{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:45:34Z","timestamp":1791193534406,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,8,30]],"date-time":"2013-08-30T00:00:00Z","timestamp":1377820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NMR in Biomedicine"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>The objectives of this study were to assess the diffusion parameters derived from intravoxel incoherent motion (IVIM) MRI in head and neck squamous cell carcinoma (HNSCC) and to investigate the agreement between different methods of tumor delineation and two numerical methods to extract the perfusion fraction <jats:italic>f<\/jats:italic>. Thirty\u2010seven untreated patients with histopathologically confirmed primary HNSCC were included retrospectively in the study. The entire volume of the primary tumor was outlined on diffusion\u2010weighted images using co\u2010registered morphological images as a guide to the tumor location. Apparent diffusion coefficient (ADC) and IVIM diffusion parameters were estimated considering the largest tumor section as well as the entire tumor volume. A bi\u2010exponential fit was implemented to extract <jats:italic>f<\/jats:italic>, <jats:italic>D<\/jats:italic> (pure diffusion coefficient) and <jats:italic>D<\/jats:italic>* (pseudo\u2010diffusion coefficient). A second simplified method, based on an asymptotic extrapolation, was used to determine <jats:italic>f<\/jats:italic>. The agreement between ADC and IVIM diffusion parameters derived from the delineation of single and multiple slices, and between the two <jats:italic>f<\/jats:italic> estimations, was assessed by Bland\u2013Altman plots. The inter\u2010slice variability of ADC and IVIM diffusion parameters was evaluated. The Kruskal\u2013Wallis test was used to investigate whether the tumor location had a statistically significant influence on the values of the parameters. Comparing the tumor delineation methods, a better accordance was found for ADC and <jats:italic>D<\/jats:italic>, with a mean percentage difference of less than 2%. Larger discrepancies were found for <jats:italic>f<\/jats:italic> and <jats:italic>D<\/jats:italic>*, with mean differences of 4.5% and 5.5%, respectively. When comparing the two <jats:italic>f<\/jats:italic> estimation methods, small mean differences were found (&lt;3.5%), suggesting that the two methods may be considered as equivalent for the assessment of <jats:italic>f<\/jats:italic> in our patient population. The observed ADC and IVIM diffusion parameters were dependent on the anatomic site of the lesion, carcinoma of the nasopharynx showing more homogeneous and dissimilar estimations than other HNSCCs. 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