ADNEX Model-Based Diagnosis of Ovarian Cancer Using MRI Images

This exploration aims to investigate the important role of magnetic resonance imaging (MRI) in the diagnosis of ovarian cancer under the ADNEX. From March 2017 to December 2019, 84 patients with ovarian cancer confirmed by pathological operation were selected as the research objects. The consistency of ADNEX, MRI, and ADNEX ∗ MRI in the diagnosis and staging of ovarian cancer was calculated separately. SPSS 26.0 statistical software was used to compare the accuracy, sensitivity, specificity, and diagnostic value of the two diagnostic methods. The results show that the accuracy and sensitivity of ADNEX are 78.6% and 93.2%, respectively. The accuracy and sensitivity of MRI are 81.2% and 89.4%, respectively. There is no significant difference between the two methods ( p < 0.05 ). The overall consistency rates of ADNEX ∗ MRI, MRI diagnosis, and ADNEX for ovarian cancer staging are 94.2%, 74%, and 65.4%, respectively. There was a significant difference ( p < 0.05 ). ADNEX ∗ MRI and MRI diagnosis were compared with each stage of ADNEX. There is a significant difference between the second and fourth stages ( p < 0.05 ), and there is also a significant difference in the fourth stage ( p < 0.017 ). It is concluded that MRI diagnosis of ovarian cancer based on ADNEX is superior to ADNEX and MRI examination alone, which provides a certain reference value for clinical staging of ovarian cancer.

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Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer

EJNMMI Research ◽

10.1186/s13550-020-00712-3 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Hideaki Tsuyoshi ◽

Tetsuya Tsujikawa ◽

Shizuka Yamada ◽

Hidehiko Okazawa ◽

Yoshio Yoshida

Keyword(s):

Ovarian Cancer ◽

Fdg Pet ◽

Diagnostic Value ◽

Mri Contrast ◽

Diagnostic Potential ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Imaging Results ◽

N Stage ◽

Sensitivity Specificity

Abstract Purpose To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) in ovarian cancer. Materials and methods Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95% CI 0.72–0.83) (p < 0.05). Accuracy for T status was 96.4% (95% CI 0.96–0.96) and 92.9% (95% CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95% CI 0.88–1.00) and 100% (95% CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95% CI 0.76–0.85) and 30.8% (95% CI 0.19–0.31) for ceCT and M staging representing significant differences (p < 0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95% CI 0.57–0.91), 95.7% (95% CI 0.93–0.97) and 93.9% (95% CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95% CI 0.24–0.58), 96.6% (95% CI 0.94–0.98) and 90.8% (95% CI 0.87–0.94) for ceCT. Conclusions [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

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Comparison of conventional, doppler and contrast-enhanced ultrasonography in differential diagnosis of ovarian masses: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-052830 ◽

2021 ◽

Vol 11 (12) ◽

pp. e052830

Author(s):

Lizhang Xun ◽

Lamei Zhai ◽

Hui Xu

Keyword(s):

