Motion compensated renal diffusion weighted imaging

link to paper

Motion compensated renal diffusion weighted imaging

Sean McTavish, Anh T. Van, Johannes M. Peeters, Kilian Weiss, Marcus R. Makowski, Rickmer F. Braren, Dimitrios C. Karampinos

Abstract

Purpose

To assess the effect of respiratory motion and cardiac driven pulsation in renal DWI and to examine asymmetrical velocity-compensated diffusion encoding waveforms for robust ADC mapping in the kidneys.

Methods

The standard monopolar Stejskal-Tanner pulsed gradient spin echo (pgse) and the asymmetric bipolar velocity-compensated (asym-vc) diffusion encoding waveforms were used for coronal renal DWI at 3T. The robustness of the ADC quantification in the kidneys was tested with the aforementioned waveforms in respiratory-triggered and breath-held cardiac-triggered scans at different trigger delays in 10 healthy subjects.

Results

The pgse waveform showed higher ADC values in the right kidney at short trigger delays in comparison to longer trigger delays in the respiratory triggered scans when the diffusion gradient was applied in the feet-head (FH) direction. The coefficient of variation over all respiratory trigger delays, averaged over all subjects was 0.15 for the pgse waveform in the right kidney when diffusion was measured in the FH direction; the corresponding coefficient of variation for the asym-vc waveform was 0.06. The effect of cardiac driven pulsation was found to be small in comparison to the effect of respiratory motion.

Conclusion

Short trigger delays in respiratory-triggered scans can cause higher ADC values in comparison to longer trigger delays in renal DWI, especially in the right kidney when diffusion is measured in the FH direction. The asym-vc waveform can reduce ADC variation due to respiratory motion in respiratory-triggered scans at the cost of reduced SNR compared to the pgse waveform.

Dear Sean McTavish,

I believe the results of your paper are correct and I am interested in the results. Several related similar studies have been reported. In this study, a difference was identified between the ADC obtained with the sym-vc DW-EPI pulse sequence and the ADC from regular DW-EPI. They argue that this ADC change is due to organ migration and IVIM effects. I have two questions.

The first is, is the phase difference in the phase image in Figure 6 a sequence that can represent movement? To what extent does the phase shift represent the speed of movement?

Please answer the second question if possible. What is the diffusion time and how much did you estimate the IVIM effect (ADC increase) due to the amount of tissue movement within that time? What are your thoughts on the basis for this and what research reports did you refer to?

Regards.

Masahiro Umeda