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Apparent diffusion coefficient (ADC) is a measure of the magnitude ofdiffusion of water molecules within tissues. We argue that ADC value containsinformation of both diffusion and T2 relaxation. In this letter, we listliterature evidence to support our argument. Firstly, we list uterinemyometrium tumors as examples. Myometrium has a T2 relaxation time of 79 ms at3T. Literature shows, when the myometrium tumors are T2 weighted signalintensity hypertensive (relative to myometrium), these tumors likely showdiffusion restriction. This is similar to that, while the spleen is T2 weightedsignal intensity hypertensive relative to the liver, the spleen demonstratesdiffusion restriction relative to the liver. On the other hand, when themyometrium tumors are T2 weighted signal intensity hypotensive (relative tomyometrium), these tumors likely do not show diffusion restriction. However,when the myometrium tumors are very highly hypertensive such as the cases ofleiomyoma cystic degeneration and myxoid degeneration, the relationship betweenT2 weighted signal intensity and diffusion is similar to that of a normalgallbladder, i.e., T2 weighted signal highly hypertensive without diffusionrestriction. For most of the tumors, much longer T2 may suggest a tumor iswaterier. On b=0 images, the signal of tumor (relative to other tissues) can bedominated by T2 effect. On a high b-value images such as b=1000 images, it ispossible that tumor regions are dominated by noises. In the end, the ADCs,which are determined by the slope between the signal at b=0 and the signal atb=1000, are also dominated by the T2 effect, with longer T2 being associatedwith higher ADC measure. In fact, since there is no diffusion gradient with b=0images, and there are only noises on b=1000 (or b=800), ADC map is devoid ofdiffusion information.

Complicated relationships between tissue T2 relaxation time and in vivo tissue diffusion measures, depending on the ranges of T2 value