MR diffusion imaging in mediastinal masses the differentiation between benign and malignant lesions

Sabri, Youssriah Yahia; Kolta, Marian Fayek Farid; Khairy, Mostafa Ahmed

doi:10.1016/j.ejrnm.2017.03.015

Cited by 8 publications

(12 citation statements)

References 10 publications

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“…Benign cases included sarcoidosis (10, 33.3%) and tuberculous lymphadenitis (3, 10%). This was similar to Sabri et al [12] with mediastinal lymphadenopathy; 6 pathologically proven as sarcoidosis and 7 as lymphoma).…”

Section: Discussionsupporting

confidence: 89%

“…The same was reported by Gümüştaş et al [15] who stated that ADC value for lymphoma was 1.130 ± 0.581 and for sarcoidosis was 2.065 ± 0.518. Also, Sabri et al [12] showed that ADC for lymphoma (1.22 ± 0.23) was lower than that of sarcoidosis (1.9±0.28), and the difference was statistically significant. Vandecaveye et al [13] again, reported that metastatic and lymphomatous nodes present reduction of diffusivity, which can be attributed to hypercellularity, cellular pleomorphism, increased mitosis and nuclear-to-cytoplasmatic ratio.…”

Section: Discussionmentioning

confidence: 96%

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Evaluation of Mediastinal Lymphadenopathy by Diffusion Weighted MRI; Correlation with Histopathological Results

Youssef

Elzorkany

Hussein

et al. 2019

Advances in Respiratory Medicine

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Introduction: Diffusion weighted imaging (DWI) has shown its potential as a reliable noninvasive technique for tissue characterization. DWI reflects the tissue specific diffusion capacity which can be used for tissue characterization. Hypercellular tissue (e.g; malignant tumors) had restricted diffusion capacity with increased signals on DWI and low ADC values. Non-tumoral tissues show low cellularity, and diffusion capacity is not restricted resulting in signal loss on DWI and high apparent diffusion coefficient (ADC). Differential diagnosis of mediastinal lymphadenopathy is an issue of debate, especially in malignant benign differentiation. Diffusion weighted imaging with magnetic resonance could improve the diagnostic accuracy in differentiation between benign and malignant mediastinal nodes. Objectives: to determine the efficacy of diffusion weighted MRI in evaluation of mediastinal lymphadenopathy with histopathological correlation to differentiate benign from malignant lymph nodes. Material and methods: 30 patients with mediastinal lymphadenopathy underwent diffusion weighted MRI. ADCs of lymph nodes were derived and constructed from b = 0 and b = 1000 sec/mm 2 values by drawing regions of interests (ROI). Consequently, mediastinal nodes were studied, biopsies and histopathological analysis were done after MRI examination. Results: The best cutoff point of ADC to differentiate benign from malignant lesions was 1.15 mm/sec (sensitivity 77%, specificity 92% and AUC 81.4%). Significant negative correlation of ADC by DW MRI and the size of the LNs. The mean ADC values in the lymphoma group was lower than in the sarcoidosis group, and the difference was statistically significant. Conclusion: The study supports that MRI with diffusion weighted images can differentiate benign from malignant mediastinal lymphadenopathy and differentiate lymphoma from sarcoidosis non-invasively.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 96%

Evaluation of Mediastinal Lymphadenopathy by Diffusion Weighted MRI; Correlation with Histopathological Results

Youssef

Elzorkany

Hussein

et al. 2019

Advances in Respiratory Medicine

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“…In agreement with Sabri et al . [9], we found a significant difference between the malignant masses and the distal collapse as regard the signal on DWI and the mean ADC value. The hilar masses showed high signal on DWI with restricted diffusion pattern and mean ADC value 1.25 ± 0.36 × 10 –3 mm 2 /s, while the distal collapse showed low signal on DWI with free diffusion pattern and mean ADC value 1.92 ± 0.42 × 10 –3 mm 2 /s (Figure 5).…”

