Can diffusion-weighted imaging be used as a reliable sequence in the detection of malignant pulmonary nodules and masses?

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

“…Wu et al 153 performed a meta-analysis of 10 studies (712 nodules) assessing the diagnostic accuracy of DWI-MRI in differentiating benign from malignant lesions (pulmonary nodules and masses) and reported a pooled sensitivity and specificity of 84% and area under the summary ROC curve of 0.9. The authors noted significant between-study heterogeneity with a high proportion of retrospective studies with significantly higher and potentially confounding pooled sensitivity and specificity estimates.…”

Apparent diffusion coefficient values of diffusion-weighted imaging for distinguishing focal pulmonary lesions and characterizing the subtype of lung cancer: a meta-analysis

“…The apparent diffusion coefficient (ADC) value is highly inversely correlated with tumour cellularity and is potentially used to differentiate the malignant and benign lesions, predict the tumour subtype and the response to therapy [13][14][15]. Although several systematic reviews and meta-analyses have reported that DWI is useful for detecting malignant lung lesions using qualitative or quantitative analysis, they did not focus on comparing the differences of ADC values of malignant and benign lesions [16,17]. In addition, there are also some inconclusive or conflicting results published [18].…”

PET/MRI in Lung Cancer

“…31 In addition, SI of DWI can differentiate the cell differentiation and subtypes of lung adenocarcinomas. 32,33 With DWI, pooled sensitivity and specificity were 84% in distinguishing benign and malignant nodules in a metaanalysis of 10 studies with 586 nodules 34 and 80% sensitivity and 93% specificity in another meta-analysis of 755 malignant and 294 benign pulmonary nodules. 35 ADC mean exhibited a significant inverse correlation with SUV max as well as with SUVmean assessed by FDG-PET/MRI in NSCLC.…”