B-Value Optimization in the Estimation of Intravoxel Incoherent Motion Parameters in Patients with Cervical Cancer

Objective: This study aimed to find the optimal number of b-values for intravoxel incoherent motion (IVIM) imaging analysis, using simulated and in vivo data from cervical cancer patients.Materials and Methods: Simulated data were generated using literature pooled means, which served as reference values for simulations.In vivo data from 100 treatment-naïve cervical cancer patients with IVIM imaging (13 b-values, scan time, 436 seconds) were retrospectively reviewed.A stepwise b-value fitting algorithm calculated optimal thresholds.Feed forward selection determined the optimal subsampled b-value distribution for biexponential IVIM fitting, and simplified IVIM modeling using monoexponential fitting was attempted.IVIM parameters computed using all b-values served as reference values for in vivo data.Results: In simulations, parameters were accurately estimated with six b-values, or three b-values for simplified IVIM, respectively.In vivo data showed that the optimal threshold was 40 s/mm 2 for patients with squamous cell carcinoma and a subsampled acquisition of six b-values (scan time, 198 seconds) estimated parameters were not significantly different from reference parameters (individual parameter error rates of less than 5%).In patients with adenocarcinoma, the optimal threshold was 100 s/mm 2 , but an optimal subsample could not be identified.Irrespective of the histological subtype, only three b-values were needed for simplified IVIM, but these parameters did not retain their discriminative ability.Conclusion: Subsampling of six b-values halved the IVIM scan time without significant losses in accuracy and discriminative ability.Simplified IVIM is possible with only three b-values, at the risk of losing diagnostic information.