Systematic Review ◽

Ovarian Cancer ◽

Data Extraction ◽

Meta Analysis ◽

Diagnostic Value ◽

Doppler Us ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography ◽

Sensitivity Specificity ◽

Ovarian Masses

ObjectivesTo assess the value of conventional, Doppler and contrast-enhanced ultrasonography (CEUS) (conventional ultrasonography (US), Doppler US and CEUS) for diagnosing ovarian cancer.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase and the Cochrane Library were conducted for studies published until October 2021.Eligibility criteriaStudies assessed the diagnostic value of conventional US, Doppler US or CEUS for detecting ovarian cancer, with no restrictions placed on published language and status.Data extraction and synthesisThe study selection and data extraction were performed by two independent authors. The sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), diagnostic OR (DOR) and area under the receiver operating characteristic curve (AUC) were pooled using the bivariate generalised linear mixed model and random effects model.ResultsThe meta-analysis included 72 studies and involved 9296 women who presented with ovarian masses. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for conventional US were 0.91 (95% CI: 0.87 to 0.94) and 0.87 (95% CI: 0.82 to 0.91), 6.87 (95% CI: 4.98 to 9.49) and 0.10 (95% CI: 0.07 to 0.15), 57.52 (95% CI: 36.64 to 90.28) and 0.95 (95% CI: 0.93 to 0.97), respectively. The sensitivity, specificity, PLR, NLR, DOR and AUC for Doppler US were 0.93 (95% CI: 0.91 to 0.95) and 0.85 (95% CI: 0.80 to 0.89), 6.10 (95% CI: 4.59 to 8.11) and 0.08 (95% CI: 0.06 to 0.11), 61.76 (95% CI: 39.99 to 95.37) and 0.96 (95% CI: 0.94 to 0.97), respectively. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for CEUS were 0.97 (95% CI: 0.92 to 0.99) and 0.92 (95% CI: 0.85 to 0.95), 11.47 (95% CI: 6.52 to 20.17) and 0.03 (95% CI: 0.01 to 0.09), 152.11 (95% CI: 77.77 to 297.51) and 0.99 (95% CI: 0.97 to 0.99), respectively. Moreover, the AUC values for conventional US (p=0.002) and Doppler US (p=0.005) were inferior to those of CEUS.ConclusionsConventional US, Doppler US and CEUS have a relatively high differential diagnostic value for differentiating between benign and malignant ovarian masses. The diagnostic performance of CEUS was superior to that of conventional US and Doppler US.

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Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer

10.21203/rs.3.rs-46817/v3 ◽

2020 ◽

Author(s):

Hideaki Tsuyoshi ◽

Tetsuya Tsujikawa ◽

Shizuka Yamada ◽

Hidehiko Okazawa ◽

Yoshio Yoshida

Keyword(s):

Ovarian Cancer ◽

Fdg Pet ◽

Diagnostic Value ◽

Mri Contrast ◽

Diagnostic Potential ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Imaging Results ◽

N Stage ◽

Sensitivity Specificity

Abstract Purpose: To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) in ovarian cancer.Materials and Methods: Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.Results: Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95%CI 0.72–0.83) (p <0.05). Accuracy for T status was 96.4% (95%CI 0.96–0.96) and 92.9% (95%CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95%CI 0.88–1.00) and 100% (95%CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95%CI 0.76–0.85) and 30.8% (95%CI 0.19–0.31) for ceCT and M staging representing significant differences (p<0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95%CI 0.57–0.91), 95.7% (95%CI 0.93–0.97) and 93.9% (95%CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95%CI 0.24–0.58), 96.6% (95%CI 0.94–0.98) and 90.8% (95%CI 0.87–0.94) for ceCT. Conclusions: [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

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Diagnostic value of Telomerase Activity in patients with Bladder cancer: a meta-analysis of diagnostic test

10.21203/rs.2.11915/v2 ◽

2019 ◽

Author(s):

Lei Peng ◽

Jinze Li ◽

ZhengJu Ren ◽

Hong De Cao ◽

Lujia He ◽

...

Keyword(s):

Bladder Cancer ◽

Subgroup Analysis ◽

Meta Analysis ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Diagnostic Value ◽

Telomerase Activity ◽

Low Grade ◽

Significant Difference ◽

Sensitivity Specificity

Abstract Background: This study aimed to evaluate the diagnostic value of telomerase activity (TA) for bladder cancer (BC) by meta-analysis. Methods: We conducted a systematic search of studies published on PubMed, Embase, and Web of Science up to June 1, 2019. We used Stata 15 and Review Manager 5.3 for calculations and statistical analysis. Results: To evaluate the diagnostic value of TA for BC, we performed a meta-analysis on 22 studies, with a total of 2867 individuals, including sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR), and 95% confidence intervals (CIs). The pooled parameters were calculated from all studies and we found a sensitivity of 0.79 (95% CI: 0.72 – 0.84), a specificity of 0.91 (95% CI: 0.87–0.94), a PLR of 8.91 (95% CI: 5.91–13.43), an NLR of 0.24 (95% CI: 0.15–0.37), a DOR of 37.90 (95% CI: 23.32–61.59), and an AUC of 0.92 (95% CI: 0.90–0.94). We also conducted a subgroup analysis based on the different stages and grades of BC. Results from the subgroup analysis showed that there was no significant difference in TA in either high and low stages of BC, but that low-grade tumours had a lower TA than high-grade tumours. Conclusions: In BC, there is a high overall diagnostic value for TA, and this could provide an alternative to cystoscopy for staging and grading of tumours. The tumor characteristics also showed a good diagnostic value

