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European Radiology
Published in: European Radiology 2/2014

01-02-2014 | Magnetic Resonance

Diffusion-weighted magnetic resonance imaging for assessment of lung lesions: repeatability of the apparent diffusion coefficient measurement

Authors: L. Bernardin, N. H. M. Douglas, D. J. Collins, S. L. Giles, E. A. M. O’Flynn, M. Orton, N. M. deSouza

Published in: European Radiology | Issue 2/2014

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Abstract

Purpose

To establish repeatability of apparent diffusion coefficients (ADCs) acquired from free-breathing diffusion-weighted magnetic resonance imaging (DW-MRI) in malignant lung lesions and investigate effects of lesion size, location and respiratory motion.

Methods

Thirty-six malignant lung lesions (eight patients) were examined twice (1- to 5-h interval) using T1-weighted, T2-weighted and axial single-shot echo-planar DW-MRI (b = 100, 500, 800 s/mm2) during free-breathing. Regions of interest around target lesions on computed b = 800 s/mm2 images by two independent observers yielded ADC values from maps (pixel-by-pixel fitting using all b values and a mono-exponential decay model). Intra- and inter-observer repeatability was assessed per lesion, per patient and by lesion size (> or <2 cm) or location.

Results

ADCs were similar between observers (mean ± SD, 1.15 ± 0.28 × 10-3 mm2/s, observer 1; 1.15 ± 0.29 × 10-3 mm2/s, observer 2). Intra-observer coefficients of variation of the mean [median] ADC per lesion and per patient were 11 % [11.4 %], 5.7 % [5.7 %] for observer 1 and 9.2 % [9.5 %], 3.9 % [4.7 %] for observer 2 respectively; inter-observer values were 8.9 % [9.3 %] (per lesion) and 3.0 % [3.7 %] (per patient). Inter-observer coefficient of variation (CoV) was greater for lesions <2 cm (n = 20) compared with >2 cm (n = 16) (10.8 % vs 6.5 % ADCmean, 11.3 % vs 6.7 % ADCmedian) and for mid (n = 14) vs apical (n = 9) or lower zone (n = 13) lesions (13.9 %, 2.7 %, 3.8 % respectively ADCmean; 14.2 %, 2.8 %, 4.7 % respectively ADCmedian).

Conclusion

Free-breathing DW-MRI of whole lung achieves good intra- and inter-observer repeatability of ADC measurements in malignant lung tumours.

Key Points

• Diffusion-weighted MRI of the lung can be satisfactorily acquired during free-breathing
• DW-MRI demonstrates high contrast between primary and metastatic lesions and normal lung
• Apparent diffusion coefficient (ADC) measurements in lung tumours are repeatable and reliable
• ADC offers potential in assessing response in lung metastases in clinical trials
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Metadata
Title
Diffusion-weighted magnetic resonance imaging for assessment of lung lesions: repeatability of the apparent diffusion coefficient measurement
Authors
L. Bernardin
N. H. M. Douglas
D. J. Collins
S. L. Giles
E. A. M. O’Flynn
M. Orton
N. M. deSouza
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-3048-y

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