Elevation of HCC perfusion by diffusion-derived vessel density (DDVD) biomarker: Higher HCC perfusion than earlier IVIM reports.

Motivation: HCCs mostly show higher perfusion values compared with the adjacent normal liver tissue. Paradoxically authors reported a decrease IVIM-PF(perfusion fraction) of HCC relative to adjacent liver. Goal(s): DWI-derived surrogate biomarker DDVD (diffusion-derived vessel density) is a physiological surrogate of the area of micro-vessels per unit tissue area. This study applied DDVD to assess perfusion of HCC. Approach: 72 patients were included. DDVD= (signal intensity at b=0)/ROIarea – (signal intensity at b=2/ROIarea). Results: (tumor DDVD)/(liver DDVD) was 2.942 (median), majority of HCC showing a much higher DDVD than liver. Impact: DDVD overcome the pitfalls associated with IVIM PF.