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Objectives: This study was conducted in order to explore the value of histogram analysis of the intravoxel incoherent motion-kurtosis (IVIM-kurtosis) model in the diagnosis and grading of prostate cancer (PCa), compared with monoexponential model (MEM). Materials and Methods: Thirty patients were included in this study. Single-shot echo-planar imaging (SS-EPI) diffusion-weighted images (b -values of 0, 20, 50, 100, 200, 500, 1,000, 1,500, 2,000 s/mm2) were acquired. The pathologies were confirmed by in-bore MR-guided biopsy. The postprocessing and measurements were processed using the software tool Matlab R2015b for the IVIM-kurtosis model and MEM. Regions of interest (ROIs) were drawn manually. Mean values of D , D *, f , K , ADC, and their histogram parameters were acquired. The values of these parameters in PCa and benign prostatic hyperplasia (BPH)/prostatitis were compared. Receiver operating characteristic (ROC) curves were used to investigate the diagnostic efficiency. The Spearman test was used to evaluate the correlation of these parameters and Gleason scores (GS) of PCa. Results: For the IVIM-kurtosis model, D (mean, 10th, 25th, 50th, 75th, 90th), D * (90th), and f (10th) were significantly lower in PCa than in BPH/prostatitis, while D (skewness), D * (kurtosis), and K (mean, 75th, 90th) were significantly higher in PCa than in BPH/prostatitis. For MEM, ADC (mean, 10th, 25th, 50th, 75th, 90th) was significantly lower in PCa than in BPH/prostatitis. The area under the ROC curve (AUC) of the IVIM-kurtosis model was higher than MEM, without significant differences (z = 1.761, P = 0.0783). D (mean, 50th, 75th, 90th), D * (mean, 10th, 25th, 50th, 75th), and f (skewness, kurtosis) correlated negatively with GS, while D (kurtosis), D * (skewness, kurtosis), f (mean, 75th, 90th), and K (mean, 75th, 90th) correlated positively with GS. The histogram parameters of ADC did not show correlations with GS. Conclusion: The IVIM-kurtosis model has potential value in the differential diagnosis of PCa and BPH/prostatitis. IVIM-kurtosis histogram analysis may provide more information in the grading of PCa than MEM. [ABSTRACT FROM AUTHOR]

Background: Intravoxel incoherent motion (IVIM) parameters derived from iZOOM diffusion-weighted imaging (DWI) can be used to quantitatively identify malignant thyroid nodules. However, the criteria are not standardized. Purpose: To determine IVIM parameter values derived from iZOOM DWI that can differentiate malignant from benign thyroid nodules. Material and Methods: Forty-two patients with 46 pathologically confirmed thyroid nodules. All patients underwent preoperative examinations with conventional and iZOOM DWI. A three-dimensional region of interest was drawn on multiple slices to cover the entire nodule. IVIM parameters (D, pure diffusion; f, perfusion fraction; and D*, pseudodiffusion) were measured. The IVIM parameters of the malignant and benign thyroid nodules were compared using independent samples t - tests, a multiple logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: D, D*, and f exhibited good reproducibility. The D and f values in the malignant nodules (D = [0.72 ± 0.14] × 10−3 mm2/s, [29.94 ± 7.36] %) were significantly lower than those in benign nodules (D = [1.23 ± 0.35] × 10−3 mm2/s, [36.00 ± 8.35] %). The D value achieved the highest area under curve (0.939). The optimal cut-off value for D was 0.87 × 10−3 mm2/s (sensitivity = 95.83%, specificity = 90.91%, positive predictive value [PPV] = 92.00%, negative predictive value [NPV] = 95.24%, and accuracy rate = 93.48%). The area under ROC curve (AUC) of D combined with the f value did not significantly differ from that of D. Conclusion: IVIM parameter D derived from iZOOM DWI may be helpful in differentiating malignant from benign thyroid nodules. [ABSTRACT FROM AUTHOR]

Background: Many locally advanced rectal cancer (LARC) patients can benefit from neoadjuvant chemotherapy (NACT), with some achieving a pathological complete response (pCR). However, there is limited research reporting on the value of intravoxel incoherent motion (IVIM) in monitoring pCR in patients with LARC.Purpose: To identify whether IVIM parameters derived from whole-tumor volume (WTV) before and after NACT could accurately assess pCR in patients with LARC.Study Type: Prospective patient control study.Population: Fifty-one patients with LARC before and after NACT, prior to surgery.Field Strength/sequence: IVIM-diffusion imaging at 3T.Assessment: Apparent diffusion coefficient (ADC), slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion-related diffusion fraction (f) values were obtained on diffusion-weighted magnetic resonance images (DW-MRI) using WTV methods and calculated using a biexponential model before and after NACT.Statistical Tests: DWI-derived ADC and IVIM-derived parameters and their percentage changes (ΔADC%, ΔD%, ΔD*%, and Δf%) were compared using independent-samples t-test and Mann-Whitney U-test between the pCR and non-pCR groups. The diagnostic performance of IVIM parameters and their percentage changes were evaluated using receiver operating characteristic curves.Results: Compared with the non-pCR group, the pCR group exhibited significantly lower pre-ADCmean (P = 0.003) and pre-D values (P = 0.024), and significantly higher post-f (P = 0.002), ΔADCmean % (P = 0.002), ΔD% (P = 0.001), and Δf% values (P = 0.017). Receiver operating characteristic curves showed that the pre-D value had the best specificity (95.12%) and accuracy (86.27%) in predicting the pCR status, and ΔD% had the highest area under the curve (0.832) in assessing the pCR response to NACT.Data Conclusions: The IVIM-derived D value is a promising tool in predicting the pCR status before therapy. The percentage changes in D values after therapy may help assess the pCR status prior to surgery.Level Of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017. [ABSTRACT FROM AUTHOR]