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Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging.

Gümüştaş S, Inan N, Akansel G, Ciftçi E, Demirci A, Ozkara SK - Radiol Oncol (2012)

Bottom Line: The statistical significance was determined using the Student-t test.There was no significant difference in SIs or ADC values between small cell carcinoma and non-small cell carcinoma.When comparing undifferentiated with well- partially differentiated cancers, SIs were higher with all b values, but the difference was statistically significant only with b=1000 s/mm(2) (p<0.04).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology.

ABSTRACT

Background: The aim of the study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the differential diagnosis of lung lesions. PATIENTS AND METHODS.: Sixty-seven patients with lung lesions (48 malignant, 19 benign) were included in this prospective study. Signal intensities (SIs) were measured in diffusion-weighted MR images that were obtained with b=0, 500 and 1000 s/mm(2) values. Apparent diffusion coefficient (ADC) maps were calculated by using images with b=0 and 1000 s/mm(2) values. The statistical significance was determined using the Student-t test.

Results: The SIs of malignant lesions were significantly higher than those of benign lesions (p<0.004 for b=0 s/mm(2) and p<0.000 for the other b values). Using b=500 s/mm(2), SI≥391 indicated a malignant lesion with a sensitivity of 95%, specificity of 73% and positive predictive value of 87%. Using b=1000 s/mm(2), SI≥277 indicated a malignant lesion with a sensitivity of 93%, specificity of 69% and positive predictive value of 85%. There was no significant difference between malignant and benign lesions regarding ADC values (p=0.675). There was no significant difference in SIs or ADC values between small cell carcinoma and non-small cell carcinoma. When comparing undifferentiated with well- partially differentiated cancers, SIs were higher with all b values, but the difference was statistically significant only with b=1000 s/mm(2) (p<0.04).

Conclusions: Diffusion-weighteted MR trace image SI is useful for the differentiation of malignant versus benign lung lesions.

No MeSH data available.


Related in: MedlinePlus

A 32-year-old woman with bacterial pneumonia. (A) Axial T2-weighted MR image shows ill-defined peripheral mass in the superior segment of the lower lobe of the left lung (arrows). (B) diffusion-weighted magnetic resonance image with b value of 500 sec/mm2 shows minimal hyperintense mass (SI = 203). (C) diffusion-weighted magnetic resonance image with b value of 1000 sec/mm2 shows hyperintensity of the mass is less remarkable (SI = 162). (D) ADC map shows ADC value is (2.76×10−3) sec/mm2.
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f2-rado-46-02-106: A 32-year-old woman with bacterial pneumonia. (A) Axial T2-weighted MR image shows ill-defined peripheral mass in the superior segment of the lower lobe of the left lung (arrows). (B) diffusion-weighted magnetic resonance image with b value of 500 sec/mm2 shows minimal hyperintense mass (SI = 203). (C) diffusion-weighted magnetic resonance image with b value of 1000 sec/mm2 shows hyperintensity of the mass is less remarkable (SI = 162). (D) ADC map shows ADC value is (2.76×10−3) sec/mm2.

Mentions: We could obtain DWI SI and an ADC value for all lesions. The results of the quantitative analysis of SIs and ADC values are reviewed in Table 2. The mean SI of malignant lesions was higher than that of benign lesions (Figure 1, 2). The difference between malignant and benign lesions was significant for all b values (p < 0.004 for b = 0 s/mm2 and p < 0.000 for the other b values) (Figure 3). The area under the ROC curve was 0.933 ± 0.031 for the SI on images with b = 500 s/mm2. Using b = 500 s/mm2, a SI ≥391 indicated a ma lignant lesion with a sensitivity of 95%, specificity of 73% and positive predictive value of 87%. Six among 48 malignant lesions (4 NSCLCs and 2 SCLCs) revealed SIs <391, which could be confused as benign.


Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging.

Gümüştaş S, Inan N, Akansel G, Ciftçi E, Demirci A, Ozkara SK - Radiol Oncol (2012)

A 32-year-old woman with bacterial pneumonia. (A) Axial T2-weighted MR image shows ill-defined peripheral mass in the superior segment of the lower lobe of the left lung (arrows). (B) diffusion-weighted magnetic resonance image with b value of 500 sec/mm2 shows minimal hyperintense mass (SI = 203). (C) diffusion-weighted magnetic resonance image with b value of 1000 sec/mm2 shows hyperintensity of the mass is less remarkable (SI = 162). (D) ADC map shows ADC value is (2.76×10−3) sec/mm2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3472932&req=5

f2-rado-46-02-106: A 32-year-old woman with bacterial pneumonia. (A) Axial T2-weighted MR image shows ill-defined peripheral mass in the superior segment of the lower lobe of the left lung (arrows). (B) diffusion-weighted magnetic resonance image with b value of 500 sec/mm2 shows minimal hyperintense mass (SI = 203). (C) diffusion-weighted magnetic resonance image with b value of 1000 sec/mm2 shows hyperintensity of the mass is less remarkable (SI = 162). (D) ADC map shows ADC value is (2.76×10−3) sec/mm2.
Mentions: We could obtain DWI SI and an ADC value for all lesions. The results of the quantitative analysis of SIs and ADC values are reviewed in Table 2. The mean SI of malignant lesions was higher than that of benign lesions (Figure 1, 2). The difference between malignant and benign lesions was significant for all b values (p < 0.004 for b = 0 s/mm2 and p < 0.000 for the other b values) (Figure 3). The area under the ROC curve was 0.933 ± 0.031 for the SI on images with b = 500 s/mm2. Using b = 500 s/mm2, a SI ≥391 indicated a ma lignant lesion with a sensitivity of 95%, specificity of 73% and positive predictive value of 87%. Six among 48 malignant lesions (4 NSCLCs and 2 SCLCs) revealed SIs <391, which could be confused as benign.

Bottom Line: The statistical significance was determined using the Student-t test.There was no significant difference in SIs or ADC values between small cell carcinoma and non-small cell carcinoma.When comparing undifferentiated with well- partially differentiated cancers, SIs were higher with all b values, but the difference was statistically significant only with b=1000 s/mm(2) (p<0.04).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology.

ABSTRACT

Background: The aim of the study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the differential diagnosis of lung lesions. PATIENTS AND METHODS.: Sixty-seven patients with lung lesions (48 malignant, 19 benign) were included in this prospective study. Signal intensities (SIs) were measured in diffusion-weighted MR images that were obtained with b=0, 500 and 1000 s/mm(2) values. Apparent diffusion coefficient (ADC) maps were calculated by using images with b=0 and 1000 s/mm(2) values. The statistical significance was determined using the Student-t test.

Results: The SIs of malignant lesions were significantly higher than those of benign lesions (p<0.004 for b=0 s/mm(2) and p<0.000 for the other b values). Using b=500 s/mm(2), SI≥391 indicated a malignant lesion with a sensitivity of 95%, specificity of 73% and positive predictive value of 87%. Using b=1000 s/mm(2), SI≥277 indicated a malignant lesion with a sensitivity of 93%, specificity of 69% and positive predictive value of 85%. There was no significant difference between malignant and benign lesions regarding ADC values (p=0.675). There was no significant difference in SIs or ADC values between small cell carcinoma and non-small cell carcinoma. When comparing undifferentiated with well- partially differentiated cancers, SIs were higher with all b values, but the difference was statistically significant only with b=1000 s/mm(2) (p<0.04).

Conclusions: Diffusion-weighteted MR trace image SI is useful for the differentiation of malignant versus benign lung lesions.

No MeSH data available.


Related in: MedlinePlus