Diffusion-Weighted MRI in the Genitourinary System

Article Article scientifique Article Diffusion-Weighted MRI in the Genitourinary System eng 2022-03-30 2022-03-30 author De Perrot Thomas Benoît 88988 author Sadjo Zoua Christine 674958 author Glassgen Carl G. author Botsikas Diomidis 0000-0002-0543-0742 690294 author Berchtold Lena 0000-0001-8815-4263 635029 author Salomir Rares Vincent 682178 author De Seigneux Matthey Sophie 105798 author Thoeny Harriet C. author Vallée Jean-Paul 0000-0001-7546-2013 29185 1921 10.3390/JCM11071921 35407528 2077-0383 PMC9000195 https://www.mdpi.com/2077-0383/11/7/1921 <p>Diffusion weighted imaging (DWI) constitutes a major functional parameter performed in Magnetic Resonance Imaging (MRI). The DW sequence is performed by acquiring a set of native images described by their b-values, each b-value representing the strength of the diffusion MR gradients specific to that sequence. By fitting the data with models describing the motion of water in tissue, an apparent diffusion coefficient (ADC) map is built and allows the assessment of water mobility inside the tissue. The high cellularity of tumors restricts the water diffusion and decreases the value of ADC within tumors, which makes them appear hypointense on ADC maps. The role of this sequence now largely exceeds its first clinical apparitions in neuroimaging, whereby the method helped diagnose the early phases of cerebral ischemic stroke. The applications extend to whole-body imaging for both neoplastic and non-neoplastic diseases. This review emphasizes the integration of DWI in the genitourinary system imaging by outlining the sequence’s usage in female pelvis, prostate, bladder, penis, testis and kidney MRI. In gynecologic imaging, DWI is an essential sequence for the characterization of cervix tumors and endometrial carcinomas, as well as to differentiate between leiomyosarcoma and benign leiomyoma of the uterus. In ovarian epithelial neoplasms, DWI provides key information for the characterization of solid components in heterogeneous complex ovarian masses. In prostate imaging, DWI became an essential part of multi-parametric Magnetic Resonance Imaging (mpMRI) to detect prostate cancer. The Prostate Imaging–Reporting and Data System (PI-RADS) scoring the probability of significant prostate tumors has significantly contributed to this success. Its contribution has established mpMRI as a mandatory examination for the planning of prostate biopsies and radical prostatectomy. Following a similar approach, DWI was included in multiparametric protocols for the bladder and the testis. In renal imaging, DWI is not able to robustly differentiate between malignant and benign renal tumors but may be helpful to characterize tumor subtypes, including clear-cell and non-clear-cell renal carcinomas or low-fat angiomyolipomas. One of the most promising developments of renal DWI is the estimation of renal fibrosis in chronic kidney disease (CKD) patients. In conclusion, DWI constitutes a major advancement in genitourinary imaging with a central role in decision algorithms in the female pelvis and prostate cancer, now allowing promising applications in renal imaging or in the bladder and testicular mpMRI.</p> Cancer Diffusion Female pelvis Genitourinary MRI Kidney Prostate Dewey 616.0757 Dewey 616 Swiss National Science Foundation Renal diffusion MRI in chronic kidney disease: a multi-centric approach 177140 CH Programmes Swiss National Science Foundation Diffusion MRI in chronic kidney patients 159714 CH Projects Swiss National Science Foundation Post-transcriptional regulation of germ cell apoptosis in C. elegans 127454 CH Programmes 62 Département de radiologie et informatique médicale 227 56 Département de médecine 221 false 286 Imagerie cardiaque fonctionnelle 541 897 Insuffisance rénale chronique 941 926 Imagerie per-opératoire multi-modalité en radiologie interventionnelle 949 Journal of clinical medicine 11 7 11b5b8e2-804e-494c-8d32-7e0c0622ea74 Article (Published version) Public Article-scientifique-from-crossref.pdf 3924602 application/pdf CC BY-4.0 openAccess Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale Faculté de médecine / Section de médecine clinique / Département de médecine

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Diffusion-Weighted MRI in the Genitourinary System	Journal of clinical medicine			2022	167	416

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Sadjo Zoua, Christine