scholarly journals Role of Quantitative Diffusion-Weighted Imaging in Differentiating Benign and Malignant Orbital Masses

2021 ◽  
Author(s):  
Preeti Mundhada ◽  
Sudarshan Rawat ◽  
Ullas Acharya ◽  
Dhananjay Raje
Keyword(s):  
Roc Curve ◽  
Diffusion Weighted Imaging ◽  
Care Hospital ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Orbital Masses ◽  
Adc Values ◽  
Orbital Lesions

Abstract Aim To determine the role of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) values in differentiating benign and malignant orbital masses. Materials and Methods After obtaining institutional ethical board approval and informed consent from all patients, an observational study was done for a period of 24 months in the radiology department of a tertiary care hospital in South India. Conventional magnetic resonance imaging and DWI using a 3T scanner was done for all patients with suspected orbital mass lesion. ADC value and clinicohistopathological correlation were studied for every patient. Chi-square test was used to compare the signal characteristics of DWI and ADC maps between benign and malignant lesions. A comparison of mean ADC values for benign and malignant masses was performed using Student’s t-test for independent samples. The cut-off value for ADC was obtained using the receiver operating characteristic (ROC) curve. Results Of 44 patients with orbital lesions, 70% were benign and 30% were malignant. There was a significant difference in the mean ADC values of benign and malignant orbital masses. Using ROC curve analysis, an optimal ADC threshold of 1.26 × 10−3 mm2/s was calculated for the prediction of malignancy with 100% sensitivity, 80.65% specificity, and 86.36% accuracy (95% confidence interval: 0.872, 1.00, p < 0.0001). Two ADC thresholds were used to characterize the orbital masses with more than 90% confidence. Conclusion Quantitative assessment of ADC is a useful noninvasive diagnostic tool for differentiating benign and malignant orbital masses. Malignant orbital lesions demonstrate significantly lower ADC values as compared with benign lesions.

Role of Diffusion Weighted Imaging in Differentiating Benign from Pathological Vertebral Compression

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Faten Mohammed Mahmoud Kamel ◽  
Hazem Ibrahim Abdel Rahman ◽  
Amany Sayed Khaleel Ahmed Elkhayat
Keyword(s):  
Vertebral Fractures ◽  
Diffusion Weighted Imaging ◽  
Laboratory Evaluation ◽  
Vertebral Collapse ◽  
Adc Value ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Significant Difference

Abstract Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p &lt; 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference &lt;0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

scholarly journals Role of Diffusion-Weighted Imaging in the Evaluation of Perianal Fistulae

2021 ◽  
Author(s):  
Deb K. Boruah ◽  
Karuna Hazarika ◽  
Halimuddin Ahmed ◽  
Krishna K. Borah ◽  
Samudra Borah ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Imaging Modality ◽  
Perianal Fistula ◽  
P Value ◽  
Adc Value ◽  
Perianal Fistulas ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Perianal Fistulae

Abstract Background Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating perianal fistulae, due to its ability to show the relationship of perianal fistulae with anal sphincters, fistula extensions, secondary ramifications and associated complications. Aim To evaluate the role of diffusion-weighted MRI in the evaluation of perianal fistulae. Settings and Design A hospital-based cross-sectional study. Materials and Methods The study group composed of 47 patients of perianal fistula. MRI with diffusion-weighted imaging (DWI) was performed with Philips 0.5 T Ingenia scanner. DWI with different b-values (b = 50, b = 400, and b = 800 smm2) were obtained. The MRI findings were correlated with local clinical examination and or surgical findings. Statistical Analysis Used Chi-square test, independent samples t-test, and receiver operating characteristic curve analysis. Result Fifty-nine perianal fistulas in 47 patients were included in the study sample. The visibility of perianal fistula on DWI was less than T2-weighted (T2W) and combined DWI-T2W images. Distinctly visualized (visibility score 2) perianal fistulas were observed in 47 fistulas (79.6%) on DWI, 54 (91.5%) on T2W, and 58 (98.3%) on DWI-T2W images. The mean of apparent diffusion coefficient (ADC) values of active fistula was 0.972 ± 0.127 [SD] 10−3 mm2/s and inactive was 1.232 ± 0.185 [SD] 10−3 mm2/s with a significant difference (p-value < 0.0005). A cut-off mean ADC value of 1.105 × 10−3 mm2/s was used to differentiate active from the inactive fistula with a sensitivity of 87.5% and specificity of 73.3%. Conclusion Combined DWI-T2W evaluation had a better performance in the detection of fistula than DWI or T2W alone. DWI with mean ADC calculation had a good performance in differentiating active from the inactive fistulas.

