Honors & Awards
Stanford Center for Pediatric IBD and Celiac Disease Research Training Award, Stanford Maternal & Child Health Research Inst. (07/01/2022)
PhD, University of Illinois at Chicago, Bioengineering (2021)
Bachelor, Xidian Universitiy, Biomedical Imaging (2011)
Shreyas Vasanawala, Postdoctoral Faculty Sponsor
Zheng Zhong, Christophor M. Sandino, Shreyas S. Vasanavala. "United States Patent 63/313480 Method to Improve the Efficiency of 3D SPGR in MRI", Leland Stanford Junior University, Feb 24, 2022
XJ Zhou, Zheng Zhong, M.M Karaman. "United States Patent 62,794,326 Methods for Producing Magnetic Resonance Images with Sub-Millisecond Temporal Resolution.", Jan 18, 2020
Gradient-echo-train-based sub-millisecond periodic event encoded dynamic imaging with random (k, t)-space undersampling: k-t get-SPEEDI.
Magnetic resonance in medicine
PURPOSE: The gradient-echo-train-based Sub-millisecond Periodic Event Encoded Dynamic Imaging (get-SPEEDI) technique provides ultrahigh temporal resolutions (0.6ms) for detecting rapid physiological activities, but its practical adoption can be hampered by long scan times. This study aimed at developing a more efficient variant of get-SPEEDI for reducing the scan time without degrading temporal resolution or image quality.METHODS: The proposed pulse sequence, named k-t get-SPEEDI, accelerated get-SPEEDI acquisition by undersampling the k-space phase-encoding lines semi-randomly. At each time frame, k-space was fully sampled in the central region whereas randomly undersampled in the outer regions. A time-series of images was reconstructed using an algorithm based on the joint partial separability and sparsity constraints. To demonstrate the performance of k-t get-SPEEDI, images of human aortic valve opening and closing were acquired with 0.6-ms temporal resolution and compared with those from conventional get-SPEEDI.RESULTS: k-t get-SPEEDI achieved a 2-fold scan time reduction over the conventional get-SPEEDI (from 6 to 3min), while achieving comparable SNRs and contrast-to-noise ratio (CNRs) for visualizing the dynamic process of aortic valve: SNR/CNR $$ \approx $$ 70/38 vs. 73/39 in the k-t and conventional get-SPEEDI scans, respectively. The time courses of aortic valve area also matched well between these two sequences with a correlation coefficient of 0.86.CONCLUSIONS: The k-t get-SPEEDI pulse sequence was able to half the scan time without compromising the image quality and ultrahigh temporal resolution. Additional scan time reduction may also be possible, facilitating in vivo adoptions of SPEEDI techniques.
View details for DOI 10.1002/mrm.29313
View details for PubMedID 35666824
Three-dimensional reduced field-of-view imaging (3D-rFOVI)
MAGNETIC RESONANCE IN MEDICINE
This study aimed at developing a 3D reduced field-of-view imaging (3D-rFOVI) technique using a 2D radiofrequency (RF) pulse, and demonstrating its ability to achieve isotropic high spatial resolution and reduced image distortion in echo planar imaging (EPI).The proposed 3D-rFOVI technique takes advantage of a 2D RF pulse to excite a slab along the conventional slice-selection direction (i.e., z-direction) while limiting the spatial extent along the phase-encoded direction (i.e., y-direction) within the slab. The slab is phase-encoded in both through-slab and in-slab phase-encoded directions. The 3D-rFOVI technique was implemented at 3T in gradient-echo and spin-echo EPI pulse sequences for functional MRI (fMRI) and diffusion-weighted imaging (DWI), respectively. 3D-rFOVI experiments were performed on a phantom and human brain to illustrate image distortion reduction, as well as isotropic high spatial resolution, in comparison with 3D full-FOV imaging.In both the phantom and the human brain, image voxel dislocation was substantially reduced by 3D-rFOVI when compared with full-FOV imaging. In the fMRI experiment with visual stimulation, 3D isotropic spatial resolution of (2 × 2 × 2 mm3 ) was achieved with an adequate signal-to-noise ratio (81.5) and blood oxygen level-dependent (BOLD) contrast (2.5%). In the DWI experiment, diffusion-weighted brain images with an isotropic resolution of (1 × 1 × 1 mm3 ) was obtained without appreciable image distortion.This study indicates that 3D-rFOVI is a viable approach to 3D neuroimaging over a zoomed region.
