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Diffusion-weighted MRI of pulmonary lesions: Comparison of apparent diffusion coefficient and lesion-to-spinal cord signal intensity ratio in lesion characterization
Journal article   Open access   Peer reviewed

Diffusion-weighted MRI of pulmonary lesions: Comparison of apparent diffusion coefficient and lesion-to-spinal cord signal intensity ratio in lesion characterization

Vefa Çakmak, Furkan Ufuk and Nevzat Karabulut
Journal of magnetic resonance imaging, Vol.45(3), pp.845-854
03/2017
DOI: 10.1002/jmri.25426
PMID: 27519160
url
https://doi.org/10.1002/jmri.25426View
Published (Version of record) Open Access

Abstract

To evaluate the diagnostic performance of minimum apparent diffusion coefficient (ADC ) and lesion-to-spinal cord signal intensity ratio (LSR) in the differentiation of benign and malignant pulmonary lesions. Forty-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/mm . The ADC values and LSR were calculated. A receiver operating characteristic (ROC) curve analysis was performed to detect the threshold value of the ADC and LSR values for discrimination between benign and malignant pulmonary lesions. There were 42 malignant (33 primary tumors, 9 metastases) and 20 benign lesions. The mean ADC  ± standard deviations (×10 mm /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 ADC (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 ADC to be 1.78 × 10 mm /s and that of LSR to be 0.86. Using these cutoff values, accuracy of ADC and LSR were 89%, 74%, respectively (P = 0.383). Being a contrast-free and radiation-free technique, DWI allows discrimination of benign and malignant lung lesions. The ADC value performed marginally better than LSR values in distinction of benign and malignant lesions. 1 J. Magn. Reson. Imaging 2017;45:845-854.
 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 Lung - pathology Lung Neoplasms - diagnostic imaging Lung Neoplasms - pathology Male Middle Aged Models, Biological Reproducibility of Results Sensitivity and Specificity Spinal Cord - diagnostic imaging Spinal Cord - pathology Young Adult

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