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Open Access 01-12-2020 | Magnetic Resonance Imaging | Research article

Differentiating the lung lesions using Intravoxel incoherent motion diffusion-weighted imaging: a meta-analysis

Authors: Jianye Liang, Jing Li, Zhipeng Li, Tiebao Meng, Jieting Chen, Weimei Ma, Shen Chen, Xie Li, Yaopan Wu, Ni He

Published in: BMC Cancer | Issue 1/2020

Abstract

Background and objectives

The diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the differential diagnosis of pulmonary tumors remained debatable among published studies. This study aimed to pool and summary the relevant results to provide more robust evidence in this issue using a meta-analysis method.

Materials and methods

The researches regarding the differential diagnosis of lung lesions using IVIM-DWI were systemically searched in Pubmed, Embase, Web of science and Wangfang database without time limitation. Review Manager 5.3 was used to calculate the standardized mean difference (SMD) and 95% confidence intervals of apparent diffusion coefficient (ADC), tissue diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction (f). Stata 12.0 was used to pool the sensitivity, specificity, and area under the curve (AUC), as well as publication bias and heterogeneity. Fagan’s nomogram was used to predict the post-test probabilities.

Results

Eleven studies with 481 malignant and 258 benign lung lesions were included. Most include studies showed a low to unclear risk of bias and low concerns regarding applicability. Lung cancer demonstrated a significant lower ADC (SMD = -1.17, P < 0.001), D (SMD = -1.02, P < 0.001) and f values (SMD = -0.43, P = 0.005) than benign lesions, except D* value (SMD = 0.01, P = 0.96). D value demonstrated the best diagnostic performance (sensitivity = 89%, specificity = 71%, AUC = 0.90) and highest post-test probability (57, 57, 43 and 43% for D, ADC, f and D* values) in the differential diagnosis of lung tumors, followed by ADC (sensitivity = 85%, specificity = 72%, AUC = 0.86), f (sensitivity = 71%, specificity = 61%, AUC = 0.71) and D* values (sensitivity = 70%, specificity = 60%, AUC = 0.66).

Conclusion

IVIM-DWI parameters show potentially strong diagnostic capabilities in the differential diagnosis of lung tumors based on the tumor cellularity and perfusion characteristics, and D value demonstrated better diagnostic performance compared to mono-exponential ADC.

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Title: Differentiating the lung lesions using Intravoxel incoherent motion diffusion-weighted imaging: a meta-analysis
Authors: Jianye Liang
Jing Li
Zhipeng Li
Tiebao Meng
Jieting Chen
Weimei Ma
Shen Chen
Xie Li
Yaopan Wu
Ni He
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Lung Cancer
Lung Cancer
Lung Cancer
Published in: BMC Cancer / Issue 1/2020
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-020-07308-z

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