scholarly journals Role of diffusion weighted MR imaging in diagnosis of acute pancreatitis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K A A Sabry ◽  
O F Kamel ◽  
A Y Ahmed ◽  
H M Abuzeid
Keyword(s):  
Acute Pancreatitis ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Normal Controls

Abstract Purpose to assess the role of Diffusion-weighted MRI in diagnosis of acute pancreatitis by measure the apparent diffusion coefficient (ADC) values detected by diffusion-weighted imaging (DWI) in acute pancreatitis and compare them with the control group Methods and Material sixteen patients with acute pancreatitis and sixteen normal controls underwent DWI with b values (0,200 & 800). Apparent diffusion coefficient (ADC) maps are generated from DWI and ADC values were calculated for pancreas and compared the results between the two groups Results The mean pancreatic ADC in the AP group (1.17 × 10(-3) mm(2)/s ± 0.2) was significantly lower than in the normal group (1.6 × 10(-3) mm(2)/s ± 0.32). There was no significant difference in mean ADCs between each of the pancreatic segments in the controls. A threshold ADC value of 1.38 × 10-3 mm(2)/s yielded a sensitivity of 93% and specificity of 87% for detecting acute pancreatitis. Pancreatic ADCs are significantly lower in patients with AP than normal controls. Conclusion MR diffusion imaging could be an important supportive tool in diagnosis of acute pancreatitis

ROLE OF DIFFUSION WEIGHTED MRI IN ASSESSMENT OF BENIGN AND MALIGNANT HEPATIC FOCAL LESIONS IN ADULT AGE GROUP

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan Mohammed Hanafy ◽  
Ayman Mohammed Ibrahim ◽  
Haytham Mohamed Nasser ◽  
Moataz Metwally Elsayed
Keyword(s):  
Focal Lesions ◽  
Adc Value ◽  
Adult Age ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging ◽  
Mri Sequences ◽  
Value Measurement

Abstract Purpose of this study is: To evaluate the role of diffusion weighted magnetic resonance imaging in differentiation between malignant & benign hepatic focal lesions. Methods The study included 38 patients all of them were with hepatic focal lesions detected by ultrasound (between 20 and 85 years of age) referred from GIT and oncology departments. Each patient included in the study was subjected to full history taking, ultrasonography and conventional MRI sequences, post Gd- DTPA dynamic and Diffusion Weighted imaging as well as ADC value measurement. Technique was performed using a standard 1.5 Tesla unit (Ingenia, Philips). Detailed MRI and laboratory investigations were done. Results The study showed significant results were obtained between ADC values of benign and malignant hepatic focal lesions (p &lt; 0.001). Conclusion We concluded in this study according to the obtained results that DWI sequence together with quantitative ADC values should be used as an essential sequence to supplement the conventional MRI sequences for proper detection and characterization of hepatic focal lesions.

Predicting axillary response to neoadjuvant chemotherapy: the role of diffusion weighted imaging

2021 ◽  
Author(s):  
Lucia Graña-López ◽  
Tania Pérez-Ramos ◽  
Fiz Andrés Maciñeira ◽  
Ángeles Villares ◽  
Manuel Vázquez-Caruncho
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Diffusion Weighted Imaging ◽  
Primary Tumour ◽  
Pathologic Complete Response ◽  
Tumour Response ◽  
Complete Response ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Response To Neoadjuvant Chemotherapy

