Mediastinal lymph nodes: Assessment with diffusion‐weighted MR imaging

Koşucu, Polat; Tekinbaş, Celal; Erol, Mehmet Muharrem; Sarı, Ahmet; Kavgacı, Halil; Öztuna, Funda; Ersöz, Şafak

doi:10.1002/jmri.21850

Cited by 66 publications

(74 citation statements)

References 24 publications

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“…In an evaluation of 734 lymph nodes in 88 patients with non-small-cell lung carcinoma, Nomori et al (35) reported a sensitivity of 70% and a specificity of 97% using an ADC cutoff value of 1.6×10 -3 mm 2 /s. Similarly, Kosucu et al (26) reported that the ADC of metastatic lymph nodes was significantly lower than that of benign nodes. Nakayama et al (38) calculated the ADC difference between a lung cancer and a lymph node in 70 patients with non-small-cell lung cancer and found that the mean ADC difference in the lymph node group with metastases was significantly lower than that in the group without metastases.…”

Section: Thoracic Applicationsmentioning

confidence: 90%

“…The STIR approach has been most commonly used for fat suppression to achieve a more accurate ADC estimation. Early studies employed free breathing or breath holding (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). The latter type of study can be completed in two or more separate breathholding scans.…”

Section: Thoracic Applicationsmentioning

confidence: 99%

“…The latter type of study can be completed in two or more separate breathholding scans. Respiratory or ECG gating has been used, but typically only at the lesion site rather than for the entire chest (25)(26)(27). The typical slice thickness is 4-9 mm with an interslice gap of 0-1.5 mm, and the number of excitations ranges from 1 to 10.…”

Section: Thoracic Applicationsmentioning

confidence: 99%

“…In heterogeneous tumors, care should be taken to place the ROI in the solid portion of the mass, excluding cystic or necrotic areas. DWI has been used to characterize lung lesions (27), to detect and classify adenocarcinomas (37), to predict tumor invasiveness in early-stage lung cancer (24), to detect tumors in collapsed lungs (32,33), and for nodal staging of lung cancer (26,35).…”

Section: Thoracic Applicationsmentioning

confidence: 99%

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Diffusion weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging

Türkbey

Aras

Karabulut

et al. 2011

Diagn Interv Radiol

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Imaging is used to detect, characterize, and monitor cancer. Recently, diffusion-weighted magnetic resonance imaging (DWI) has become a useful adjunct for assessing tumors with magnetic resonance imaging (MRI). DWI involves the acquisition of a magnetic resonance signal related to random thermal motion (Brownian motion) or the "diffusion" of water protons in tissue. The signal obtained with DWI is a measure of the net displacement of water molecules, e.g., the water path length in the extracellular, intracellular and intravascular spaces. This motion is largely random and can be reduced by structural barriers, such as cell membranes and collagen. Restricted diffusion in biological tissues is inversely proportional to tissue cellularity and the integrity of cell membranes, and it can be quantified with apparent diffusion coefficient (ADC) measurements (1). Depending on the microarchitecture, either restricted or increased diffusion can occur in malignant tumors. For instance, diffusion is restricted in cellular portions of the tumor, but it may be increased in necrotic portions (2, 3). Other causes of enhanced diffusion include increased water content arising from intratumoral edema and cystic tumor components (4-6).Although initially used to evaluate neurological diseases, the applications of DWI have been extended to oncologic imaging throughout the body made possible by improvements in MRI hardware and new sequences. The use of DWI as a complement to conventional MRI methods has led to improvements in the detection and characterization of tumors, treatment response monitoring, and detection of recurrence in oncology patients. Basic concepts of DWIIn 1965, Stejskal and Tanner (7) proposed the application of a symmetric pair of additional gradients on either side of the 180˚ refocusing radiofrequency pulse. The Stejskal-Tanner sequence is still the basis of modern DWI. For static water molecules, the phasing effect caused by the first gradient will be reversed by the second gradient, leading to no signal loss; however, this phasing effect will not be completely reversed if the water molecules are not stationary, which results in the observed well-known diffusion signal decay. The amount of diffusion weighting is determined by the b value, which describes the amplitude, duration of the applied gradient, and time interval between the two diffusion gradients (4). The degree of signal attenuation from water molecules is cor- ABSTRACT Diffusion-weighted magnetic resonance imaging (MRI), which involves the acquisition of a magnetic resonance signal related to the Brownian motion of water protons in tissue, has become a useful technique for assessing tumors. In this article, we review the basic concepts, imaging strategies, and body applications of diffusion-weighted MRI in detecting and monitoring cancer.

