Role of diffusion-weighted MRI in characterization of mediastinal masses

Raafat, Tarek; Ahmed, Shimaa Mohamed; Seif, Emam Mohamed Abo; Mikhael, Hisham S. Wahba; Awad, Ahmed

doi:10.1186/s43055-020-00313-z

Cited by 3 publications

(3 citation statements)

References 19 publications

(38 reference statements)

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“…When using the hot-spot approach, the mean ADC to distinguish malignant from benign tumors was 1.17 x10 -3 mm 2 /s, with the area under curve ROC was 0.794, sensitivity and specificity were 80%. This result is concordant with that of Raafat et al who revealed that the cut-off ADC value for the differentiation between malignant and benign mediastinal lesions was 1.11 x10 -3 mm 2 /s, with sensitivity of 90.9% and specificity of 100% [10]. However, our result is discordant with Usuda et al, who reported higher cut-off value of 2.21 x10 -3 mm 2 /s for the discrimination between malignant and benign mediastinal tumors [11].…”

Section: Discussionsupporting

confidence: 92%

Role of Diffusion-weighted MRI in Differentiation between Benign and Malignant Anterior Mediastinal Masses

Thuy¹,

Trang²,

Vy³

et al. 2022

Preprint

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Background. To describe the characteristics of anterior mediastinal masses on conventional magnetic resonance imaging (MRI) and to assess the role of the Apparent Diffusion Coefficient (ADC) value in distinguishing benign from malignant mediastinal lesions. Methods. We conducted a retrospective cross-sectional study on 55 patients with anterior mediastinal mass who performed MRI before treatment. Biopsy and histopathological assessments were done after that. A radiologist evaluates the changes of signal intensity on these sequences: T1- weighted VIBE DIXON pre and post-contrast with Gadolinium, T2 HASTE, T2 TIRM, DWI/ADC, to determine the size, margin of the lesion, the presence of fat, cystic in it. ADCs values were calculated from the ADC maps which were constructed from b = 0 and b = 2000 Results. The study was composed of 55 patients, with 5 benign lesions and 50 malignant lesions. The ADCmean, ADCmedian, ADC10, and ADC90 in the histogram-based approach and hot-spot-ROI-based mean ADC for the malignant lesions was significantly lower than those found in benign lesions (P-value <0.05). The hot-spot-ROI-based mean ADC had the highest value in differentiation between benign and malignant mediastinal lesions, between group A (benign lesions, thymoma A, AB, B1) and group B (thymoma B2, B3 and other malignant lesions). The cut-off point of the ADC value differentiating malignant from benign mediastinal lesions was 1,17x10-3mm2/s with sensitivity of 80%, and specificity of 80%. The cut off point of the ADC value differentiating group A from group B was 0.99 x10-3mm2/s with sensitivity of 78,4%, and specificity of 88.9%. The cut-off point of the ADC value differentiating lymphoma from other malignant lesions was 0,91 x10-3mm2/s with sensitivity of 100%, and specificity of 60.5%. Conclusion. Diffusion-weighted MRI and measurement of ADC value in histogram-based approach and hot-spot-ROI-based mean ADC are very helpful in the differentiation between benign and malignant anterior mediastinal lesions.

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Section: Discussionsupporting

confidence: 92%

Role of Diffusion-weighted MRI in Differentiation between Benign and Malignant Anterior Mediastinal Masses

Thuy¹,

Trang²,

Vy³

et al. 2022

Preprint

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“…This result is concordant with that of Raafat et al. who reported that the cutoff ADC value for the differentiation between malignant and benign mediastinal lesions was 1.11 x 10 -3 mm 2 /sec, with sensitivity of 90.9% and specificity of 100% ( 5 ). However, our result is discordant with the work of Usuda, who reported a higher cutoff value of 2.21 x 10 -3 mm 2 /sec for discriminating between malignant and benign mediastinal tumors ( 6 ).…”

Section: Discussionsupporting

confidence: 92%

“…The knowledge regarding MRI features of these masses is still considered to be modest because of their paucity. There have been published studies on the role of MRI in evaluating anterior mediastinal masses, some of which stressed the value of DWI in differentiating benign lesions and malignancies ( 5 , 6 ). Yet only a few studies tried various approaches to obtain the ADCs or to group the lesions.…”

