Diffusion‐weighted MRI of pulmonary lesions: Comparison of apparent diffusion coefficient and lesion‐to‐spinal cord signal intensity ratio in lesion characterization
Copyright policy )Diffusion‐weighted MRI of pulmonary lesions: Comparison of apparent diffusion coefficient and lesion‐to‐spinal cord signal intensity ratio in lesion characterization
PurposeTo evaluate the diagnostic performance of minimum apparent diffusion coefficient (ADCmin) and lesion‐to‐spinal cord signal intensity ratio (LSR) in the differentiation of benign and malignant pulmonary lesions.Materials and MethodsForty‐seven patients (36 men, 11 women; range, 17–81 years) with 62 pulmonary lesions underwent magnetic resonance imaging (MRI) and diffusion‐weighted imaging (DWI) performed using a 1.5T scanner during free‐breathing using b 600 s/mm2. The ADCmin values and LSR were calculated. A receiver operating characteristic (ROC) curve analysis was performed to detect the threshold value of the ADCmin and LSR values for discrimination between benign and malignant pulmonary lesions.ResultsThere were 42 malignant (33 primary tumors, 9 metastases) and 20 benign lesions. The mean ADCmin ± standard deviations (×10−3 mm2/s) were 1.45 ± 0.33 for malignant tumors, and 2.4 ± 0.69 for benign lesions (P < 0.001). The mean LSR ± standard deviations for lung cancer was 1.24 ± 0.78, and for benign lesions was 0.55 ± 0.57 (P < 0.001). The area under the ROC curve for ADCmin (0.931; 95% confidence interval [CI]: 0.868–0.993) was greater than that for LSR (0.801; 95% CI: 0.675–0.926) (P = 0.029). For benign/malignant discrimination, the ROC curve showed threshold value of ADCmin to be 1.78 × 10−3 mm2/s and that of LSR to be 0.86. Using these cutoff values, accuracy of ADCmin and LSR were 89%, 74%, respectively (P = 0.383).ConclusionBeing a contrast‐free and radiation‐free technique, DWI allows discrimination of benign and malignant lung lesions. The ADCmin value performed marginally better than LSR values in distinction of benign and malignant lesions.Level of Evidence: 1J. Magn. Reson. Imaging 2017;45:845–854.
- Pamukkale University Turkey
respiratory tract disease assessment, Male, Lung Neoplasms, organizing pneumonia, tuberculoma, very elderly, lesion to spinal cord signal intensity ratio, image display, non invasive procedure, lung tumor, atelectasis, differential diagnosis, middle aged, lung hydatid cyst, Lung, Aged, 80 and over, clinical article, lung metastasis, adult, Middle Aged, aged, female, neuroectoderm tumor, Spinal Cord, nuclear magnetic resonance scanner, pulmonary lesions, hamartoma, histopathology, apparent diffusion coefficient, lung lesion, young adult, diagnostic accuracy, Female, MRI, minimum apparent diffusion coefficient, Adult, Adolescent, diagnostic imaging, diffusion-weighted imaging, 610, neurogenic tumor, Models, Biological, Sensitivity and Specificity, Article, lung, Diagnosis, Differential, Young Adult, male, Image Interpretation, Computer-Assisted, diffusion weighted imaging, Humans, controlled study, human, image enhancement, procedures, reproducibility, Aged, invasive aspergillosis, Wegener granulomatosis, radiological parameters, spinal cord, Reproducibility of Results, computer assisted diagnosis, Adolescent; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging/*methods; Female; Humans; Image Enhancement/methods; Image Interpretation, Computer-Assisted/*methods; Lung/*diagnostic imaging/pathology; Lung Neoplasms/*diagnostic imaging/pathology; Male; Middle Aged; Models, Biological; Reproducibility of Results; Sensitivity and Specificity; Spinal Cord/*diagnostic imaging/pathology; Young Adult, lung adenocarcinoma, biological model, Image Enhancement, human tissue, lung cancer, Diffusion Magnetic Resonance Imaging, inflammation, tumor differentiation, sensitivity and specificity, adolescent, pathology, small cell lung cancer, squamous cell lung carcinoma
respiratory tract disease assessment, Male, Lung Neoplasms, organizing pneumonia, tuberculoma, very elderly, lesion to spinal cord signal intensity ratio, image display, non invasive procedure, lung tumor, atelectasis, differential diagnosis, middle aged, lung hydatid cyst, Lung, Aged, 80 and over, clinical article, lung metastasis, adult, Middle Aged, aged, female, neuroectoderm tumor, Spinal Cord, nuclear magnetic resonance scanner, pulmonary lesions, hamartoma, histopathology, apparent diffusion coefficient, lung lesion, young adult, diagnostic accuracy, Female, MRI, minimum apparent diffusion coefficient, Adult, Adolescent, diagnostic imaging, diffusion-weighted imaging, 610, neurogenic tumor, Models, Biological, Sensitivity and Specificity, Article, lung, Diagnosis, Differential, Young Adult, male, Image Interpretation, Computer-Assisted, diffusion weighted imaging, Humans, controlled study, human, image enhancement, procedures, reproducibility, Aged, invasive aspergillosis, Wegener granulomatosis, radiological parameters, spinal cord, Reproducibility of Results, computer assisted diagnosis, Adolescent; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging/*methods; Female; Humans; Image Enhancement/methods; Image Interpretation, Computer-Assisted/*methods; Lung/*diagnostic imaging/pathology; Lung Neoplasms/*diagnostic imaging/pathology; Male; Middle Aged; Models, Biological; Reproducibility of Results; Sensitivity and Specificity; Spinal Cord/*diagnostic imaging/pathology; Young Adult, lung adenocarcinoma, biological model, Image Enhancement, human tissue, lung cancer, Diffusion Magnetic Resonance Imaging, inflammation, tumor differentiation, sensitivity and specificity, adolescent, pathology, small cell lung cancer, squamous cell lung carcinoma
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