Li-Ping Qi1,2, Wan-Pu Yan3, Ke-Neng Chen3, Zheng Zhong2,4, Xiao-Ting Li1, Kejia Cai2,4,5, Ying-Shi Sun6, Xiaohong Joe Zhou7,8,9,10. 1. 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, Beijing, 100142, China. 2. Center for MR Research, and Department of Radiology, University of Illinois at Chicago, 2242 West Harrison Street, Suite 103, M/C 831, Chicago, IL, 60612, USA. 3. Department of Thoracic Oncosurgery, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, Beijing, China. 4. Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA. 5. Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA. 6. 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, Beijing, 100142, China. sys27@163.com. 7. Center for MR Research, and Department of Radiology, University of Illinois at Chicago, 2242 West Harrison Street, Suite 103, M/C 831, Chicago, IL, 60612, USA. xjzhou@uic.edu. 8. Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA. xjzhou@uic.edu. 9. Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA. xjzhou@uic.edu. 10. Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA. xjzhou@uic.edu.
Abstract
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.
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.
Authors: Gene Young Cho; Linda Moy; Sungheon G Kim; Steven H Baete; Melanie Moccaldi; James S Babb; Daniel K Sodickson; Eric E Sigmund Journal: Eur Radiol Date: 2015-11-28 Impact factor: 5.315
Authors: Jurgen Peerlings; Esther G C Troost; Patricia J Nelemans; David C P Cobben; Johannes C J de Boer; Aswin L Hoffmann; Regina G H Beets-Tan Journal: Radiology Date: 2016-04-25 Impact factor: 11.105
Authors: Francisco de Souza Santos; Nupur Verma; Guilherme Watte; Edson Marchiori; Tan-Lucien H Mohammed; Tássia Machado Medeiros; Bruno Hochhegger Journal: Radiol Bras Date: 2021 Jul-Aug