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European Radiology
Published in: European Radiology 3/2018

01-03-2018 | Chest

Discrimination of Malignant versus Benign Mediastinal Lymph Nodes Using Diffusion MRI with an IVIM Model

Authors: Li-Ping Qi, Wan-Pu Yan, Ke-Neng Chen, Zheng Zhong, Xiao-Ting Li, Kejia Cai, Ying-Shi Sun, Xiaohong Joe Zhou

Published in: European Radiology | Issue 3/2018

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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.
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Metadata
Title
Discrimination of Malignant versus Benign Mediastinal Lymph Nodes Using Diffusion MRI with an IVIM Model
Authors
Li-Ping Qi
Wan-Pu Yan
Ke-Neng Chen
Zheng Zhong
Xiao-Ting Li
Kejia Cai
Ying-Shi Sun
Xiaohong Joe Zhou
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5049-8

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