B-Value Optimization in the Estimation of Intravoxel Incoherent Motion Parameters in Patients with Cervical Cancer

• Published in: Korean journal of radiology Vol. 21; no. 2; pp. 218 - 227
• Main Authors: Perucho, Jose Angelo Udal, Chang, Hing Chiu Charles, Vardhanabhuti, Varut, Wang, Mandi, Becker, Anton Sebastian, Wurnig, Moritz Christoph, Lee, Elaine Yuen Phin
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.02.2020; 대한영상의학회
• Subjects: Adenocarcinoma - pathology; Adult; Aged; Aged, 80 and over; Algorithms; Carcinoma, Squamous Cell - pathology; Cervical cancer; Estimates; Female; Genitourinary Imaging; Humans; Image Processing, Computer-Assisted - methods; Mann-Whitney U test; Middle Aged; Neoplasm Staging; Patients; Reproducibility; Retrospective Studies; Signal-To-Noise Ratio; Simulation; Statistical analysis; Uterine Cervical Neoplasms - pathology; Young Adult; 방사선과학; Diffusion-weighted imaging; Magnetic resonance imaging; b-values; Cervical cancer; Intravoxel incoherent motion
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2019.0232

This study aimed to find the optimal number of b-values for intravoxel incoherent motion (IVIM) imaging analysis, using simulated and data from cervical cancer patients. Simulated data were generated using literature pooled means, which served as reference values for simulations. data from 100 treatment-naïve cervical cancer patients with IVIM imaging (13 b-values, scan time, 436 seconds) were retrospectively reviewed. A stepwise b-value fitting algorithm calculated optimal thresholds. Feed forward selection determined the optimal subsampled b-value distribution for biexponential IVIM fitting, and simplified IVIM modeling using monoexponential fitting was attempted. IVIM parameters computed using all b-values served as reference values for data. In simulations, parameters were accurately estimated with six b-values, or three b-values for simplified IVIM, respectively. data showed that the optimal threshold was 40 s/mm² for patients with squamous cell carcinoma and a subsampled acquisition of six b-values (scan time, 198 seconds) estimated parameters were not significantly different from reference parameters (individual parameter error rates of less than 5%). In patients with adenocarcinoma, the optimal threshold was 100 s/mm², but an optimal subsample could not be identified. Irrespective of the histological subtype, only three b-values were needed for simplified IVIM, but these parameters did not retain their discriminative ability. Subsampling of six b-values halved the IVIM scan time without significant losses in accuracy and discriminative ability. Simplified IVIM is possible with only three b-values, at the risk of losing diagnostic information.