Efficacy of ZOOMit coronal diffusion-weighted imaging and MR texture analysis for differentiating between benign and malignant distal bile duct strictures

Ki Choon Sim, Beom Jin Park, Na Yeon Han, Deuk Jae Sung, Min Ju Kim, Yeo Eun Han

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)

    Abstract

    Purpose: To investigate the diagnostic efficacy of ZOOMit coronal diffusion-weighted imaging (Z-DWI) and MR texture analysis (MRTA) for differentiating benign from malignant distal bile duct strictures. Methods: We retrospectively enrolled a total of 71 patients with distal bile duct stricture who underwent magnetic resonance cholangiopancreatography (MRCP). For quantitative analysis, the average apparent diffusion coefficient (ADC) value at suspected stricture sites was assessed on both Z-DWI and conventional DWI (C-DWI). For qualitative analysis, two reviewers independently reviewed two image sets containing different diffusion-weighted images, and receiver operating characteristic (ROC) curve analysis was performed. Several MRTA parameters were extracted from the area of the stricture on the ADC map of the ZOOMit coronal diffusion-weighted images using commercially available software. Results: Among 71 patients, 26 patients were diagnosed with malignant stricture. On quantitative analysis, the average ADC value of the malignant and benign strictures, using Z-DWI, was 1.124 × 10−3 mm2/s and 1.522 × 10−3 mm2/s, respectively (P < 0.001). The average ADC value of the malignant and benign strictures, using C-DWI, was 1.107 × 10−3 mm2/s and 1.519 × 10−3 mm2/s, respectively (P < 0.001). On qualitative analysis, for each reviewer, the area under the ROC curve (AUC) values for differentiating benign from malignant stricture was 0.928 and 0.939, respectively, for the ZOOMit diffusion set and 0.851 and 0.824, respectively, for the conventional diffusion set. Multiple MRTA parameters showed a significantly different distribution for the benign and malignant strictures, including mean, entropy, mean of positive pixels, and kurtosis at spatial filtration values of 0, 5, and 6 mm. Conclusion: The addition of Z-DWI to conventional MRCP is helpful in differentiating benign from malignant bile duct strictures, and some MRTA parameters also can be helpful in differentiating benign from malignant distal bile duct strictures.

    Original languageEnglish
    Pages (from-to)2418-2429
    Number of pages12
    JournalAbdominal Radiology
    Volume45
    Issue number8
    DOIs
    Publication statusPublished - 2020 Aug 1

    Keywords

    • Bile duct disease
    • Diffusion
    • Magnetic resonance imaging
    • Texture analysis

    ASJC Scopus subject areas

    • Radiological and Ultrasound Technology
    • Radiology Nuclear Medicine and imaging
    • Gastroenterology
    • Urology

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