# Current Update on DWI-MRI and Its Radiomics in Liver Fibrosis—A Review of the Literature

## TL;DR

This review summarizes the use of diffusion-weighted MRI techniques for diagnosing and monitoring liver fibrosis, highlighting their potential and limitations.

## Contribution

The paper provides a comprehensive review and critical analysis of advanced DWI methods for liver fibrosis assessment.

## Key findings

- Advanced DWI sequences show promise for liver fibrosis assessment but produce inconsistent results.
- IVIM, DKI, and DTI techniques have overlapping outcomes across fibrosis stages, limiting reliability.
- Current limitations include lack of robustness and reproducibility in measurements.

## Abstract

Introduction: Diffusion-weighted imaging (DWI) is a non-invasive technique for acquiring liver pathology data and characterizing liver lesions. This modality shows promise for applications in the initial diagnosis and monitoring of liver diseases, providing valuable insights for clinical assessment and treatment strategies. Intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), and diffusion tensor imaging (DTI) are advanced forms of DWI. These techniques have proven effective for assessing liver lesions, including liver tumors and fibrosis. However, the results can be inconsistent. Thus, it is essential to summarize the current applications of these methods in liver fibrosis, identify existing limitations, and suggest future directions for development. Methods: This review assessed studies concerning liver DWI and its applications published in the PubMed database over the last nine years. It presents these techniques’ fundamental principles and key factors before discussing their application in liver fibrosis. Results and conclusions: It has been observed that advanced DWI sequences remain unreliable in ensuring the robustness and reproducibility of measurements when assessing liver fibrosis grades, due to inconsistent results and significant overlap among these techniques across different stages of fibrotic conditions.