Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Oct 28, 2018; 10(10): 116-123
Published online Oct 28, 2018. doi: 10.4329/wjr.v10.i10.116
Could intravoxel incoherent motion diffusion-weighted magnetic resonance imaging be feasible and beneficial to the evaluation of gastrointestinal tumors histopathology and the therapeutic response?
Hou-Dong Zuo, Xiao-Ming Zhang
Hou-Dong Zuo, Xiao-Ming Zhang, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: All authors contributed to writing the paper and had full control over preparation of manuscript; all authors approved the final draft manuscript.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Ming Zhang, MD, PhD, Professor, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, Nanchong 637000, Sichuan Province, China. cjr.zhxm@vip.163.com
Telephone: +86-817-2262218 Fax: +86-817-2222856
Received: June 23, 2018
Peer-review started: June 24, 2018
First decision: July 19, 2018
Revised: August 2, 2018
Accepted: August 2, 2018
Article in press: August 26, 2018
Published online: October 28, 2018
Processing time: 126 Days and 15.8 Hours
Abstract

Gastrointestinal tumors (GTs) are among the most common tumors of the digestive system and are among the leading causes of cancer death worldwide. Functional magnetic resonance imaging (MRI) is crucial for assessment of histopathological changes and therapeutic responses of GTs before and after chemotherapy and radiotherapy. A new functional MRI technique, intravoxel incoherent motion (IVIM), could reveal more detailed useful information regarding many diseases. Currently, IVIM is widely used for various tumors because the derived parameters (diffusion coefficient, D; pseudo-perfusion diffusion coefficient, D*; and perfusion fraction, f) are thought to be important surrogate imaging biomarkers for gaining insights into tissue physiology. They can simultaneously reflect the microenvironment, microcirculation in the capillary network (perfusion) and diffusion in tumor tissues without contrast agent intravenous administration. The sensitivity and specificity of these parameters used in the evaluation of GTs vary, the results of IVIM in GTs are discrepant and the variability of IVIM measurements in response to chemotherapy and/or radiotherapy in these studies remains a source of controversy. Therefore, there are questions as to whether IVIM diffusion-weighted MRI is feasible and helpful in the evaluation of GTs, and whether it is worthy of expanded use.

Keywords: Intravoxel incoherent motion; Metastasis; Gastric cancer; Colorectal cancer

Core tip: In general, the gastrointestinal tumors (GTs) can be diagnosed by routine computed tomography/magnetic resonance imaging (MRI) and biopsy, but the intravoxel incoherent motion (IVIM), a new emerging MRI technique, plays a important role in the tumor evaluation before and after surgery, and provides more useful information in tumor properties, stage and chemoradiotherapy (CRT) response. What’s more, the quantitative parameters derived from IVIM, including D, D* and f, can gain an insight into tumor tissue physiology changes and simultaneously reflect the microenvironment, microcirculation in the capillary network and diffusion in tumor tissues, thus, new imaging biomarkers for monitoring and evaluating the tumor and the CRT response in GTs.