Discrimination of Malignant versus Benign Mediastinal Lymph Nodes Using Diffusion MRI with an IVIM Model.

Objectives: To investigate the value of an intravoxel incoherent motion (IVIM) diffusion model for discriminating malignant versus benign mediastinal lymph nodes (MLN).Methods: Thirty-five subjects with enlarged MLN were scanned at 1.5 Tesla. Diffusion-weighted imaging was performed with eight b-val...

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Published in:European Radiology Vol. 28; no. 3; pp. 1301 - 1310
Main Authors: Qi, Li-Ping, Yan, Wan-Pu, Chen, Ke-Neng, Zhong, Zheng, Li, Xiao-Ting, Cai, Kejia, Sun, Ying-Shi, Zhou, Xiaohong Joe
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Mar2018
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Discrimination of Malignant versus Benign Mediastinal Lymph Nodes Using Diffusion MRI with an IVIM Model.
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          Qi, Li-Ping
          Yan, Wan-Pu
          Chen, Ke-Neng
          Zhong, Zheng
          Li, Xiao-Ting
          Cai, Kejia
          Sun, Ying-Shi
          Zhou, Xiaohong Joe
        affil: Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Rd, Hai Dian District, 100142, Beijing, China
      sug:
        subj:
          Mediastinal Neoplasms
          Lymph Nodes Pathology
          Magnetic Resonance Imaging Methods
          Mediastinum
          Male
          Middle Age
          Aged
          Neoplasm Metastasis Diagnosis
          Female
          ROC Curve
          Mediastinal Neoplasms Diagnosis
          Diagnosis, Differential
          Adult
          Human
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Male
          Female
      ab: Objectives: To investigate the value of an intravoxel incoherent motion (IVIM) diffusion model for discriminating malignant versus benign mediastinal lymph nodes (MLN).Methods: Thirty-five subjects with enlarged MLN were scanned at 1.5 Tesla. Diffusion-weighted imaging was performed with eight b-values. IVIM parameters D, D*, and f, as well as apparent diffusion coefficient (ADC) from a mono-exponential model were obtained. 91 nodes (49 malignant and 42 benign) were analysed with pathologic (n=90) or radiologic (n=1) confirmations. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance.Results: The mean values of D, ADC, and f for the malignant group were significantly lower than those for the benign group (p<0.001), while D* showed no significant difference (p=0.281). In the ROC analysis, the combination of D and f produced the largest area under the curve (0.953) compared to ADC or other individual IVIM parameters, leading to the best specificity (92.9%) and diagnostic accuracy (90.1%).Conclusion: This study demonstrates that the combination of IVIM parameters can improve differentiation between malignant and benign MLN as compared to using ADC alone.Key Points: • Diffusion MRI is useful for non-invasively discriminating malignant versus benign lymph nodes. • A mono-exponential model is not adequate to characterise diffusion process in lymph nodes. • IVIM model is advantageous over mono-exponential model for assessing lymph node malignancy. • Combination of IVIM parameters improves differentiation of malignant versus benign lymph nodes.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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