Section: Introductionmentioning

confidence: 99%

Role of diffusion-weighted MRI in differentiation between benign and malignant anterior mediastinal masses

et al. 2022

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Diffusion-weighted imaging (DWI) is considered to be a useful biomarker to characterize the cellularity of lesions, yet its application in the thorax to evaluate anterior mediastinal lesions has not been well investigated. The aims of our study were to describe the magnetic resonance (MR) characteristics of anterior mediastinal masses and to assess the role of apparent diffusion coefficient (ADC) value in distinguishing benign from malignant lesions of the anterior mediastinum. We conducted a retrospective cross-sectional study including 55 patients with anterior mediastinal masses who underwent preinterventional MR scanning with the following sequences: T1 VIBE DIXON pre and post-contrast, T2 HASTE, T2 TIRM, DWI-ADC map (b values of 0 and 2000 sec/mm2). The ADC measurements were obtained by two approaches: hot-spot ROI and whole-tumor histogram analysis. The lesions were grouped by three distinct ways: benign versus malignant, group A (benign lesions and type A, AB, B1 thymoma) versus group B (type B2, B3 thymoma and other malignant lesions), lymphoma versus other malignancies. The study was composed of 55 patients, with 5 benign lesions and 50 malignant lesions. The ADCmean, ADCmedian, ADC10, ADC90 in the histogram-based approach and the hot-spot-ROI-based mean ADC of the malignant lesions were significantly lower than those of benign lesions (P values< 0.05). The hot-spot-ROI-based mean ADC had the highest value in differentiation between benign and malignant mediastinal lesions, as well as between group A and group B; the ADC cutoffs (with sensitivity, specificity) to differentiate malignant from benign lesions and group A from group B were 1.17 x 10-3 mm2/sec (80%, 80%) and 0.99 x 10-3 mm2/sec (78.4%, 88.9%), respectively. The ADC values obtained by using the hot-spot-ROI-based and the histogram-based approaches are helpful in differentiating benign and malignant anterior mediastinal masses.

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Role of Diffusion-Weighted Magnetic Resonance Imaging for Characterization of Mediastinal Lymphadenopathy

et al. 2023

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Background: To assess the diagnostic performance of diffusion-weighted (DW) magnetic resonance imaging (MRI) in the characterization of mediastinal lymph nodes and compare them with morphological parameters. Methods: A total of 43 untreated patients with mediastinal lymphadenopathy underwent DW and T2 weighted MRI followed by pathological examination in the period from January 2015 to June 2016. The presence of diffusion restriction, apparent diffusion coefficient (ADC) value, short axis dimensions (SAD), and T2 heterogeneous signal intensity of the lymph nodes were evaluated using receiver operating characteristic curve (ROC) and forward step-wise multivariate logistic regression analysis. Results: The ADC of malignant lymphadenopathy was significantly lower (0.873 ± 0.109 × 10−3 mm2/s) than that of benign lymphadenopathy (1.663 ± 0.311 × 10−3 mm2/s) (p = 0.001). When an ADC of 1.0955 × 10−3 mm2/s was used as a threshold value for differentiating malignant from benign nodes, the best results were obtained with a sensitivity of 94%, a specificity of 96%, and an area under the curve (AUC) of 0.996. A model combining the other three MRI criteria showed less sensitivity (88.9%) and specificity (92%) compared to the ADC-only model. Conclusion: The ADC was the strongest independent predictor of malignancy. The addition of other parameters failed to show any increase in sensitivity and specificity.

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Role of diffusion-weighted MRI in characterization of mediastinal masses

Cited by 3 publications

References 19 publications

Role of Diffusion-weighted MRI in Differentiation between Benign and Malignant Anterior Mediastinal Masses

Role of Diffusion-weighted MRI in Differentiation between Benign and Malignant Anterior Mediastinal Masses

Role of diffusion-weighted MRI in differentiation between benign and malignant anterior mediastinal masses

Role of Diffusion-Weighted Magnetic Resonance Imaging for Characterization of Mediastinal Lymphadenopathy

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