View details for DOI 10.1002/mrm.29121
View details for Web of Science ID 000729179800001
View details for PubMedID 34894639
Predicting the aggressiveness of peripheral zone prostate cancer using a fractional order calculus diffusion model
EUROPEAN JOURNAL OF RADIOLOGY
2021; 143: 109913
To evaluate the performance of parameters D, β, μ from the Fractional Order Calculus (FROC) model at differentiating peripheral zone (PZ) prostate cancer (PCa) MATERIAL AND METHODS: 75 patients who underwent targeted MRI-guided TRUS prostate biopsy within 6 months of MRI were reviewed retrospectively. Regions of interest (ROI) were placed on suspicious lesions on MRI scans. ROIs were then correlated to pathological results based on core biopsy location. The final tumor count is a total: 23 of GS 6 (3 + 3), 36 of GS 7 (3 + 4), 18 of GS 7 (4 + 3), and 19 of GS ≥ 8. Diffusion-weighted imaging (DWI) scans were fitted into the FROC and monoexponential model to calculate ADC and FROC parameters: anomalous diffusion coefficient D, intravoxel diffusion heterogeneity β, and spatial parameter μ. The performance of FROC parameters and ADC at differentiating PCa grade was evaluated with receiver operating characteristic (ROC) analysis.In differentiating low (GS 6) vs. intermediate (GS 7) risk PZ PCa, combination of (D, β) provides the best performance with AUC of 0.829 with significance of p = 0.018 when compared to ADC (AUC of 0.655). In differentiating clinically significant (GS 6) vs. clinically significant (GS ≥ 7) PCa, combination of (D, β, μ) provides highest AUC of 0.802 when compared to ADC (AUC of 0.671) with significance of p = 0.038. Stratification of intermediate (GS 7) and high (GS ≥ 8) risk PCa with FROC did not reach a significant difference when compared to ADC.Combination of FROC parameters shows greater performance than ADC at differentiating low vs. intermediate risk and clinically insignificant vs. significant prostate cancers in peripheral zone lesions. The FROC diffusion model holds promise as a quantitative imaging technique for non-invasive evaluation of PZ PCa.
View details for DOI 10.1016/j.ejrad.2021.109913
View details for Web of Science ID 000697681500010
View details for PubMedID 34464907
In-plane simultaneous multisegment imaging using a 2D RF pulse.
Magnetic resonance in medicine
PURPOSE: To develop an in-plane simultaneous multisegment (IP-SMS) imaging technique using a 2D-RF pulse and to demonstrate its ability to achieve high spatial resolution in EPI while reducing image distortion.METHODS: The proposed IP-SMS technique takes advantage of periodic replicates of the excitation profile of a 2D-RF pulse to simultaneously excite multiple segments within a slice. These segments were acquired over a reduced FOV and separated using a joint GRAPPA reconstruction by leveraging virtual coils that combined the physical coil sensitivity and 2D-RF pulse spatial response. Two excitations were used with complementary spatial response profiles to adequately cover a full FOV, producing a full-FOV image that had the benefits of reduced FOV with high spatial resolution and reduced distortion. The IP-SMS technique was implemented in a diffusion-weighted single-shot EPI sequence. Experimental demonstrations were performed on a phantom and healthy human brain.RESULTS: In the phantom experiment, IP-SMS enabled a four-fold acceleration using an eight-channel coil without causing residual aliasing artifacts. In the human brain experiment, diffusion-weighted images with high in-plane resolution (1 * 1 mm2 ) and substantially reduced image distortion were obtained in all imaging planes in comparison with a commercial diffusion-weighted EPI sequence. The capability of IP-SMS for contiguous whole-brain coverage was also demonstrated.CONCLUSION: The proposed IP-SMS technique can realize the benefits of reduced-FOV imaging while achieving a full-FOV coverage with good image quality and time efficiency.
