Intravoxel Incoherent Motion Diffusion-weighted MR Imaging for Early Evaluation of the Effect of Radiofrequency Ablation in Rabbit Liver VX2 Tumors

Rationale and Objectives: This study aims to investigate the value of intravoxel incoherent motion (IVIM)-derived parameters for early evaluation of the efficiency of radiofrequency ablation (RFA) treatment for rabbit liver VX2 tumor. Materials and Methods: Eighteen rabbit liver VX2 tumor models were constructed, and computed tomography-guided RFA was performed. One day before and 7 days after RFA, 18 models underwent magnetic resonance imaging, including contrast-enhanced imaging and IVIM diffusion-weighted imaging with 16 b-factors (0-1000 s/mm(2)). Post-RFA liver tumors were segmented into viable tumor, inflammatory reaction, and ablation necrotic regions according to gross and histopathologic examinations. Parameters derived from IVIM were calculated. One-way analysis of variance and least significant difference test were used for comparisons among the three regions. The diagnostic performance of parameters was evaluated using receiver operating characteristic (ROC) analysis. Results: ADC(total), D, and f values were significantly lower in viable tumor than in inflammatory reaction regions (all P < .05), but D* showed no significant difference between the two regions. ADC(total) values of viable tumor regions were significantly lower than that of ablation necrotic regions (P = .007), but D* values of necrotic regions were significantly lower than that of viable tumor regions (P = .045). In ROC analysis, ADC showed the highest area under the ROC curve for differentiating inflammatory reaction from viable tumor region. Conclusions: ADC(total), D, and f were valuable discriminating markers for differentiation between regions of viable tumor and inflammatory reaction in post-RFA tumor, especially ADC(total) outperformed the other two parameters with higher diagnostic performance.