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TP8.1.12 Diagnostic Utility of MRI in the Evaluation of Potential Malignancy in Patients Presented with Nipple Discharge

British Journal of Surgery ◽

10.1093/bjs/znab362.074 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Nixon Phua Cher Yang ◽

Muhammad Adeel Javed Butt ◽

Parmvir Singh Nijjar ◽

Saung Phyu ◽

Musa Barkeji

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Ductal Carcinoma ◽

Nipple Discharge ◽

Diagnostic Value ◽

Predictive Values ◽

Imaging Tool ◽

Additional Imaging ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Abstract Aims Nipple discharge is a presentation commonly seen at breast clinics. It is conventionally evaluated with physical examination and sonography( or mammography). The aim of this study is to investigate the diagnostic value of magnetic resonance imaging (MRI) as an additional imaging tool in the evaluation of potential malignancy in patients presented with nipple discharge. Methods A retrospective evaluation of 85 patients with nipple discharge who underwent breast ultrasound (USS) and MRI between 04/06/2008 and 25/10/2019 was conducted. Clinical notes, radiographic reports and biopsy results were reviewed. Sensitivity, specificity, positive predictive value and negative predictive value of USS and MRI were calculated. Results Out of the 85 patients (all female; mean age 45.33 +/- 12.93 years old) with nipple discharge, 11 were found to have biopsy-proven malignancy (invasive ductal carcinoma/ ductal carcinoma in situ; 12.94% risk). USS failed to identify seven malignancies (27.27% sensitivity) while MRI missed three malignancies (72.72% sensitivity). USS falsely identified four malignancies from 74 patients with no malignancy (94.59% specificity) while MRI only falsely identified one case (98.65% specificity). For patients with negative USS results (U1/U2/U3) or negative MRI results (BI-RADS category 1,2 or 3), the negative predictive values of USS is 89.74% while that of MRI is 96.05%. The positive predictive values of USS and MRI are 42.86% and 88.88% respectively. Conclusion Compared to USS, MRI has a higher sensitivity, specificity, positive predictive value and predictive value. It will be a valuable addition to the standard nipple discharge evaluation workup to help rule out malignancy.

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Diagnostic value of Telomerase Activity in patients with Bladder cancer: a meta-analysis of diagnostic test

10.21203/rs.2.11915/v1 ◽

2019 ◽

Author(s):

Lei Peng ◽

Lujia He ◽

ZhengJu Ren ◽

Hong De Cao ◽

Jinze Li ◽

...

Keyword(s):

Bladder Cancer ◽

Meta Analysis ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Diagnostic Value ◽