View details for DOI 10.1002/mrm.28956
View details for PubMedID 34350601
Evaluation of a fractional-order calculus diffusion model and bi-parametric VI-RADS for staging and grading bladder urothelial carcinoma
To evaluate the feasibility of high b-value diffusion-weighted imaging (DWI) for distinguishing non-muscle-invasive bladder cancer (NMIBC) from muscle-invasive bladder cancer (MIBC) and low- from high-grade bladder urothelial carcinoma using a fractional-order calculus (FROC) model as well as a combination of FROC DWI and bi-parametric Vesical Imaging-Reporting and Data System (VI-RADS).Fifty-eight participants with bladder urothelial carcinoma were included in this IRB-approved prospective study. Diffusion-weighted images, acquired with 16 b-values (0-3600 s/mm2), were analyzed using the FROC model. Three FROC parameters, D, β, and μ, were used for delineating NMIBC from MIBC and for tumor grading. A receiver operating characteristic (ROC) analysis was performed based on the individual FROC parameters and their combinations, followed by comparisons with apparent diffusion coefficient (ADC) and bi-parametric VI-RADS based on T2-weighted images and DWI.D and μ were significantly lower in the MIBC group than in the NMIBC group (p = 0.001 for each), and D, β, and μ all exhibited significantly lower values in the high- than in the low-grade tumors (p ≤ 0.011). The combination of D, β, and μ produced the highest specificity (85%), accuracy (78%), and the area under the ROC curve (AUC, 0.782) for distinguishing NMIBC and MIBC, and the best sensitivity (89%), specificity (86%), accuracy (88%), and AUC (0.892) for tumor grading, all of which outperformed the ADC. The combination of FROC parameters with bi-parametric VI-RADS improved the AUC from 0.859 to 0.931.High b-value DWI with a FROC model is useful in distinguishing NMIBC from MIBC and grading bladder tumors.• Diffusion parameters derived from a FROC diffusion model may differentiate NMIBC from MIBC and low- from high-grade bladder urothelial carcinomas. • Under the condition of a moderate sample size, higher AUCs were achieved by the FROC parameters D (0.842) and μ (0.857) than ADC (0.804) for bladder tumor grading with p ≤ 0.046. • The combination of the three diffusion parameters from the FROC model can improve the specificity over ADC (85% versus 67%, p = 0.031) for distinguishing NMIBC and MIBC and enhance the performance of bi-parametric VI-RADS.
View details for DOI 10.1007/s00330-021-08203-2
View details for Web of Science ID 000680795800005
View details for PubMedID 34342693
MRI with sub-millisecond temporal resolution over a reduced field of view.
Magnetic resonance in medicine
PURPOSE: To demonstrate an MRI pulse sequence-Sub-millisecond Periodic Event Encoded Dynamic Imaging with a reduced field of view (or rFOV-SPEEDI)-for decreasing the scan times while achieving sub-millisecond temporal resolution.METHODS: rFOV-SPEEDI was based on a variation of SPEEDI, known as get-SPEEDI, which used each echo in an echo-train to sample a distinct k-space raster by synchronizing with a cyclic event. This can produce a set of time-resolved images of the cyclic event with a temporal resolution determined by the echo spacing (typically < 1 ms). rFOV-SPEEDI incorporated a 2D radiofrequency (RF) pulse into get-SPEEDI to limit the field of view (FOV), leading to reduction in phase-encoding steps and subsequently decreased scan times without compromising the spatial resolution. Two experiments were performed at 3T to illustrate rFOV-SPEEDI's capability of capturing fast-changing electric currents in a phantom and the rapid opening and closing of aortic valve in human subjects over reduced FOVs. The results were compared with those from full FOV get-SPEEDI.RESULTS: In the first experiment, the rapidly varying currents (50-200 Hz) were successfully captured with a temporal resolution of 0.8 ms, and agreed well with the applied currents. In the second experiment, the rapid opening and closing processes of aortic valve were clearly visualized with a temporal resolution of 0.6 ms over a reduced FOV (12 * 12 cm2 ). In both experiments, the acquisition times of rFOV-SPEEDI were decreased by 33%-50% relative to full FOV get-SPEEDI acquisitions and the spatial resolution was maintained.CONCLUSION: Reducing the FOV is a viable approach to shortening the scan times in SPEEDI, which is expected to help stimulate SPEEDI applications for studying ultrafast, cyclic physiological and biophysical processes over a focal region.
