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Comparison of intravoxel incoherent motion diffusion‐weighted MR imaging with dynamic contrast‐enhanced MRI for differentiating lung cancer from benign solitary pulmonary lesions
Author(s) -
Yuan Mei,
Zhang YuDong,
Zhu Chan,
Yu TongFu,
Shi HaiBin,
Shi ZhaoFei,
Li Hai,
Wu JiangFen
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25018
Subject(s) - intravoxel incoherent motion , benignity , medicine , nuclear medicine , lung cancer , receiver operating characteristic , diffusion mri , magnetic resonance imaging , radiology , malignancy , pathology
Background To compare intravoxel incoherent motion (IVIM) and pharmacokinetic analysis dynamic contrast‐enhanced MR imaging (DCE‐MRI) in distinguishing lung cancer (LC) from benign solitary pulmonary lesions (SPL). Methods This prospective study was approved by the institutional review board, and written informed consent was obtained. Eighty‐one consecutive patients considered for SPL underwent DW‐IVIM and DCE‐3T MRI. ADC, D, D*, and f were calculated with mono‐ and bi‐exponential models. K trans , k ep , v e , and v p were calculated with the modified Tofts model. Receiver operating characteristic (ROC) analysis was constructed to determine the diagnostic performance of IVIM and DCE‐MRI in discriminating LC from benignity. Results There were 29 patients with a total of 48 benign SPL and 52 LCs: 4 small cell carcinomas (SCLC), 19 squamous cell carcinomas (SCC), and 29 adenocarcinomas (Adeno‐Ca). Both Adeno‐Ca (ADC: 1.19 ± 0.23 × 10 −3 mm 2 /s; D:1.12 ± 0.35 × 10 −3 mm 2 /s; v e :0.27 ± 0.13; K trans :0.24 ± 0.09 min −1 ; k ep :0.90 ± 0.45 min −1 ) and SCC (1.13± 0.28 × 10 −3 mm 2 /s; 1.02 ± 0.32 10 −3 mm 2 /s; 0.32 ± 0.14; 0.26 ± 0.08 min −1 ; 0.90 ± 0.48 min −1 ) had significantly lower ADC, D, v e and larger K trans , k ep than benignity (1.37 ± 0.38 × 10 −3 mm 2 /s; 1.34 ± 0.45 × 10 −3 mm 2 /s; 0.42 ± 0.19; 0.19 ± 0.08 min −1 ; 0.53 ± 0.26 min −1 ). D (72.2%) had significantly higher accuracy (72.2%) and higher sensitivity (91.3%) than other imaging indices (accuracy: 55.5–68.0%; sensitivity: 41.3–78.3%; all P < 0.01) except for accuracy in k ep (70.8%; P > 0.05) in discriminating LC from benignity. K trans exhibited significantly higher specificity (84.6%) than the other indices (38.5–73.1%; P < 0.01). These results can be improved by combined D and K trans , leading to a sensitivity, specificity and accuracy of 94.2%, 92%, and 93.5%, respectively. Conclusion IVIM‐derived D and DCE‐derived K trans are two promising parameters for differentiating LC from benignity. J. MAGN. RESON. IMAGING 2016;43:669–679.