Role of Various DW MRI and DCE MRI Parameters as Predictors of Malignancy in Solid Pulmonary Lesions

Kumar, Neeraj; Sharma, Mahak; Aggarwal, Neeti; Sharma, Sanjeev; Sarkar, Malay; Singh, Balraj; Sharma, Neeraj

doi:10.1177/0846537120914894

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…IVIM perfusion-related D star and f values did not demonstrate a good diagnostic efficacy for differentiating malignant SPLs from benign SPLs, consistent with most previous studies 6 , 18 , 19 , but not the same as the studies conducted by Deng et al 20 and Wang et al 21 . The inconsistencies between these studies may be associated with the diverse pathological types included in each study and the poor measurement reproducibility of D star and f. Ultimately, D star and f values could be used to obtain tissue perfusion information without the injection of contrast agents, and this possibility should be confirmed in future studies.…”

Section: Discussionsupporting

confidence: 88%

“…Our study found that diffusion-related parameters derived from TSE-IVIM-DWI, D, and ADC values could distinguish between malignant and benign SPLs and possess higher diagnostic accuracy than D star and f, consistent with most lung DWI studies using echo planar–based acquisition techniques 18 , 19 . Furthermore, the AUC of D was slightly higher than that of ADC total , followed by ADC 800 .…”

Section: Discussionsupporting

confidence: 85%

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Value of turbo spin echo–based diffusion-weighted imaging in the differential diagnosis of benign and malignant solitary pulmonary lesions

Lei,

Liu,

et al. 2024

Sci Rep

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To quantitatively assess the diagnostic efficacy of multiple parameters derived from multi-b-value diffusion-weighted imaging (DWI) using turbo spin echo (TSE)–based acquisition techniques in patients with solitary pulmonary lesions (SPLs). A total of 105 patients with SPLs underwent lung DWI using single-shot TSE–based acquisition techniques and multiple b values. The apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM) parameters, and lesion-to-spinal cord signal intensity ratio (LSR), were analyzed to compare the benign and malignant groups using the Mann–Whitney U test and receiver operating characteristic analysis. The Dstar values observed in lung cancer were slightly lower than those observed in pulmonary benign lesions (28.164 ± 31.950 versus 32.917 ± 34.184; Z = -2.239, p = 0.025). The LSR values were significantly higher in lung cancer than in benign lesions (1.137 ± 0.581 versus 0.614 ± 0.442; Z = − 4.522, p < 0.001). Additionally, the ADC800, ADCtotal, and D values were all significantly lower in lung cancer than in the benign lesions (Z = − 5.054, -5.370, and -6.047, respectively, all p < 0.001), whereas the f values did not exhibit any statistically significant difference between the two groups. D had the highest area under the curve (AUC = 0.887), followed by ADCtotal (AUC = 0.844), ADC800 (AUC = 0.824), and LSR (AUC = 0.789). The LSR, ADC800, ADCtotal, and D values did not differ statistically significantly in diagnostic effectiveness. Lung DWI using TSE is feasible for differentiating SPLs. The LSR method, conventional DWI, and IVIM have comparable diagnostic efficacy for assessing SPLs.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 85%

Value of turbo spin echo–based diffusion-weighted imaging in the differential diagnosis of benign and malignant solitary pulmonary lesions

Lei,

Liu,

et al. 2024

Sci Rep

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“…In our study, The ADC min value was significantly higher among benign lesions compared to malignant ones (1.45 ± 0.5 vs. 0.99 ± 0.26) with cutoff point < 1.34 yielding sensitivity 56.3%, specificity 100%. Jiang et al [15], Kumar et al [16] and study results also reported that the ADC min in malignant pulmonary lesions were significantly lower than benign lesions.…”

Section: Discussionmentioning

confidence: 84%

Value of diffusion‐weighted MRI and lesion‐to‐spinal cord signal intensity ratio in pulmonary lesion characterization

