Intravoxel incoherent motion and diffusion kurtosis imaging for discriminating soft tissue sarcoma from vascular anomalies

To investigate the feasibility of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in discriminating soft tissue sarcoma from vascular anomalies. Twenty-two patients with lower extremity soft tissue sarcoma and 15 patients with lower extremity vascular anomalies underwent IVIM-DWI and DKI. IVIM model generated true diffusion (D), perfusion fraction (f), and pseudo-diffusion coefficient (D(∗)). DKI model generated mean kurtosis (MK) and mean diffusion (MD). These parameters were measured by 2 radiologists separately through drawing region of interest. Intraclass correlation coefficient (ICC) was calculated to evaluate the inter-reader viability in measurement. The Mann–Whitney test was used to compare the parameters between vascular anomalies and soft tissue sarcoma. Receiver operating characteristic curves were constructed for assessing diagnostic accuracies. ICC was more than 0.8 for apparent diffusion coefficient (ADC), D, D(∗), f, MK, and MD. Mean ADC, D, and MD were significantly lower in soft tissue sarcoma versus vascular anomalies (P < .05). Mean D(∗) and f were not significantly different (P > .05). Soft tissue sarcoma had significantly higher MK than vascular anomalies (P < .05). Areas under curve for ADC, D, MK, and MD were 0.876, 0.885, 0.894, and 0.812, respectively. IVIM and DKI are feasible in discriminating soft tissue sarcoma from vascular anomalies.