Yoshio Kitazume1, Shin-Ichi Taura2, Shuichiro Nakaminato2, Osamu Noguchi3, Yukiyoshi Masaki4, Ichiro Kasahara5, Mitsuhiro Kishino1, Ukihide Tateishi6. 1. Department of Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8519, Japan. 2. Department of Radiology, Ome Municipal General Hospital, 4-16-5, Higashi-Ome, Ome City, Tokyo 198-0042, Japan. 3. Department of Gastroenterology, Ome Municipal General Hospital, 4-16-5, Higashi-Ome, Ome City, Tokyo 198-0042, Japan. 4. Department of Surgery, Ome Municipal General Hospital, 4-16-5, Higashi-Ome, Ome City, Tokyo 198-0042, Japan. 5. Department of Pathology, Ome Municipal General Hospital, 4-16-5, Higashi-Ome, Ome City, Tokyo 198-0042, Japan. 6. Department of Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: ttisdrnm@tmd.ac.jp.
Abstract
PURPOSE: To retrospectively evaluate the utility of apparent diffusion coefficient (ADC) and lesion to spinal cord ratio (LSR) in diffusion-weighted magnetic resonance (MR) imaging (DWI) as compared with morphological assessment alone, for differentiating malignant from benign gallbladder disorders. METHODS: This study was approved by the ethics committee, and written informed consent was waived. Ninety-one patients (13 malignancy and 78 benignancy) were reviewed. ADC was calculated using two DW images with different motion-probing gradient strengths (b=0, 1000s/mm(2)). LSR was measured by dividing the signal intensity of a thickened gallbladder wall by the maximum signal intensity of the lumbar enlargement of the spinal cord. In addition, the morphology of the gallbladders was assessed with conventional MR imaging. RESULTS: In receiver operating characteristic curve analysis, the areas under the curves for ADC and LSR were 0.861 and 0.906, respectively. Three morphological findings were considered: a massive formation, a disrupted mucosal line, and the absence of a two-layered pattern. When a combination of two or more of these morphological findings was positive for malignancy, the sensitivity, specificity, and accuracy were 76.9%, 84.0%, and 83.0%, respectively. When a combination of three or more of the above morphological findings together with ADC of less than 1.2 × 10(-3)mm(2)/s or LSR of more than 0.48 were positive for malignancy, these values were 73.0%, 96.2%, and 92.9%, respectively. There were significant differences in specificity and accuracy. CONCLUSION: Use of ADC and LSR in DWI can improve diagnostic performance for differentiating malignant from benign gallbladder disorders.
PURPOSE: To retrospectively evaluate the utility of apparent diffusion coefficient (ADC) and lesion to spinal cord ratio (LSR) in diffusion-weighted magnetic resonance (MR) imaging (DWI) as compared with morphological assessment alone, for differentiating malignant from benign gallbladder disorders. METHODS: This study was approved by the ethics committee, and written informed consent was waived. Ninety-one patients (13 malignancy and 78 benignancy) were reviewed. ADC was calculated using two DW images with different motion-probing gradient strengths (b=0, 1000s/mm(2)). LSR was measured by dividing the signal intensity of a thickened gallbladder wall by the maximum signal intensity of the lumbar enlargement of the spinal cord. In addition, the morphology of the gallbladders was assessed with conventional MR imaging. RESULTS: In receiver operating characteristic curve analysis, the areas under the curves for ADC and LSR were 0.861 and 0.906, respectively. Three morphological findings were considered: a massive formation, a disrupted mucosal line, and the absence of a two-layered pattern. When a combination of two or more of these morphological findings was positive for malignancy, the sensitivity, specificity, and accuracy were 76.9%, 84.0%, and 83.0%, respectively. When a combination of three or more of the above morphological findings together with ADC of less than 1.2 × 10(-3)mm(2)/s or LSR of more than 0.48 were positive for malignancy, these values were 73.0%, 96.2%, and 92.9%, respectively. There were significant differences in specificity and accuracy. CONCLUSION: Use of ADC and LSR in DWI can improve diagnostic performance for differentiating malignant from benign gallbladder disorders.
Authors: Kieran G Foley; Max J Lahaye; Ruedi F Thoeni; Marek Soltes; Catherine Dewhurst; Sorin Traian Barbu; Yogesh K Vashist; Søren Rafael Rafaelsen; Marianna Arvanitakis; Julie Perinel; Rebecca Wiles; Stuart Ashley Roberts Journal: Eur Radiol Date: 2021-12-17 Impact factor: 7.034