Combination Assessment of Diffusion-Weighted Imaging and T2-Weighted Imaging Is Acceptable for the Differential Diagnosis of Lung Cancer from Benign Pulmonary Nodules and Masses

Abstract

The purpose of this study is to determine whether the combination assessment of DWI and T2-weighted imaging (T2WI) improves the diagnostic ability for differential diagnosis of lung cancer from benign pulmonary nodules and masses (BPNMs). The optimal cut-off value (OCV) for differential diagnosis was set at 1.470 × 10−3 mm2/s for apparent diffusion coefficient (ADC), and at 2.45 for T2 contrast ratio (T2 CR). The ADC (1.24 ± 0.29 × 10−3 mm2/s) of lung cancer was significantly lower than that (1.69 ± 0.58 × 10−3 mm2/s) of BPNM. The T2 CR (2.01 ± 0.52) of lung cancer was significantly lower than that (2.74 ± 1.02) of BPNM. As using the OCV for ADC, the sensitivity was 83.9% (220/262), the specificity 63.4% (33/52), and the accuracy 80.6% (253/314). As using the OCV for T2 CR, the sensitivity was 89.7% (235/262), the specificity 61.5% (32/52), and the accuracy 85.0% (267/314). In 212 PNMs which were judged to be malignant by both DWI and T2WI, 203 PNMs (95.8%) were lung cancers. In 33 PNMs which were judged to be benign by both DWI and T2WI, 23 PNMs (69.7%) were BPNMs. The combined assessment of DWI and T2WI could judge PNMs more precisely and would be acceptable for differential diagnosis of PNMs.

Automatic Detection of Colorectal Polyps Using Transfer Learning

“…Image processing in the medical field is also used with great results for other types of image. For example in [ 25 , 26 ] a diffusion-weighted magnetic resonance imaging is discussed for breast and lung cancer detection. Reference [ 27 ] presented a survey of deep learning algorithms used in medical applications.…”

Novel Insights of T2-Weighted Imaging: Significance for Discriminating Lung Cancer from Benign Pulmonary Nodules and Masses

“…T2WI combined with DWI may be a useful tool for detecting prostate cancer in the overall evaluation of prostate cancer [34,35], and myometrial invasion and staging of endometrial carcinoma [36,37]. Diagnostic possibilities would be increased after T2WI and DWI are fused for the diagnosing of lung cancer and BPNMs [38]. A previous paper [38] dealt with a whole MRI value of DWI and T2WI and determined the effectiveness of, not only DWI, but also T2WI in the assessment of the differential value and a combined assessment of how effective they were for discriminating PNMs.…”

“…Diagnostic possibilities would be increased after T2WI and DWI are fused for the diagnosing of lung cancer and BPNMs [38]. A previous paper [38] dealt with a whole MRI value of DWI and T2WI and determined the effectiveness of, not only DWI, but also T2WI in the assessment of the differential value and a combined assessment of how effective they were for discriminating PNMs. On the other hand, this paper only dealt with the diagnostic efficacy of T2WI for discriminating PNMs.…”

Pulmonary Nodule and Mass: Superiority of MRI of Diffusion-Weighted Imaging and T2-Weighted Imaging to FDG-PET/CT

“…Combined assessment of DWI and T2WI works well together for detecting PNMs. We reported MRI (DWI + T2WI) was useful for the assessment of PNMs in a previous paper [25]. In this paper, we compared diagnostic performance between MRI (DWI + T2WI) and FDG-PET/CT.…”

“…Although DWI can be valuable for differential diagnosis of lung cancer from benign PNMs, the diagnostic capability may not be perfect. DWI has a weak point for pulmonary abscesses and mycobacteria infections [25]. The usefulness of T2WI was demonstrated, especially in the evaluation of high-intensity fluid materials associated with the organ lesions, such as intratumoral necrosis, cysts, mucus, hemorrhage, or edema [26,27].…”