Tumor Detection by Diffusion-Weighted MRI and ADC-Mapping???Initial Clinical Experiences in Comparison to PET-CT

Lichy, Matthias P.; Aschoff, Philip; Plathow, Christian; Stemmer, Alto; Horger, Wilhelm; Mueller-Horvat, Christian; Steidle, Günter; Horger, Marius; Schäfer, Jürgen; Eschmann, Susanne Martina; Kiefer, Berthold; Claussen, Claus D.; Pfannenberg, Christina; Schlemmer, Heinz Peter

doi:10.1097/rli.0b013e31804ffd49

Cited by 98 publications

(48 citation statements)

References 23 publications

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“…The lower ADC values were obtained in prostate carcinoma, hepatocellular carcinoma, colorectal carcinoma, melanoma, neuroblastoma, and breast carcinoma when compared to benign lesions of each organ (25)(26)(27)(28)(29). As in most of the malignancies of other organs studied, we found markedly lower ADC values in malignant thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

Diffusion‐weighted images differentiate benign from malignant thyroid nodules

Erdem

Muammer

et al. 2009

Magnetic Resonance Imaging

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Purpose:To reveal the possible role of diffusion-weighted images (DWI) in the differential diagnosis of benign and malignant thyroid nodules by comparing the results of fine-needle aspiration cytology (FNAC). Materials and Methods:In an 18-month period (December 2005 to May 2007), 27 cases with benign thyroid nodules with a total of 52 benign nodules, nine cases with thyroid gland malignancy, and 24 healthy control cases were included in the study. Cases that were indicated to undergo to FNAC examination and sent by a clinician for biopsy to the radiology unit were included in the study to assess the cytopathologic confirmation of the clinic, ultrasonographic, and magnetic resonance imaging (MRI) findings. Results:The mean apparent diffusion coefficient (ADC) values of thyroid nodules were 2745.3 6 601.1 Â 10 À6 mm 2 /s (1605-3899 Â 10 À6 mm 2 /s) in the benign group and 695.2 6 312.5 Â 10 À6 mm 2 /s (165-1330 Â 10 À6 mm 2 /s) in the malignant group. Normal thyroid tissues had mean ADC values of 1344.1 6 276.4 Â 10 À6 mm 2 /s (1015-1764 Â 10 À6 mm 2 /s). The ADC values of three subgroups were significantly different (P ¼ 0.0001). A reduced ADC was observed in most types of malignant tumors due to the consequent decrease of the extracellular extravascular space. Conclusion:Our preliminary results showed that ADC values of nodules may provide useful data about the nature of a thyroid nodule.

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Section: Discussionmentioning

confidence: 99%

Diffusion‐weighted images differentiate benign from malignant thyroid nodules

Erdem

Muammer

et al. 2009

Magnetic Resonance Imaging

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“…The Jeong simplification of WHO classification includes low-risk thymomas, high-risk thymomas, and thymic carcinomas [9]. The Masaoka-Koga system includes early (stage I-II) and advanced thymomas (stage III-IV) [8].…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging of thymoma: ability of the Apparent Diffusion Coefficient in predicting the World Health Organization (WHO) classification and the Masaoka-Koga staging system and its prognostic significance on disease-free survival

Priola

Giraudo³

et al. 2015

Eur Radiol

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Objectives: To evaluate the usefulness of diffusion-weighted magnetic resonance for distinguishing thymomas according to WHO and Masaoka-Koga classifications and in predicting disease-free survival (DFS) by using the apparent diffusion coefficient (ADC). Methods:Forty-one patients were grouped based on WHO (low-risk vs. high-risk) and MasaokaKoga (early vs. advanced) classifications. For prognosis, seven patients with recurrence at followup were grouped separately from healthy subjects. Differences on ADC levels between groups were tested using Student-t testing. Logistic regression models and areas under the ROC curve (AUROC) were estimated. Results:Mean ADC values were different between groups of WHO (low-risk=1.58±0.20×10-3mm2/sec; high-risk=1.21±0.23×10-3mm2/sec; p<0.0001) and Masaoka-Koga (early=1.43±0.26×10-3mm2/sec; advanced=1.31±0.31×10-3mm2/sec; p=0.016) classifications.Mean ADC of type-B3 (1.05±0.17×10-3mm2/sec) was lower than type-B2 (1.32±0.20×10-3mm2/sec; p=0.023). AUROC in discriminating groups was 0.864 for WHO classification (cutpoint=1.309×10-3mm2/sec; accuracy=78.1 %) and 0.730 for Masaoka-Koga classification (cut-point=1.243×10-3mm2/sec; accuracy=73.2 %). Logistic regression models and two-way ANOVA were significant for WHOclassification (odds ratio[OR]=0.93, p=0.007; p<0.001), but not for Masaoka-Koga classification (OR=0.98, p=0.31; p=0.38). ADC levels were significantly associated with DFS recurrence rate being higher for patients with ADC≤1.299× 10-3mm2/sec (p=0.001; AUROC, 0.834; accuracy=78.0 %).Conclusions: ADC helps to differentiate high-risk from lowrisk thymomas and discriminates the more aggressive type-B3. Primary tumour ADC is a prognostic indicator of recurrence. Key Points• DW-MRI is useful in characterizing thymomas and in predicting disease-free survival.• ADC can differentiate low-risk from high-risk thymomas based on different histological composition • The cutoff-ADC-value of 1.309×10-3mm2/sec is proposed as optimal cut-point for this differentiation • The ADC ability in predicting Masaoka-Koga stage is uncertain and needs further validations• ADC has prognostic value on disease-free survival and helps in stratification of risk

