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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(01): 6-15
DOI: 10.1055/s-0043-1771530
Original Article

A Prospective Observational Study of Diagnostic Reliability of Semiquantitative and Quantitative High b-Value Diffusion-Weighted MRI in Distinguishing between Benign and Malignant Lung Lesions at 3 Tesla

Sudipta Mohakud 
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Rasmibala Das
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Nerbadyswari D. Bag
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Prasanta R. Mohapatra
2   Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Pritinanda Mishra
3   Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Suprava Naik
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
› Author Affiliations Funding None.
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Abstract

Aim The aim of this study was to evaluate the usefulness of high b-value diffusion-weighted imaging (DWI) to differentiate benign and malignant lung lesions in 3 Tesla magnetic resonance imaging (MRI).

Materials and Methods Thirty-one patients with lung lesions underwent a high b-value (b= 1000 s/mm 2) DW MRI in 3 Tesla. Thirty lesions were biopsied, followed by histopathological analysis, and one was serially followed up for 2 years. Statistical analysis was done to calculate the sensitivity, specificity, and accuracy of different DWI parameters in distinguishing benign and malignant lesions. Receiver operating characteristic (ROC) curves were used to determine the cutoff values of different parameters.

Results The qualitative assessment of signal intensity on DWI based on a 5-point rank scale had a mean score of 2.71 ± 0.75 for benign and 3. 75 ± 0.60 for malignant lesions. With a cutoff of 3.5, the sensitivity, specificity, and accuracy were 75, 86, and 77.6%, respectively. The mean ADC min (minimum apparent diffusion coefficient) value of benign and malignant lesions was 1. 49 ± 0.38 × 10-3 mm 2/s and 1.11 ± 0.20 ×10-3 mm 2/s, respectively. ROC curve analysis showed a cutoff value of 1.03 × 10-3 mm 2/s; the sensitivity, specificity, and accuracy were 87.5, 71.4, and 83.3%, respectively. For lesion to spinal cord ratio and lesion to spinal cord ADC ratio with a cutoff value of 1.08 and 1.38, the sensitivity, specificity, and accuracy were 83.3 and 87.5%, 71.4 and 71.4%, and 80.6 and 83.8%, respectively. The exponential ADC showed a low accuracy rate.

Conclusion The semiquantitative and quantitative parameters of high b-value DW 3 Tesla MRI can differentiate benign from malignant lesions with high accuracy and make it a reliable nonionizing modality for characterizing lung lesions.

Keywords

magnetic resonance imaging - diffusion-weighted imaging - lung neoplasm

Note

Informed patient consent was obtained before subjecting the patient to MRI lung.




Publication History

Article published online:
16 August 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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