Objective: The aim of this study is to investigate whether the primary tumour response to neoadjuvant chemotherapy (NAC), based on the increase in the ADC-values (apparent diffusion coefficient) within the breast lesion, could help to predict axillary complete response. Methods: We retrospectively included 74 patients who were treated with NAC followed by surgery at Lucus Augusti Hospital between January 2015 and September 2020. Simple logistic regression was used to evaluate the factors associated with axillary pathological complete response, including the changes in breast tumour ADC-values due to the treatment. Results: Axillary complete response was correlated with negative oestrogen receptor status, Her2 positivity and response of primary tumour. It was achieved in 31% of the patients. In addition, the increase in the tumour ADC-values with NAC was higher for responders. Among the tumours that demonstrated an increase in ADC-value >0.92 ×10−3 mm2/s, 42.8% (15/35) showed axillary complete response. Eight (20.5%) breast cancers with an increase in ADC below the cut-off value were found to have no metastatic nodes after treatment (p = 0.038). Conclusion: Our results suggest that the performance of models predicting axillary response to NAC can be improved by adding the tumour response determined also using diffusion-weighted imaging. Advances in knowledge: For the fist time, we investigate the relation between tumour response to NAC, assessed using diffusion-weighted imaging, and axillary pathologic complete response.

Clinical suspicion of spondylodiscitis with equivocal MRI findings: does diffusion-weighted imaging prove helpful here?

2020 ◽  
pp. 028418512092790
Author(s):  
Jeanette Henkelmann ◽  
Kristina Bremicker ◽  
Timm Denecke ◽  
Karl-Titus Hoffmann ◽  
Ralf Henkelmann ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Region Of Interest ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Mri Findings ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values

Background Despite the high sensitivity of magnetic resonance imaging (MRI), early detection of spondylodiscitis (SpD) remains challenging due to its low specificity. Purpose To assess the diagnostic value of diffusion-weighted imaging (DWI) in suspected cases of SpD with ambiguous early MRI findings in the differentiation of degenerative disorders (DD). Material and Methods In this prospective study, 52 patients suspected of having SpD underwent a whole-spine 3-T MRI scan comprising sagittal DWI. Of 58 conspicuous, T2-weighted, signal increased discs, 39 were successfully evaluated using DWI. Apparent diffusion coefficient (ADC) values and ADC maps were blindly analyzed using the region of interest of the conspicuous disc and a normal adjacent reference disc. Intraindividual ratios (conspicuous disc: reference disc) were calculated. Results All conspicuous discs showed increased absolute ADC values, which did not differ significantly between SpD (n = 22) and DD (n = 17). However, ADC ratio was significantly higher in SpD vs. DD ( P < 0.05). In receiver operating characteristic curve analysis, an ADC ratio threshold of 1.6 resulted in 45% sensitivity and 88% specificity (area under the curve = 0.69) for SpD diagnosis. Conclusion The absolute ADC value does not provide a reliable diagnosis of SpD. Increased diffusivity can be an indication of infection but should always be discussed in the context of existing disc degeneration.

MRI findings and demographics of elastofibroma dorsi: assessment of diffusion-weighted imaging and contrast enhancement patterns

2017 ◽  
Vol 59 (6) ◽  
pp. 709-715 ◽  
Author(s):  
Maho Tsubakimoto ◽  
Tsuneo Yamashiro ◽  
Nanae Tsuchiya ◽  
Masahiro Okada ◽  
Hiroki Maehara ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Signal Intensity ◽  
Diffusion Weighted Imaging ◽  
Enhancement Pattern ◽  
Mri Findings ◽  
Adc Value ◽  
Diffusion Restriction ◽  
Diffusion Weighted ◽  
Elastofibroma Dorsi ◽  
Significant Difference

Background Elastofibroma dorsi is a rare pseudotumoral lesion. Thus, there is no report of magnetic resonance imaging (MRI) findings that investigates multiple patients particularly with respect to diffusion-weighted imaging (DWI) findings and contrast enhancement patterns. Purpose To describe the imaging findings of elastofibroma on MRI, particularly DWI findings and contrast enhancement patterns, and to further investigate patient demographics. Material and Methods Forty-four patients with elastofibroma that underwent MRI were enrolled in this retrospective study. All images were evaluated by two radiologists to visually assess the signal intensity for each sequence. Enhanced elastofibromas were classified into four categories to assess the enhancement pattern. Differences in gender and laterality were also assessed statistically. Results An equal number of men and women were included (n = 22 each). There was no significant difference in laterality ( P = 0.783). All lesions (73 lesions) had low signal intensity on both T1-weighted (T1W) and T2-weighted (T2W) images: heterogeneous in 56, homogeneous in 17. None of the 41 lesions with DWI had true abnormal diffusion restriction. The average ADC value was 1.36 × 10–3 ± 0.29 mm2/s. All 31 lesions that had contrast-enhanced MRI were classified according to enhancement pattern: homogeneous (three lesions, 9.7%); heterogeneous (15 lesions, 48.4%); streak-like (three lesions, 9.7%); and rim-like (ten lesions, 32.2%). Conclusion There were no statistically significant differences in gender or laterality. Elastofibroma showed homogeneous to heterogeneous low signal intensity on T1W and T2W images. No lesion showed abnormal diffusion restriction, and all lesions demonstrated enhancement on MRI.