View details for DOI 10.1002/mrm.28924
View details for PubMedID 34270138
- Diffusion in Sephadex Gel Structures: Time Dependency Revealed by Multi-Sequence Acquisition over a Broad Diffusion Time Range MATHEMATICS 2021; 9 (14)
Visualization of Human Aortic Valve Dynamics Using Magnetic Resonance Imaging with Sub-Millisecond Temporal Resolution
JOURNAL OF MAGNETIC RESONANCE IMAGING
Visualization of aortic valve dynamics is important in diagnosing valvular diseases but is challenging to perform with magnetic resonance imaging (MRI) due to the limited temporal resolution.To develop an MRI technique with sub-millisecond temporal resolution and demonstrate its application in visualizing rapid aortic valve opening and closing in human subjects in comparison with echocardiography and conventional MRI techniques.Prospective.Twelve healthy subjects.3 T; gradient-echo-train-based sub-millisecond periodic event encoded imaging (get-SPEEDI) and balanced steady-state free precession (bSSFP).Images were acquired using get-SPEEDI with a temporal resolution of 0.6 msec. get-SPEEDI was triggered by an electrocardiogram so that each echo in the gradient echo train corresponded to an image at a specific time point, providing a time-resolved characterization of aortic valve dynamics. For comparison, bSSFP was also employed with 12 msec and 24 msec temporal resolutions, respectively. The durations of the aortic valve rapid opening (Tro ), rapid closing (Trc ), and the maximal aortic valve area (AVA) normalized to height were measured with all three temporal resolutions. M-mode echocardiograms with a temporal resolution of 0.8 msec were obtained for further comparison.Parameters were compared between the three sequences, together with the echocardiography results, with a Mann-Whitney U test.Significantly shorter Tro (mean ± SD: 27.5 ± 6.7 msec) and Trc (43.8 ± 11.6 msec) and larger maximal AVA/height (2.01 ± 0.29 cm2 /m) were measured with get-SPEEDI compared to either bSSFP sequence (Tro of 56.3 ± 18.8 and 63.8 ± 20.2 msec; Trc of 68.2 ± 16.6 and 72.8 ± 18.2 msec; maximal AVA/height of 1.63 ± 0.28 and 1.65 ± 0.32 cm2 /m for 12 msec and 24 msec temporal resolutions, respectively, P < 0.05). In addition, the get-SPEEDI results were more consistent with those measured using echocardiography, especially for Tro (29.0 ± 4.1 msec, P = 0.79) and Trc (41.6 ± 4.3 msec, P = 0.16). DATA CONCLUSION: get-SPEEDI allows for visualization of human aortic valve dynamics and provided values closer to those measured using echocardiography than the bSSFP sequences.1 TECHNICAL EFFICACY STAGE: 1.
View details for DOI 10.1002/jmri.27603
View details for Web of Science ID 000632130600001
View details for PubMedID 33761166
Magnetic resonance imaging with submillisecond temporal resolution
MAGNETIC RESONANCE IN MEDICINE
2021; 85 (5): 2434-2444
To demonstrate an MRI technique-Submillisecond Periodic Event Encoded Dynamic Imaging (SPEEDI)-for capturing cyclic dynamic events with submillisecond temporal resolution.The SPEEDI technique is based on an FID or an echo signal in which each time point in the signal is used to sample a distinct k-space raster, followed by repeated FIDs or echoes to produce the remaining k-space data in each k-space raster. All acquisitions are synchronized with a cyclic event, resulting in a set of time-resolved images of the cyclic event with a temporal resolution determined by the dwell time. In SPEEDI, spatial encoding is accomplished by phase encoding. The SPEEDI technique was demonstrated in two experiments at 3 T to (1) visualize fast-changing electric currents that mimicked the waveform of an action potential, and (2) characterize rapidly decaying eddy currents in an MRI system, with a temporal resolution of 0.2 ms and 0.4 ms, respectively. In both experiments, compressed sensing was incorporated to reduce the scan times. Phase difference maps related to the dynamics of electric currents or eddy currents were then obtained.In the first experiment, time-resolved phase maps resulting from the action potential-mimicking current waveform were successfully obtained and agreed well with theoretical calculations (normalized RMS error = 0.07). In the second experiment, spatially resolved eddy current phase maps revealed time constants (27.1 ± 0.2 ms, 41.1 ± 3.5 ms, and 34.8 ± 0.7 ms) that matched well with those obtained from an established method using point sources (26.4 ms, 41.2 ms and 34.8 ms). For both experiments, phase maps from fully sampled and compressed-sensing-accelerated k-space data exhibited a high structural similarity (> 0.8) despite a two-fold to three-fold acceleration.We have illustrated that SPEEDI can provide submillisecond temporal resolution. This capability will likely lead to future exploration of ultrafast, cyclic biomedical processes using MRI.
