A comparative study of methods for determining Intravoxel incoherent motion parameters in cervix cancer

Background: To compare different fitting methods for determining IVIM (Intravoxel Incoherent Motion) parameters and to determine whether the use of different IVIM fitting methods would affect differentiation of cervix cancer from normal cervix tissue. Methods: Diffusion-weighted echo-planar imaging of 30 subjects was performed on a 3.0 T scanner with b-values of 0, 30, 100, 200, 400, 1000 s/mm(2). IVIM parameters were estimated using the segmented (two-step) fitting method and by simultaneous fitting of a bi-exponential function. Segmented fitting was performed using two different cut-off b-values (100 and 200 s/mm(2)) to study possible variations due to the choice of cut-off. Friedman's test and Student's t-test were respectively used to compare IVIM parameters derived from different methods, and between cancer and normal tissues. Results: No significant difference was found between IVIM parameters derived from the segmented method with b-value cutoff of 200 s/mm(2) and the simultaneous fitting method (P>0.05). Tissue diffusivity (D) and perfusion fraction (f) were significantly lower in cervix cancer than normal tissue (P< 0.05). Conclusions: IVIM parameters derived using fitting methods with small cutoff b-values could be different, however, the segmented method with b-value cutoff of 200 s/mm(2) are consistent with the simultaneous fitting method and both can be used to differentiate between cervix cancer and normal tissue.

Automated summary

The study found that there was no significant difference between IVIM parameters obtained from the segmented method with a b-value cutoff of 200 s/mm(2) and the simultaneous fitting method. Tissue diffusivity (D) and perfusion fraction (f) were significantly lower in cervix cancer compared to normal tissue. Therefore, both the segmented method and simultaneous fitting method can be used to differentiate between cervix cancer and normal tissue.