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“…1,2 DWI has been used to detect malignancies in the body because it has been shown that the diŠusion of water molecules in malignant tumors is slower than that of the normal parenchyma. [3][4][5][6] The breast is a popular target for DWI, and many reports demonstrate its clinical utility for breast tumors. [7][8][9][10][11][12][13][14][15][16][17][18][19] In a meta-analysis of DWI of breast tumors performed with 1.5-tesla MR imaging, Tsushima and associates 19 reported sensitivity of 0.89 and speciˆcity of 0.77, comparable to results of meta-analysis of contrastenhanced breast MR imaging.…”

Section: Introductionmentioning

confidence: 99%

Biexponential Signal Attenuation Analysis of Diffusion-weighted Imaging of Breast

et al. 2010

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Purpose: In vivo, the attenuation of diŠusion-weighted imaging (DWI) signal at high bvalues is sometimes nonlinear when plotted with semilogarithmic function and isˆt well by a biexponential function. Previous reports have indicated that the fast and slow component fractions of the apparent diŠusion coe‹cient (ADC) can be derived by biexponentialˆtting and that these fractions correspond to the actual diŠusion components in the extra-and intracellular space. In this study, we investigated the clinical utility of DWI for the breast by performing DWI using multiple b-factors on healthy volunteers and clinical subjects, analyzing the signal byˆtting it with a biexponential equation, and comparing theˆtting parameters of breast lesions.Patients and Methods: We investigated 8 healthy women as normal cases and 80 female patients with a total of 100 breast tumors (42 benign, 58 malignant tumors) as clinical cases. We performed DWI using 12 b-values for the healthy cases and 6 b-values for the clinical cases, up to a maximum b-value of 3500 s/mm 2 .Results: Decay of DWI signal of normal mammary glands, most cysts, and someˆbro-adenomas showed a monoexponential relationship, and conversely, that of intraductal papilloma (IDP) and malignant tumors was wellˆtted by a biexponential function. Comparison of parameters derived from biexponentialˆtting demonstrated no signiˆcant difference between benign and malignant lesions. For malignant tumor subtype, the fast component fraction of noninvasive ductal carcinoma was statistically greater than that of invasive ductal carcinoma.Conclusions: Although the parameters from biexponentialˆtting may re‰ect the character of tumor cellularity, because pathological diagnosis was performed with an emphasis on cell conˆguration or shape rather than cellularity, it was di‹cult to distinguish malignant from benign tumors, including many IDPs, or to distinguish tissue types using DWI signal attenuation alone.

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Tumor Detection by Diffusion-Weighted MRI and ADC-Mapping???Initial Clinical Experiences in Comparison to PET-CT

Abstract: DWI is a feasible clinical technique, improving the assessment of metastatic spread in routine magnetic resonance imaging examinations.

Cited by 98 publications

References 23 publications

Diffusion‐weighted images differentiate benign from malignant thyroid nodules

Diffusion‐weighted images differentiate benign from malignant thyroid nodules

Diffusion-weighted magnetic resonance imaging of thymoma: ability of the Apparent Diffusion Coefficient in predicting the World Health Organization (WHO) classification and the Masaoka-Koga staging system and its prognostic significance on disease-free survival

Biexponential Signal Attenuation Analysis of Diffusion-weighted Imaging of Breast

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