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. 2025 Feb 7:90:e66-e73.
doi: 10.5114/pjr/199686. eCollection 2025.

Predictive intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in the staging of fibrosis in hepatitis B patients

Sevde Nur Emir  1 , Fatma Kulali  1 , Ilkay Tosun  1 , Yasar Bukte  1
Affiliations

Predictive intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in the staging of fibrosis in hepatitis B patients

Sevde Nur Emir et al. Pol J Radiol. .

Abstract

Purpose: Our aim was to evaluate the diagnostic efficacy of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters [D, D*, f, and apparent diffusion coefficient (ADC) values] in the detection and staging of liver fibrosis in patients with hepatitis B virus (HBV).

Material and methods: In this prospective study, a patient group of 64 consecutive patients (with a mean age of 43 years, 30 women and 34 men) with HBV, who scheduled liver biopsy, and a control group of 30 healthy individuals without liver disease underwent IVIM-DWI scan. A total of 94 IVIM-DWI examinations were analysed. IVIM-DWI parameters were measured in the right lobe of the liver. The IVIM-DWI parameters of the patient and control groups were compared by Mann-Whitney U test. The patient group was classified into subgroups according to fibrosis stage of histopathological results. Receiver operating characteristic (ROC) analysis was conducted to assess the sensitivity and specificity of each parameter for detection and staging fibrosis.

Results: D and ADC values were significantly lower in the patient group compared to the control group (p < 0.05), while D* values were significantly higher (p < 0.05). No significant difference was observed in f values between the 2 groups. D* had the highest diagnostic performance, with a sensitivity of 78.1% and specificity of 73.3%, with a cut-off value of 1.4 × 10-3 mm2/s in the differentiation of fibrosis stages.

Conclusions: IVIM-DWI, particularly the D, D*, and ADC parameters, is an adjunctive non-invasive alternative to biopsy in the staging of HBV-related liver fibrosis, especially for the prediction of advanced fibrosis.

Keywords: chronic hepatitis B; cirrhosis; diffusion-weighted imaging; fibrosis; intravoxel incoherent motion; magnetic resonance imaging.

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Figures

Figure 1
Figure 1
Flowchart of the patient and control groups
Figure 2
Figure 2
Demonstration of volume of interest (VOI) measurements on axial D* (A), D (B), ADC (C), and f (D) parameter maps in a chronic hepatitis B patient
Figure 3
Figure 3
Boxplots showing the distribution of the parameters D, D*, f, and ADC between the patient and control groups
Figure 4
Figure 4
Boxplots displaying the differences in the D, D*, and ADC parameters among the fibrosis groups (F0-1, F2-3, F4-6)
See this image and copyright information in PMC

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