using magnetic resonance (MR) imaging. Twelve specimens of gastric carcinoma were examined at 1.5-T using a small, loop surface coil. They were imaged within 2 days of fixation in formalin. The field of view was 30 mm; the matrix size was 256x256, and the section thickness was 2 mm. T1-weighted, T2-weighted and short inversion time inversion recovery (STIR) images were obtained. Two radiologists evaluated the MR images independently, and in discrepant cases, consensus was obtained through discussion. Findings on MR images were compared with histopathologic findings. All T1-weighted, T2-weighted and STIR images depicted the normal gastric wall as consisting of six layers. STIR images depicted normal six layers most clearly. Histologically, the cancerous invasion was found to extend into the mucosa in 4 of the 12 specimens, the submucosa in 3, the muscularis propria in 2, the subserosa in 2 and the serosa in 1. The grading by MR imaging matched the histopathologic findings for all 12 tumors. The overall accuracy was 100%. Thus, MR imaging in vitro was sufficiently accurate for grading cancerous invasion of the gastric wall.