Apparent Diffusion Coefficient (ADC) as a quantitative parameter in diffusion weighted MR imaging in gynecologic cancer: Dependence on b-values used

Abstract

Background. Diffusion weighted imaging (DWI) has gained interest as an imaging modality for assessment of tumor extension and response to cancer treatment. The purpose of this study is to assess the impact of the choice of b-values on the calculation of the Apparent Diffusion Coefficient (ADC) for locally advanced gynecological cancer and to estimate a stable interval of diffusion gradients that allows for best comparison of the ADC between patients and institutions. Material and methods. Six patients underwent a high resolution single shot EPI based DWI scan with 16 different diffusion gradients on a 3 Tesla Philips Achieva MR-scanner. Data analysis was performed by applying a monoexponential and a biexponential model to the acquired data. The biexponential function models the effect of both perfusion and diffusion. Results and conclusion. ADC changes of up to 40% were seen with the use of different b-values. Using a lower b-value ≥ 150 s/mm² and an upper b-value ≥ 700 s/mm² limited the variation to less that 10% from the reference ADC value. By eliminating the contribution of perfusion the uncertainty of quantitative ADC values were significantly reduced.

Acknowledgements

This study has been supported by research grants from the Danish Cancer Society, Danish Council for Strategic Research, CIRRO – the Lundbeck Foundation Centre for Interventional Research in Radiation Oncology.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.