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World J Gastroenterol. Jul 21, 2022; 28(27): 3334-3345
Published online Jul 21, 2022. doi: 10.3748/wjg.v28.i27.3334
Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma
Yi Zhou, Jing Zheng, Cui Yang, Juan Peng, Ning Liu, Lin Yang, Xiao-Ming Zhang
Yi Zhou, Jing Zheng, Cui Yang, Juan Peng, Ning Liu, Lin Yang, Xiao-Ming Zhang, Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Yi Zhou, Department of Radiology, People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
Cui Yang, Department of Radiology, Panzhihua Central Hospital, Panzhihua 617000, Sichuan Province, China
Juan Peng, Department of Radiology, Sichuan Provincial People's Hospital Jinniu Hospital, Chengdu Jinniu District People's Hospital, Chengdu 610007, Sichuan Province, China
Author contributions: Zhou Y wrote the paper; Zheng J, Yang C, Peng J and Liu N collected the data; Yang L revised the paper; Zhang XM designed the research project.
Supported by the Project of Department of Science and Technology of Sichuan Province, No. 2016JY0105; Project of Medical Association of Sichuan Province, No. S20070; and the Project of City-University Science and Technology Strategic Cooperation of Nanchong City (North Sichuan Medical College), No. 20SXQT0324.
Conflict-of-interest statement: The authors have no conflicts of interest related to this article to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin Yang, MD, Professor, Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, No. 63 Wenhua Road, Nanchong 637000, Sichuan Province, China. linyangmd@163.com
Received: December 30, 2021
Peer-review started: December 30, 2021
First decision: April 16, 2022
Revised: April 26, 2022
Accepted: June 23, 2022
Article in press: June 23, 2022
Published online: July 21, 2022
Abstract

The morbidity and mortality of hepatocellular carcinoma (HCC) rank 6th and 4th, respectively, among malignant tumors worldwide. Traditional diffusion-weighted imaging (DWI) uses the apparent diffusion coefficient (ADC) obtained by applying the monoexponential model to reflect water molecule diffusion in active tissue; however, the value of ADC is affected by microcirculation perfusion. Using a biexponential model, intravoxel incoherent motion (IVIM)-DWI quantitatively measures information related to pure water molecule diffusion and microcirculation perfusion, thus compensating for the shortcomings of DWI. The number of studies examining the application of IVIM-DWI in patients with HCC has gradually increased over the last few years, and many results show that IVIM-DWI has vital value for HCC differentiation, pathological grading, and predicting and evaluating the treatment response. The present study principally reviews the principle of IVIM-DWI and its research progress in HCC differentiation, pathological grading, predicting and evaluating the treatment response, predicting postoperative recurrence and predicting gene expression prediction.

Keywords: Hepatocellular carcinoma, Intravoxel incoherent motion, Differentiation, Pathological grading, Treatment response, Gene expression

Core Tip: Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) quantitatively measures information related to pure water molecule diffusion and microcirculation perfusion using a biexponential model, thus compensating for the shortcomings of traditional DWI. The number of studies assessing IVIM-DWI in patients with hepatocellular carcinoma (HCC) has gradually increased over the last few years. This review, which is based on the literature, identified an imaging biomarker for HCC differentiation, pathological grading, predicting and evaluating the treatment response, predicting postoperative recurrence and predicting gene expression prediction. The results of this analysis show that IVIM-DWI has important value in the treatment and diagnosis of HCC.