Precision of liver and pancreas apparent diffusion coefficients using motion-compensated gradient waveforms in DWI

Background Diffusion weighted imaging (DWI) with optimized motion-compensated gradient waveforms reduces signal dropouts in the liver and pancreas caused by cardiovascular-associated motion, however its precision is unknown. We hypothesized that DWI with motion-compensated DW gradient waveforms would improve apparent diffusion coefficient (ADC)-repeatability and inter-reader reproducibility compared to conventional DWI in these organs. Methods In this IRB-approved, prospective, single center study, subjects recruited between October 2019 and March 2020 were scanned twice on a 3 T scanner, with repositioning between test and retest. Each scan included two respiratory-triggered DWI series with comparable acquisition time: 1) conventional (monopolar) 2) motion- compensated diffusion gradients. Three readers measured ADC values. One-way ANOVA, Bland-Altman analysis were used for statistical analysis. Results Eight healthy participants (4 male/4 female), with a mean age of 29 ± 4 years, underwent the liver and pancreas MRI protocol. Four patients with liver metastases (2 male/2 female) with a mean age of 58 ± 5 years underwent the liver MRI protocol.In healthy participants, motion-compensated DWI outperformed conventional DWI with mean repeatability coefficient of 0.14 × 10−3 (CI:0.12–0.17) vs. 0.31 × 10−3 (CI:0.27–0.37) mm2/s for liver, and 0.11 × 10−3 (CI:0.08–0.15) vs. 0.34 × 10−3 (CI:0.27–0.49) mm2/s for pancreas; and with mean reproducibility coefficient of 0.20 × 10−3 (CI:0.18–0.23) vs. 0.51 × 10−3 (CI:0.46–0.58) mm2/s for liver, and 0.16 × 10−3 (CI:0.13–0.20) vs. 0.42 × 10−3 (CI:0.34–0.52) mm2/s for pancreas.In patients, improved repeatability was observed for motion-compensated DWI in comparison to conventional with repeatability coefficient of 0.51 × 10− 3 mm2/s (CI:0.35–0.89) vs. 0.70 × 10−3 mm2/s (CI:0.49–1.20). Conclusion Motion-compensated DWI enhances the precision of ADC measurements in the liver and pancreas compared to conventional DWI.