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 Mult...

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Bibliographic Details
Published in:European radiology 2019-03, Vol.29 (3), p.1607-1615
Main Authors: Wan, Qi, Deng, Ying-shi, Lei, Qiang, Bao, Ying-ying, Wang, Yu-ze, Zhou, Jia-xuan, Zou, Qiao, Li, Xin-chun
Format: Article
Language:English
Subjects:
Adult
Aged
Benign
Chest
Diagnosis, Differential
Diagnostic Radiology
Diagnostic systems
Diffusion
Diffusion coefficient
Diffusion Magnetic Resonance Imaging - methods
Echo-Planar Imaging - methods
Female
Humans
Imaging
Internal Medicine
Interventional Radiology
Kurtosis
Lung - diagnostic imaging
Lung cancer
Lung Neoplasms - diagnostic imaging
Lungs
Magnetic resonance imaging
Male
Medical diagnosis
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Motion
Neuroradiology
Parameters
Perfusion
Prospective Studies
Pulmonary lesions
Radiology
Reproducibility of Results
ROC Curve
Sensitivity and Specificity
Solitary Pulmonary Nodule - diagnostic imaging
Statistical analysis
Statistical significance
Tumors
Ultrasound
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Summary: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,
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-018-5714-6