Kolta

Abdel-Hamid

Hassan

et al. 2023

Egypt J Radiol Nucl Med

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Background In the scenario of lung lesions, the differential diagnosis is important, since the treatment is determined by the characteristics of the lesion. The goal in the evaluation of pulmonary lesions is to distinguish malignant lesions from benign lesions in a non-invasive manner as possible. Since, CT is not sufficient to accurately distinguish malignant nodules from benign nodules and patients with benign nodules might undergo invasive diagnostic methods, such as lung biopsy or video-assisted thoracoscopic surgery, to rule out a malignancy. Now, MRI performed by using diffusion-weighted (DW) can offer both qualitative and quantitative information that can be helpful for tumour assessment. Moreover, lesion‐to‐spinal cord signal intensity ratio (LSR) has also been shown to be useful for the differentiation of lung lesions. Quantitative tumour assessment is possible by the calculation of ADC. Results A total of 30 patients were eligible for inclusion in our final analysis; with male/female case number about 10/20 (33.3%/ 66.7%) and age range from 20 to 74 (46.8 ± 14.9) were subjected to MRI study and MRI diffusion. Sensitivity analysis showed that ADC mean, and ADC min value can significantly predict malignant lung lesions using cutoff point < 1.53 and < 1.34 respectively, with sensitivity 75%, 56.3%, and specificity 92.9%, 100% with p values 0.001, and 0.005 respectively. SI lesion can significantly predict malignant lung lesions using cutoff point > 502.8, with sensitivity 92.9% and specificity 68.7%, AUC 89.3% and p value 0.0001. Lesion-to-spinal cord signal intensity ratio (LSR) can significantly predict malignant lung lesions using cutoff point > 1.3, with sensitivity 85.7% and specificity 75%, AUC 79.7% and p value 0.006. Conclusions This study confirmed that the DWI combined with ADC value and LSR is effective and valuable tool in differentiation of pulmonary lesions whether benign or malignant which is considered to be noninvasive alternative tool for the characterization of pulmonary lesions. We recommend before invasive intervention to perform diffusion MRI and LSR as and important aid for proper diagnosis.

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“…It can noninvasively evaluate benign and malignant lung diseases and aid in pathological classification, grading, TNM stage, efficacy, and prognosis of lung cancer ( 5 ). A variety of MR functional imaging technologies, such as dynamic contrast-enhanced (DCE) ( 6 ), diffusion weighted imaging (DWI) ( 7 ), intravoxel incoherent motion (IVIM) ( 8 ) and diffusion kurtosis imaging (DKI) ( 9 ), can not only show the morphological characteristics of lung lesions but also obtain functional information, such as internal diffusion and perfusion of lung lesions, to provide important information on tissue function, physiology, pathology and molecules, which has important significance for guiding clinical individualized precision diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

Differential value of diffusion kurtosis imaging and intravoxel incoherent motion in benign and malignant solitary pulmonary lesions

Liu

Yang

et al. 2023

Front. Oncol.

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ObjectiveTo investigate the diagnostic value of diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) whole-lesion histogram parameters in differentiating benign and malignant solitary pulmonary lesions (SPLs).Materials and MethodsPatients with SPLs detected by chest CT examination and with further routine MRI, DKI and IVIM-DWI functional sequence scanning data were recruited. According to the pathological results, SPLs were divided into a benign group and a malignant group. Independent samples t tests (normal distribution) or Mann‒Whitney U tests (nonnormal distribution) were used to compare the differences in DKI (Dk, K), IVIM (D, D*, f) and ADC whole-lesion histogram parameters between the benign and malignant SPL groups. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of the histogram parameters and determine the optimal threshold. The area under the curve (AUC) of each histogram parameter was compared by the DeLong method. Spearman rank correlation was used to analyze the correlation between histogram parameters and malignant SPLs.ResultsMost of the histogram parameters for diffusion-related values (Dk, D, ADC) of malignant SPLs were significantly lower than those of benign SPLs, while most of the histogram parameters for the K value of malignant SPLs were significantly higher than those of benign SPLs. DKI (Dk, K), IVIM (D) and ADC were effective in differentiating benign and malignant SPLs and combined with multiple parameters of the whole-lesion histogram for the D value, had the highest diagnostic efficiency, with an AUC of 0.967, a sensitivity of 90.00% and a specificity of 94.03%. Most of the histogram parameters for the Dk, D and ADC values were negatively correlated with malignant SPLs, while most of the histogram parameters for the K value were positively correlated with malignant SPLs.ConclusionsDKI (Dk, K) and IVIM (D) whole-lesion histogram parameters can noninvasively distinguish benign and malignant SPLs, and the diagnostic performance is better than that of DWI. Moreover, they can provide additional information on SPL microstructure, which has important significance for guiding clinical individualized precision diagnosis and treatment and has potential clinical application value.

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Role of Various DW MRI and DCE MRI Parameters as Predictors of Malignancy in Solid Pulmonary Lesions

Cited by 7 publications

References 26 publications

Value of turbo spin echo–based diffusion-weighted imaging in the differential diagnosis of benign and malignant solitary pulmonary lesions

Value of turbo spin echo–based diffusion-weighted imaging in the differential diagnosis of benign and malignant solitary pulmonary lesions

Value of diffusion‐weighted MRI and lesion‐to‐spinal cord signal intensity ratio in pulmonary lesion characterization

Differential value of diffusion kurtosis imaging and intravoxel incoherent motion in benign and malignant solitary pulmonary lesions

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