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Section: Thoracic Applicationsmentioning

confidence: 90%

Section: Thoracic Applicationsmentioning

confidence: 99%

Section: Thoracic Applicationsmentioning

confidence: 99%

Section: Thoracic Applicationsmentioning

confidence: 99%

See 2 more Smart Citations

Diffusion weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging

Türkbey

Aras

Karabulut

et al. 2011

Diagn Interv Radiol

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“…Previous studies have yielded promising results in the discrimination between benign and malignant lymph nodes [2,3]. Mediastinal lymph nodes have also been studied with DW-MRI [4][5][6][7]. Authors have used different and sometimes cumbersome methods and parameters in their studies, which are not useful for day-to-day practice.…”

Section: Introductionmentioning

confidence: 99%

Comparison of diffusion weighted MRI parameters of mediastinal lymph nodes with PET/CT in lung cancer patients

Bugdayci¹,

Kodalli²,

Dede³

et al. 2014

MMJ

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Objective:We have compared diffusion-weighted magnetic resonance imaging (DW-MRI) properties of mediastinal lymph nodes in lung cancer patients with positron emission tomography/ computed tomography (PET/CT) findings.Patients and Methods: Twenty-one consecutive untreated patients with lung cancer were included. DW-MRI was performed on a 1,5T scanner with b values of 50, 500 and 1000. Additional MR imaging was performed for anatomical correlation.Results: A total of 47 lymph nodes were analyzed. While no correlation was found between minimum apparent diffusion coefficient (ADC) values (ADCmin) of lymph nodes and their maximum standardized uptake values (SUVmax) on PET/CT, ADCmin ratios of lymph nodes to main lesion (ADCmin Node/ Lesion) (r = -0.407; p = 0.005) and lymph node to cerebrospinal fluid (ADCmin Node/CSF) (r = -0.364; p = 0.012) were correlated with SUVmax. Cutoff values for DW-MRI parameters were determined using ROC analysis. Six lymph nodes were histopathologically examined. Both methods correctly identified one metastatic and two metastasis negative lymph nodes, while staging one lymph node with granulomatous change as metastasis positive. Two metastasis negative lymph nodes, reported as suspicious on PET/CT, were correctly staged on DW-MRI.Conclusion: Our findings indicate that DW-MRI could be at least as valuable as PET/CT in mediastinal staging of patients with lung cancer.

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Oncologic applications of diffusion‐weighted MRI in the body

Bonekamp

Corona‐Villalobos

Kamel

2012

Magnetic Resonance Imaging

113

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Diffusion‐weighted MRI (DWI) allows the detection of malignancies in the abdomen and pelvis. Lesion detection and characterization using DWI largely depends on the increased cellularity of solid or cystic lesions compared with the surrounding tissue. This increased cellularity leads results in restricted diffusion as indicated by reduction in the apparent diffusion coefficient (ADC). Low pretreatment ADC values of several malignancies have been shown to be predictive of better outcome. DWI can assess response to systemic or regional treatment of cancer at a cellular level and will therefore detect successful treatment earlier than anatomical measures. In this review, we provide a brief technical overview of DWI, discuss quantitative image analysis approaches, and review studies which have used DWI for the purpose of detection and characterization of malignancies as well as the early prediction of treatment response. J. Magn. Reson. Imaging 2012;257–279. © 2011 Wiley Periodicals, Inc.

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Mediastinal lymph nodes: Assessment with diffusion‐weighted MR imaging

Cited by 66 publications

References 24 publications

Diffusion weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging

Diffusion weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging

Comparison of diffusion weighted MRI parameters of mediastinal lymph nodes with PET/CT in lung cancer patients

Oncologic applications of diffusion‐weighted MRI in the body

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