Section: Discussionmentioning

confidence: 80%

Role of diffusion-weighted magnetic resonance imaging in the differentiation of benign and malignant pulmonary lesions

Alnaghy¹,

El-Nahas²,

Sadek³

et al. 2018

Pol J Radiol

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PurposeTo evaluate the role of magnetic resonance (MRI) diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurement of solid and cystic pulmonary masses in differentiating benign from malignant lesions.Material and methodsThe study included 41 patients with pulmonary masses, who underwent conventional MRI and DWI (b value 0, 500, and 1000 s/mm²) examinations with 1.5-T MRI. The diffusion signal and the mean ADC values of the solid and cystic lesions were obtained. Statistical analyses were performed with the Mann-Whitney U test (z), Pearson’s chi-square test, and receiver operating characteristic (ROC) analysis.ResultsThirty-three lesions were malignant, and eight lesions were benign. The malignant masses showed significantly higher signal intensity on DWI than benign masses (p = 0.006), and the mean ADC value of malignant solid lesions was significantly lower than that of benign lesions (p = 0.02). By ROC analysis, an ADC cut-off value of 1.4 × 10–3 mm2/s was considered the threshold value, and the sensitivity and specificity were 93.8% and 75%, respectively. There was no significant difference between the ADC value of the cystic parts inside the benign and the malignant lesions.ConclusionsDiffusion-weighted MRI and measurement of ADC value can significantly differentiate between solid benign and malignant pulmonary masses.

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“…Differentiating lymphoma from sarcoidosis in mediastinal and hilar lymphadenopathy can be done by detecting the ADC value of the enlarged lymph nodes, the ADC value in the lymphoma was detected to be lower than that in the sarcoidosis group [17].…”

Section: Introductionmentioning

confidence: 99%

Role of diffusion MRI in diagnosis of mediastinal lymphoma: initial assessment and response to therapy

Sabri

Ewis

Zawam

et al. 2021

Egypt J Radiol Nucl Med

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Background Malignant lymphoma accounts for nearly 20% of all mediastinal neoplasms in adults and 50% in children. Hodgkin’s disease is the most common primary mediastinal lymphoma. In non-Hodgkin’s lymphoma, the two most common forms of primary mediastinal lymphoma are lymphoblastic lymphoma and diffuse large B-cell lymphoma. The aim of this study is to implement diffusion MRI in the algorithm of diagnosis of mediastinal lymphoma, differentiating Hodgkin's from non-Hodgkin's lymphoma and assessment of post therapeutic response. Results Using Diffusion weighted magnetic resonance imaging DWI-MRI, there were statistic significant difference between ADC values in lymph nodes and mediastinal masses in Hodgkin and non-Hodgkin lymphomas. ADC range in non-treated Hodgkin lymphoma cases was 0.774 to 1.4, while ADC range in in non-treated non-Hodgkin lymphoma was 0.476 to 0.668. In this study, there was statistically significant difference of ADC values in lymphoma cases presented by mediastinal masses with and without chemotherapy. Conclusions Diffusion weighted magnetic resonance imaging DWI-MRI is a promising functional technique in diagnosis of Hodgkin's and non-Hodgkin's lymphoma and assessment of response to treatment with no need for special preparation, contrast injection or radiation exposure.

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MR diffusion imaging in mediastinal masses the differentiation between benign and malignant lesions

Cited by 8 publications

References 10 publications

Evaluation of Mediastinal Lymphadenopathy by Diffusion Weighted MRI; Correlation with Histopathological Results

Evaluation of Mediastinal Lymphadenopathy by Diffusion Weighted MRI; Correlation with Histopathological Results

Role of diffusion-weighted magnetic resonance imaging in the differentiation of benign and malignant pulmonary lesions

Role of diffusion MRI in diagnosis of mediastinal lymphoma: initial assessment and response to therapy

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