Relationships and Qualitative Evaluation between Diffusion-Weighted Imaging and Pathologic Findings of Resected Lung Cancers

Abstract

For detecting malignant tumors, diffusion-weighted magnetic resonance imaging (DWI) as well as fluoro-2-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT) are available. It is not definitive how DWI correlates the pathological findings of lung cancer. The aim of this study is to evaluate the relationships between DWI findings and pathologic findings. In this study, 226 patients with resected lung cancers were enrolled. DWI was performed on each patient before surgery. There were 167 patients with adenocarcinoma, 44 patients with squamous cell carcinoma, and 15 patients with other cell types. Relationships between the apparent diffusion coefficient (ADC) of DWI and the pathology were analyzed. When the optimal cutoff value (OCV) of ADC for diagnosing malignancy was 1.70 × 10−3 mm2/s, the sensitivity of DWI was 92.0% (208/226). The sensitivity was 33.3% (3/9) in mucinous adenocarcinoma. The ADC value (1.31 ± 0.32 × 10−3 mm2/s) of adenocarcinoma was significantly higher than that (1.17 ± 0.29 × 10−3 mm2/s) of squamous cell carcinoma (p = 0.012), or (0.93 ± 0.14 × 10−3 mm2/s) of small cell carcinoma (p = 0.0095). The ADC value (1.91 ± 0.36 × 10−3 mm2/s) of mucinous adenocarcinoma was significantly higher than that (1.25 ± 0.25 × 10−3 mm2/s) of adenocarcinoma with mucin and that (1.24 ± 0.30 × 10−3 mm2/s) of other cell types. The ADC (1.11 ± 0.26 × 10−3 mm2/s) of lung cancer with necrosis was significantly lower than that (1.32 ± 0.33 × 10−3 mm2/s) of lung cancer without necrosis. The ADC of mucinous adenocarcinoma was significantly higher than those of adenocarcinoma of other cell types. The ADC of lung cancer was likely to decrease according to cell differentiation decreasing. The sensitivity of DWI for lung cancer was 92% and this result shows that DWI is valuable for the evaluation of lung cancer. Lung cancer could be evaluated qualitatively using DWI.

WITHDRAWN: Early Detection of Neuroendocrine Prostate Cancer as Lineage Plasticity in Recurrent Prostate Cancer After Radiation and Androgen Deprivation Therapy: A Case Report

“…Diffusion-weighted imaging (DWI) MRI detects small cell lung cancer (SCLC), which is a neuroendocrine cancer [11]. The apparent diffusion coe cient in SCLC is lower compared to benign lung tissue and non-small cell lung cancer (NSCLC) [12]. Similar to SCLC, MRI might be a better modality for NEPC detection compared to other types of imaging.…”

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

“…DWI is more useful for the differentiation of SCLC from NSCLC than STIR [ 23 ]. The ADC value of adenocarcinoma was significantly higher than that of either squamous cell carcinoma or small cell carcinoma, which shows that the tissue cellularity of squamous cell carcinoma or small cell carcinoma would be higher than that of adenocarcinoma [ 14 ]. ADC histogram analysis can provide important information on tumor biology in cervical cancer [ 24 ].…”

“…There were 262 lung cancers and 52 BPNMs. Out of 262 patients with lung cancer, 226 of those patients that were enrolled in this study were also used in another paper [ 14 ]. The diagnosis was made pathological in all lung cancers.…”

Whole-Lesion Apparent Diffusion Coefficient Histogram Analysis: Significance for Discriminating Lung Cancer from Pulmonary Abscess and Mycobacterial Infection

“…Most brain abscesses have low ADC values, whereas non-abscess (tumor) groups have high ADC values [ 27 ]. The ADC (1.11 × 10 −3 mm 2 /s) of lung cancer with necrosis was significantly lower than that (1.32 × 10 −3 mm 2 /s) of lung cancer without necrosis ( p = 0.0001) [ 28 ].…”