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European Radiology

Erschienen in:

25.09.2018 | Chest

Differentiating between malignant and benign solid solitary pulmonary lesions: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional diffusion-weighted imaging?

verfasst von: Qi Wan, Ying-shi Deng, Qiang Lei, Ying-ying Bao, Yu-ze Wang, Jia-xuan Zhou, Qiao Zou, Xin-chun Li

Erschienen in: European Radiology | Ausgabe 3/2019

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Abstract

Objective

To quantitatively compare the diagnostic values of various diffusion parameters obtained from mono- and biexponential diffusion-weighted imaging (DWI) models and diffusion kurtosis imaging (DKI) in differentiating between benign and malignant solitary pulmonary lesions (SPLs).

Methods

Multiple b-value DWIs and DKIs were performed in 89 patients with SPL by using a 3-T magnetic resonance (MR) imaging unit. The apparent diffusion coefficient (ADC) of various b-value sets, true diffusivity (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), apparent diffusional kurtosis (K_app), and kurtosis-corrected diffusion coefficient (D_app) were calculated and compared between the malignant and benign groups using a Mann-Whitney U test. Receiver-operating characteristic analysis was performed for all parameters.

Result

The ADC_{(0, 150)} values of malignant tumors were lower than those of the benign group (p = 0.01). The ADC_{(0, 300)}, ADC_{(0, 500)}, ADC_{(0, 600),} ADC_{(0, 800)}, ADC_{(0, 1000),} ADC_total, D, and D_app of malignant tumors were significantly lower than those of benign lesions (all p < 0.001). D*, f, and K_app showed no statistically significant differences between the two groups. ADC_total showed the highest area under the curve (AUC = 0.862), followed by ADC_{(0, 800)}(AUC = 0.844), ADC_{(0, 600)}(AUC = 0.843), D(AUC = 0.834), ADC_{(0, 1000)}(AUC = 0.834) and ADC_{(0, 500)}(AUC = 0.824), D_app(AUC = 0.796), and ADC_{(0, 300)} (AUC = 0.773). However, the difference in diagnostic efficacy among these parameters was not statistically significant (p > 0.05).

Conclusion

Intravoxel incoherent motion (IVIM) and DKI-derived parameters have similar performance compared with conventional ADC in differentiating SPLs.

Key Points

• Mono- and biexponential DWI and DKI are feasible for differentiating SPLs.

• ADC _{(0, ≥500)} has better performance than ADC _{(0, <500)} in assessing SPLs.

• IVIM and DKI have similar performance compared with conventional DWI in differentiating SPLs.

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Titel: Differentiating between malignant and benign solid solitary pulmonary lesions: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional diffusion-weighted imaging?
verfasst von: Qi Wan
Ying-shi Deng
Qiang Lei
Ying-ying Bao
Yu-ze Wang
Jia-xuan Zhou
Qiao Zou
Xin-chun Li
Publikationsdatum: 25.09.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 3/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5714-6

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Differentiating between malignant and benign solid solitary pulmonary lesions: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional diffusion-weighted imaging?

Abstract

Objective

Methods

Result

Conclusion

Key Points

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