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2024 ; 16
(7
): 2031-2039
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Reproducibility study of intravoxel incoherent motion and apparent diffusion
coefficient parameters in normal pancreas
#MMPMID39087122
Liu X
; Wang YF
; Qi XH
; Zhang ZL
; Pan JY
; Fan XL
; Du Y
; Zhai YM
; Wang Q
World J Gastrointest Surg
2024[Jul]; 16
(7
): 2031-2039
PMID39087122
show ga
BACKGROUND: The consistency of pancreatic apparent diffusion coefficient (ADC)
values and intravoxel incoherent motion (IVIM) parameter values across different
magnetic resonance imaging (MRI) devices significantly impacts the patient's
diagnosis and treatment. AIM: To explore consistency in image quality, ADC
values, and IVIM parameter values among different MRI devices in pancreatic
examinations. METHODS: This retrospective study was approved by the local ethics
committee, and informed consent was obtained from all participants. In total, 22
healthy volunteers (10 males and 12 females) aged 24-61 years (mean, 28.9 ± 2.3
years) underwent pancreatic diffusion-weighted imaging using 3.0T MRI equipment
from three vendors. Two independent observers subjectively scored image quality
and measured the pancreas's overall ADC values and signal-to-noise ratios (SNRs).
Subsequently, regions of interest (ROIs) were delineated for the IVIM parameters
(true diffusion coefficient, pseudo-diffusion coefficient, and perfusion
fraction) using post-processing software. These ROIs were on the head, body, and
tail of the pancrease. The subjective image ratings were assessed using the kappa
consistency test. Intraclass correlation coefficients (ICCs) and mixed linear
models were used to evaluate each device's quantitative parameter values.
Finally, a pairwise analysis of IVIM parameter values across each device was
performed using Bland-Altman plots. RESULTS: The Kappa value for the subjective
ratings of the different observers was 0.776 (P < 0.05). The ICC values for
inter-observer and intra-observer agreements for the quantitative parameters were
0.803 [95% confidence interval (CI): 0.684-0.880] and 0.883 (95%CI: 0.760-0.945),
respectively (P < 0.05). The ICCs for the SNR between different devices was
comparable (P > 0.05), and the ICCs for the ADC values from different devices
were 0.870, 0.707, and 0.808, respectively (P < 0.05). Notably, only a few
statistically significant inter-device agreements were observed for different
IVIM parameters, and among those, the ICC values were generally low. The mixed
linear model results indicated differences (P < 0.05) in the f-value for the
pancreas head, D-value for the pancreas body, and D-value for the pancreas tail
obtained using different MRI machines. The Bland-Altman plots showed significant
variability at some data points. CONCLUSION: ADC values are consistent among
different devices, but the IVIM parameters' repeatability is moderate. Therefore,
the variability in the IVIM parameter values may be associated with using
different MRI machines. Thus, caution should be exercised when using IVIM
parameter values to assess the pancreas.