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Intravoxel Incoherent Motion (IVIM) Diffusion Imaging in Prostate Cancer - What Does It Add?

Kuru, Timur H. MD*†; Roethke, Matthias C. MD; Stieltjes, Bram MD, PhD; Maier-Hein, Klaus PhD‡§; Schlemmer, Heinz-Peter MD; Hadaschik, Boris A. MD*; Fenchel, Michael MD

Journal of Computer Assisted Tomography: July/August 2014 - Volume 38 - Issue 4 - p 558–564
doi: 10.1097/RCT.0000000000000088
Abdominal Imaging

Objective: To compare 2 previously presented algorithms for extracting parameters from intravoxel incoherent motion (IVIM) studies and investigate them in the context of tissue differentiation.

Methods: Magnetic resonance imaging (MRI) was performed in 23 patients without histologically proven prostate carcinoma (PCa) and 27 patients with histologically proven PCa. Two methods were used to determine IVIM parameters (f, D, D*). Receiver operating characteristic analysis was performed for IVIM parameters and apparent diffusion coefficient for discrimination of prostate tissue.

Results: The IVIM parameters showed no significant difference between patients without PCa and normal areas in patients with PCa (r = 0.46–0.99). Results for D were not significantly different for both methods (P = 0.22), whereas f from method 1 was significantly higher than the f from method 2 (P < 0.05). The diffusion parameters D (both methods) and apparent diffusion coefficient could discriminate between tumor and normal areas (receiver operating characteristic analysis, area under the curve, ≥0.90). Additionally, in subgroup analysis, only D was able to discriminate between low- and high-grade PCa.

Conclusions: For tumor detection, IVIM diffusion does not yield a clear added value, but the perfusion-free diffusion constant D may hold potential for improved image-based tumor grading.

From the *Department of Urology, University Hospital Heidelberg, Heidelberg, Germany; †Department of Radiology, ‡Quantitative Imaging-based Disease Characterization, and §Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Received for publication December 13, 2013; accepted February 13, 2014.

Reprints: Timur H. Kuru, MD, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (e-mail: timur.kuru@med.uni-heidelberg.de).

The authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins