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

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: Mul...

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Publicado en:European Radiology Vol. 29; no. 3; pp. 1607 - 1616
Autores principales: Wan, Qi, Deng, Ying-shi, Lei, Qiang, Bao, Ying-ying, Wang, Yu-ze, Zhou, Jia-xuan, Zou, Qiao, Li, Xin-chun
Formato: Journal Article
Publicado: Springer Nature Mar2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2019
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-018-5714-6
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        atl: Differentiating between malignant and benign solid solitary pulmonary lesions: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional diffusion-weighted imaging?
      aug:
        au:
          Wan, Qi
          Deng, Ying-shi
          Lei, Qiang
          Bao, Ying-ying
          Wang, Yu-ze
          Zhou, Jia-xuan
          Zou, Qiao
          Li, Xin-chun
        affil: Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151., Guangzhou, China
      sug:
        subj:
          Lung Neoplasms
          Solitary Pulmonary Nodule
          Magnetic Resonance Imaging Methods
          Aged
          ROC Curve
          Prospective Studies
          Male
          Sensitivity and Specificity
          Middle Age
          Diagnosis, Differential
          Adult
          Lung
          Reproducibility of Results
          Female
          Motion
          Aged: 65+ years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Male
          Female
      ab: 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 (Kapp), and kurtosis-corrected diffusion coefficient (Dapp) 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), ADCtotal, D, and Dapp of malignant tumors were significantly lower than those of benign lesions (all p < 0.001). D*, f, and Kapp showed no statistically significant differences between the two groups. ADCtotal 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), Dapp(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.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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