View details for DOI 10.1002/mrm.28588
View details for Web of Science ID 000594735600001
View details for PubMedID 33252784
High-Spatial-Resolution Diffusion MRI in Parkinson Disease: Lateral Asymmetry of the Substantia Nigra
2019; 291 (1): 148-156
Background Motor symptoms in Parkinson disease (PD) have exhibited lateral asymmetry, suggesting asymmetric neuronal loss in the substantia nigra (SN). Diffusion MRI may be able to help confirm tissue microstructural alterations in the substantia nigra to probe for the presence of asymmetry. Purpose To investigate lateral asymmetry in the SN of patients with PD by using diffusion MRI with both Gaussian and non-Gaussian models. Materials and Methods In this cross-sectional study conducted from March 2015 to March 2017, 27 participants with PD and 27 age-matched healthy control (HC) participants, all right handed, underwent MRI at 3.0 T. High-spatial-resolution diffusion images were acquired with a reduced field of view by using seven b values up to 3000 sec/mm2. A continuous-time random-walk (CTRW) non-Gaussian diffusion model was used to produce anomalous diffusion coefficient (Dm) and temporal (α) and spatial (β) diffusion heterogeneity indexes followed by a Gaussian diffusion model to yield an apparent diffusion coefficient (ADC). Individual or linear combinations of diffusion parameters in the SN were unilaterally and bilaterally compared between the PD and HC groups. Results In the bilateral comparison between the PD and HC groups, differences were observed in β (0.67 ± 0.06 [standard deviation] vs 0.64 ± 0.04, respectively; P = .016), ADC (0.48 μm2/msec ± 0.08 vs 0.53 μm2/msec ± 0.06, respectively; P = .03), and the combination of CTRW parameters (P = .02). In the unilateral comparison, differences were observed in all diffusion parameters on the left SN (P < .03), but not on the right (P > .20). In a receiver operating characteristic (ROC) analysis to delineate left SN abnormality in PD, the combination of Dm, α, and β produced the best sensitivity (sensitivity, 0.78); the combination of Dm and β produced the best specificity (specificity, 0.85); and the combination of α and β produced the largest area under the ROC curve (area under the ROC curve, 0.73). Conclusion These results suggest that quantitative diffusion MRI is sensitive to brain tissue changes in participants with Parkinson disease and provide evidence of substantia nigra lateral asymmetry in this disease. © RSNA, 2019 Online supplemental material is available for this article.
View details for DOI 10.1148/radiol.2019181042
View details for Web of Science ID 000465222600031
View details for PubMedID 30777809
View details for PubMedCentralID PMC6438360
White matter structural differences in OSA patients experiencing residual daytime sleepiness with high CPAP use: a non-Gaussian diffusion MRI study
2019; 53: 51-59
To investigate factors associated with residual sleepiness in patients who were highly adherent to continuous positive airway pressure (CPAP). Nocturnal inactivity, comorbidities, concomitant medications, and, in particular, white matter (WM) differences using diffusion magnetic resonance imaging (MRI) were explored using a continuous-time random-walk (CTRW) model.Twenty-seven male patients (30-55 years of age) with obstructive sleep apnea (OSA) received CPAP as the only treatment (CPAP ≥ 6 h/night) for at least 30 days. Based on the Psychomotor Vigilance Task (PVT) results, participants were divided into a non-sleepy group (lapses ≤ 5; n = 18) and a sleepy group (lapses > 5; n = 9). Mean nocturnal inactivity (sleep proxy) was measured using actigraphy for one week. Diffusion-weighted imaging (DWI) with high b-values, as well as diffusion tensor imaging (DTI), was performed on a 3 T MRI scanner. The DWI dataset was analyzed using the CTRW model that yielded three parameters: temporal diffusion heterogeneity α, spatial diffusion heterogeneity β, and an anomalous diffusion coefficient Dm. The differences in α, β, and Dm between the two groups were investigated by a whole-brain analysis using tract-based spatial statistics (TBSS), followed by a regional analysis on individual fiber tracts using a standard parcellation template. Results from the CTRW model were compared with those obtained from DTI. The three CTRW parameters were also correlated with the clinical assessment scores, Epworth Sleepiness Scale (ESS), PVT lapses, and PVT mean reaction time (MRT) in specific fiber tracts.There were no differences between groups in mean sleep duration, comorbidities, and the number or type of medications, including alerting and sedating medications. In the whole-brain DWI analysis, the sleepy group showed higher α (17.27% of the WM voxels) and Dm (17.14%) when compared to the non-sleepy group (P < 0.05), whereas no significant difference in β was observed. In the regional fiber analysis, the sleepy and non-sleepy groups showed significant differences in α, β, or their combinations in a total of 12 fiber tracts; whereas similar differences were not observed in DTI parameters, when age was used as a covariate. Additionally, moderate to strong correlations between the CTRW parameters (α, β, or Dm) and the sleepiness assessment scores (ESS, PVT lapses, or PVT MRT) were observed in specific fiber tracts (|R| = 0.448-0.654, P = 0.0003-0.019).The observed differences in the CTRW parameters between the two groups indicate that WM alterations can be a possible mechanism to explain reversible versus residual sleepiness observed in OSA patients with identical high level of CPAP use. The moderate to strong correlations between the CTRW parameters and the clinical scores suggest the possibility of developing objective and quantitative imaging markers to complement clinical assessment of OSA patients.
