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; Rasmibala Das; Nerbadyswari D Bag; Prasanta R Mohapatra; Pritinanda Mishra; Suprava Naik

doi:10.1055/s-0043-1771530

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

Indian J Radiol Imaging. 2023 Aug 16;34(1):6-15. doi: 10.1055/s-0043-1771530. eCollection 2024 Jan.

Authors

Sudipta Mohakud¹, Rasmibala Das¹, Nerbadyswari D Bag¹, Prasanta R Mohapatra², Pritinanda Mishra³, Suprava Naik¹

Affiliations

¹ Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
² Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
³ Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

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: diffusion-weighted imaging; lung neoplasm; magnetic resonance imaging.

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Grants and funding

Funding None.