Diffusion-weighted imaging and texture analysis: current role for diffuse liver disease
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SPECIAL SECTION: DIFFUSE LIVER DISEASE
Diffusion‑weighted imaging and texture analysis: current role for diffuse liver disease Sofia Gourtsoyianni1 · Joao Santinha2 · Celso Matos3 · Nikolaos Papanikolaou2 Received: 17 June 2020 / Revised: 6 September 2020 / Accepted: 10 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Multiparametric MRI represents the primary imaging modality to assess diffuse liver disease, both in a qualitative and in a quantitative manner. Diffusion-weighted imaging (DWI) is among the imaging techniques that can be used to assess fibrosis due to its unique capability to assess microstructural changes at the tissue level. DWI is based on water mobility patterns and has the potential to become a non-invasive and non-destructive virtual biopsy to assess diffuse liver disease, overcoming sampling bias errors due to its three-dimensional imaging capabilities. Parallel to DWI, another quantitative method called texture analysis may be used to assess early and advanced diffused liver disease through quantifying spatial relationships in a global and local level, applying to any type of digital imaging technique like MRI or CT. Initial results using texture analysis hold great promise. In the current paper, we will review the role of DWI and texture analysis using MR images in assessing diffuse liver disease. Keywords Diffusion-weighted imaging · Texture analysis · Quantification · Diffuse liver disease
Introduction MRI is the imaging examination of choice for assessing diffuse liver disease, whether this is steatosis, steatohepatitis, iron overload, fibrosis, or cirrhosis. Different MRI sequences and contrast mechanisms are employed in everyday practice to qualitatively and quantitatively evaluate diffuse liver disease. During the last two decades, liver imaging has changed dramatically, with the introduction of advanced quantitative techniques. At the forefront of these changes, a “functional” imaging technique, namely diffusion-weighted imaging (DWI), based on the assessment of molecular mobility of water in tissues, provided insights related to the tissue microarchitecture [1, 2]. * Nikolaos Papanikolaou [email protected] 1
First Department of Radiology, University of Athens School of Medicine, “Areteion” Hospital, 11528 Athens, Greece
2
Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasília, Doca de Pedrouços, 1400‑038 Lisbon, Portugal
3
Department of Radiology, Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
In human tissues, water mobility is present but with different characteristics related to the relative anatomical compartments that water motion is taking place, namely the intracellular, extracellular, and intravascular spaces. Diffusion effects can be visualized, employing an MRI pulse sequence that is sensitized to microscopic water mobility using dedicated strong gradient pulses [3]. The latter sequence can provide essential insights
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