View details for DOI 10.1016/j.sleep.2018.09.011
View details for Web of Science ID 000457169500009
View details for PubMedID 30445240
View details for PubMedCentralID PMC6360120
Non-Gaussian diffusion imaging with a fractional order calculus model to predict response of gastrointestinal stromal tumor to second-line sunitinib therapy
MAGNETIC RESONANCE IN MEDICINE
2018; 79 (3): 1399-1406
To demonstrate the clinical value of a non-Gaussian diffusion model using fractional order calculus (FROC) for early prediction of the response of gastrointestinal stromal tumor to second-line sunitinib targeted therapy.Fifteen patients underwent sunitinib treatment after imatinib resistance. Diffusion-weighted imaging with multiple b-values was performed before treatment (baseline) and 2 weeks (for early prediction of response) after initiating sunitinib treatment. Conventional MRI images at 12 weeks were used to determine the good and poor responders according to the modified Choi criteria for MRI. Diffusion coefficient D, fractional order parameter β (which correlates to intravoxel tissue heterogeneity), and a microstructural quantity µ were calculated using the FROC model. The FROC parameters and the longest diameter of the lesion, as well as their changes after 2 weeks of treatment, were compared between the good and poor responders. Additionally, the pretreatment FROC parameters were individually combined with the change in D (ΔD) using a logistic regression model to evaluate response to sunitinib treatment with a receiver operating characteristic analysis.Forty-two good-responding and 32 poor-responding lesions were identified. Significant differences were detected in pretreatment β (0.67 versus 0.74, P = 0.011) and ΔD (45.7% versus 12.4%, P = 0.001) between the two groups. The receiver operating characteristic analysis showed that ΔD had a significantly higher predictive power than the tumor size change (area under the curve: 0.725 versus 0.580; 0.95 confidence interval). When ΔD was combined with pretreatment β, the area under the curve improved to 0.843 with a predictive accuracy of 75.7% (56 of 74).The non-Gaussian FROC diffusion model showed clinical value in early prediction of gastrointestinal stromal tumor response to second-line sunitinib targeted therapy. The pretreatment FROC parameter β can increase the predictive accuracy when combined with the change in diffusion coefficient during treatment. Magn Reson Med 79:1399-1406, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
View details for DOI 10.1002/mrm.26798
View details for Web of Science ID 000427184700017
View details for PubMedID 28643387
View details for PubMedCentralID PMC5741547
Discrimination of Malignant versus Benign Mediastinal Lymph Nodes Using Diffusion MRI with an IVIM Model
2018; 28 (3): 1301-1309
To investigate the value of an intravoxel incoherent motion (IVIM) diffusion model for discriminating malignant versus benign mediastinal lymph nodes (MLN).Thirty-five subjects with enlarged MLN were scanned at 1.5 Tesla. Diffusion-weighted imaging was performed with eight b-values. IVIM parameters D, D*, and f, as well as apparent diffusion coefficient (ADC) from a mono-exponential model were obtained. 91 nodes (49 malignant and 42 benign) were analysed with pathologic (n=90) or radiologic (n=1) confirmations. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance.The mean values of D, ADC, and f for the malignant group were significantly lower than those for the benign group (p<0.001), while D* showed no significant difference (p=0.281). In the ROC analysis, the combination of D and f produced the largest area under the curve (0.953) compared to ADC or other individual IVIM parameters, leading to the best specificity (92.9%) and diagnostic accuracy (90.1%).This study demonstrates that the combination of IVIM parameters can improve differentiation between malignant and benign MLN as compared to using ADC alone.• Diffusion MRI is useful for non-invasively discriminating malignant versus benign lymph nodes. • A mono-exponential model is not adequate to characterise diffusion process in lymph nodes. • IVIM model is advantageous over mono-exponential model for assessing lymph node malignancy. • Combination of IVIM parameters improves differentiation of malignant versus benign lymph nodes.
View details for DOI 10.1007/s00330-017-5049-8
View details for Web of Science ID 000424997600045
View details for PubMedID 28929210