Cerebral schistosomiasis: diffusion-weighted imaging helps to differentiate from brain glioma and metastasis

2017 ◽  
Vol 58 (11) ◽  
pp. 1371-1377 ◽  
Author(s):  
Jinbai Huang ◽  
Jing Luo ◽  
Jie Peng ◽  
Tao Yang ◽  
Huanghua Zheng ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Diffusion Weighted Imaging ◽  
Brain Mri ◽  
High Grade ◽  
Post Contrast ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Perifocal Edema ◽  
Adc Values ◽  
High Grade Gliomas

Background Diffusion-weighted imaging (DWI) was introduced into clinical use some years ago. However, its use in the diagnosis of cerebral schistosomiasis has not been reported. Purpose To investigate the ability of the apparent diffusion coefficient (ADC) value of DWI in the diagnosis of cerebral schistosomiasis, and to differentiate it from brain high-grade gliomas and metastasis. Material and Methods Conventional brain MRI with pre-contrast, post-contrast, and DWI was performed on 50 cases of cerebral schistosomiasis, high-grade glioma, and brain metastasis. The ADC values of the three lesions, the proximal and the distal perifocal edema were measured. In order to remove the individual difference effect of ADC values, relative ADC (rADC) values were calculated through dividing the ADC value of the lesion area by that of the contralateral normal white matter. rADC values were used to evaluate the differences among cerebral schistosomiasis, brain high-grade gliomas, and metastasis. Results rADC of cerebral schistosomiasis was significantly lower than rADC of brain metastasis ( P < 0.05), without any significant differences when compared with high-grade gliomas. rADC of proximal perifocal edema in cerebral schistosomiasis was significantly higher than in high-grade gliomas ( P < 0.010), but not different compared with brain metastasis. Conclusion DWI examination with ADC values of lesions and proximal perifocal edema might be helpful in the exact diagnosis of cerebral schistosomiasis.

scholarly journals The Correlation between Diffusion-Weighted Imaging and Histopathological Evaluation of 356 Prostate Biopsy Sites in Patients with Prostatic Diseases

ISRN Urology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
R. Kilinç ◽  
O. G. Doluoglu ◽  
B. Sakman ◽  
D. S. Ciliz ◽  
E. Yüksel ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Diffusion Weighted Imaging ◽  
Definitive Treatment ◽  
Apparent Diffusion Coefficients ◽  
Prostate Biopsies ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Adc Values ◽  
The Difference ◽  
Prostatic Diseases

Purpose. The aim of this study is to investigate the reliability of diffusion MRI for detection of cancer foci by comparing diffusion-weighted imaging (DWI) results and pathology results of prostate biopsy sites. Methods. Of the patients who applied with lower urinary tract symptoms, 36 patients who had suspected DRE and/or PSA ≥2.5 ng/mL were included in the study. Patients underwent DWI prior to 10 cores-prostate biopsy. 356 biopsy cores were obtained from the patients. Foci from the patients with prostate cancer were labeled as malignant or benign foci, likewise foci from the patients with benign pathology were grouped as BPH and inflammation foci. Apparent diffusion coefficients (ADCs) of biopsy groups were compared with each other in order to measure the reliability of DWI in detection of PCa foci. Results. When ADC values of adenocarcinoma foci and BPH foci were compared, a statistically significant difference was found (P<0.001). When ADC values obtained from adenocarcinoma foci and chronic inflammation foci are compared, the difference between two groups is statistically significant, too (P<0.001). Conclusions. Biopsies focused on suspected regions after formation of ADC maps by means of DWI would provide to start definitive treatment immediately as well as being beneficial to prevent morbidity related to repeated prostate biopsies.

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