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Purpose <p>This study aims to determine the feasibility, image quality, intra-subject repeatability and inter-reader variability of Diffusion tensor (DTI) and Diffusion kurtosis imaging (DKI) for pancreatic imaging using different protocols and report normative values in healthy individuals.</p> Methods <p>Single-institution prospective study performed on healthy volunteers in a clinical 3T scanner, using two different protocols (6/16 diffusion directions). Acquisitions were repeated twice to assess intra-subject repeatability. To assess inter-reader variability, Mean diffusivity (MD), Axial diffusivity (AD), Radial diffusivity (RD), Apparent diffusion coefficient (ADC) and Mean kurtosis (MK) values were extracted from segmented pancreas by two radiologists. A Likert scale was used by both readers to assess subjective image quality.</p> Results <p>Twelve healthy volunteers were recruited for each MRI protocol. The 6 diffusion directions protocol was shorter: 7&#xa0;min vs. 14&#xa0;min (corresponding to 4&#xa0;min vs. 7.5&#xa0;min for a DTI only reconstruction). No differences in image quality were found between protocols. Only MK maps showed implausible estimates, leading to the exclusion of median 16% and 17.7% pixels for the 6- and 16-direction protocols, respectively. Intra-subject repeatability was determined with negligible coefficients of repeatability for DTI; however, MK presented slightly higher values. Inter-reader agreement was excellent for all maps (ICC &gt; 0.9).</p> Conclusions <p>DTI and DKI of the pancreas are feasible in clinical settings, with excellent inter-observer agreement and good image quality. Intra-subject repeatability is excellent for DTI, but some variability was observed with DKI. A 6-directions protocol may be preferred due to faster acquisition without quantitatively compromising estimates. MK inaccuracies prompt further research for improving artifact correction.</p> Graphical abstract <p></p>

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Diffusion tensor imaging and diffusion kurtosis imaging of the pancreas - feasibility, robustness and protocol comparison in a healthy population

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月26日

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  • Carlos Bilreiro,
  • Luisa Andrade,
  • Rafael Henriques,
  • Nuno Loução,
  • Celso Matos,
  • Noam Shemesh

摘要

Purpose

This study aims to determine the feasibility, image quality, intra-subject repeatability and inter-reader variability of Diffusion tensor (DTI) and Diffusion kurtosis imaging (DKI) for pancreatic imaging using different protocols and report normative values in healthy individuals.

Methods

Single-institution prospective study performed on healthy volunteers in a clinical 3T scanner, using two different protocols (6/16 diffusion directions). Acquisitions were repeated twice to assess intra-subject repeatability. To assess inter-reader variability, Mean diffusivity (MD), Axial diffusivity (AD), Radial diffusivity (RD), Apparent diffusion coefficient (ADC) and Mean kurtosis (MK) values were extracted from segmented pancreas by two radiologists. A Likert scale was used by both readers to assess subjective image quality.

Results

Twelve healthy volunteers were recruited for each MRI protocol. The 6 diffusion directions protocol was shorter: 7 min vs. 14 min (corresponding to 4 min vs. 7.5 min for a DTI only reconstruction). No differences in image quality were found between protocols. Only MK maps showed implausible estimates, leading to the exclusion of median 16% and 17.7% pixels for the 6- and 16-direction protocols, respectively. Intra-subject repeatability was determined with negligible coefficients of repeatability for DTI; however, MK presented slightly higher values. Inter-reader agreement was excellent for all maps (ICC > 0.9).

Conclusions

DTI and DKI of the pancreas are feasible in clinical settings, with excellent inter-observer agreement and good image quality. Intra-subject repeatability is excellent for DTI, but some variability was observed with DKI. A 6-directions protocol may be preferred due to faster acquisition without quantitatively compromising estimates. MK inaccuracies prompt further research for improving artifact correction.

Graphical abstract