Telomerase Activity ◽

Low Grade ◽

Significant Difference ◽

Meta Analyses ◽

Sensitivity Specificity

Abstract Background This article aims to evaluate the diagnostic value of telomerase activity (TA) in bladder cancer (BC) by meta-analysis of diagnostic tests. Methods We conducted a systematic search of articles published on PubMed, Embase, and Web of Science up to June 1, 2019.Stata 15 and Review Manager 5.3 were used for calculation and statistical analyses. Results We use the sensitivity, specificity, positive and negative likelihood ratio (PLR,NLR),diagnostic odds ratio (DOR) and 95% confidengce intervals (CIs) to evaluate the diagnostic value of TA for BC. 22 studies were included in the meta- analyses, with a total of 2867 individuals. The pooled parameters are calculated from all studies: sensitivity of 0.79(95%CI:0.72-0.84), specificity of 0.91(95%CI:0.87-0.94), PLR of 8.91(95%CI:5.91-13.43),NLR of 0.24(95%CI:0.15-0.37), DOR of 37.90(95%CI:23.32-61.59), AUC of 0.92(95%CI:0.90-0.94). We also conducted subgroup based on different stages and grades. Results from subgroup analysis showed that there was no significant difference in TA during the high and low stages BC, but low-grade tumors have lower TA than high-grade tumors. Conclusions For the diagnosis of BC, the overall diagnostic value of TA is high, and is expected to be an alternative to cystoscopy for different staging and grading. The tumor also has a very good diagnostic value.

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Performance of the Xpert® MTB/RIF assay in the rapid diagnosis of tracheobronchial tuberculosis using bronchial washing fluid

Journal of International Medical Research ◽

10.1177/0300060520921640 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052092164

Author(s):

Yan-Hua Song ◽

Qiang Li ◽

Li-Ping Ma ◽

Rong-Mei Liu ◽

Guang-Lu Jiang ◽

...

Keyword(s):

Pulmonary Disease ◽

Predictive Value ◽

Diagnostic Yield ◽

Culture Method ◽

Diagnostic Value ◽

Acid Fast Bacillus ◽

Diagnostic Methods ◽

Bronchial Washing ◽

Sensitivity Specificity ◽

Higher Sensitivity

Objective To assess the diagnostic value of the Xpert® MTB/RIF (GeneXpert) assay for tracheobronchial tuberculosis (TBTB) using bronchial washing fluid (BWF). Methods This retrospective study enrolled patients suspected of having TBTB and patients with non-TB pulmonary disease as controls. BWF were used to undertake acid-fast bacillus (AFB) smears, the GeneXpert assay and the Lӧwenstein–Jensen (LJ) culture method. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were compared among BWF AFB smears, BWF GeneXpert and the BWF LJ culture method. Results A total of 130 patients with TBTB and 102 patients with non-TB pulmonary disease were enrolled in the study. Sputum AFB smears were positive in 62 of 130 patients (47.7%) with TBTB. Using the clinical diagnosis of TBTB as the gold standard, the sensitivity, specificity, PPV and NPV of the three methods using BWF were as follows: 93.1%, 99.0%, 99.2% and 91.8% for BWF GeneXpert; 73.1%, 100.0%, 100.0% and 74.5% for BWF LJ cultures; 53.8%, 99.0%, 98.6% and 62.7% for BWF AFB smears. The diagnostic yield of BWF GeneXpert was significantly higher compared with BWF cultures for type III and IV TBTB. Conclusion The Xpert® MTB/RIF assay using BWF exhibited higher sensitivity than bacteriological diagnostic methods and was particularly useful for the early diagnosis of smear-negative TBTB.

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Feasibility, Reproducibility and Reliability for the T2* Iron Evaluation At 3T in Comparison with 1.5T

Blood ◽

10.1182/blood.v118.21.5301.5301 ◽

2011 ◽

Vol 118 (21) ◽

pp. 5301-5301

Author(s):

Antonella Meloni ◽

Vincenzo Positano ◽

Petra Keilberg ◽

Daniele De Marchi ◽

Pasquale Pepe ◽

...

Keyword(s):

Conflicts Of Interest ◽

Region Of Interest ◽

Ventricular Septum ◽

Liver Iron ◽

Diagnostic Reliability ◽

Significant Difference ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity ◽

Lower Limits ◽

The Relationship

Abstract Abstract 5301 Introduction: The gradient echo multiecho T2* Magnetic Resonance Imaging (MRI) technique is the most robust method for sensitive and reproducible quantification of iron overload in transfusion dependent patients. The 1.5T MRI scanners are generally used in the clinical arena, but 3T scanners are becoming largely widespread. So, this study aimed to determine the feasibility, reproducibility and reliability of the multiecho T2* approach at 3T for myocardial and liver iron burden quantification and the relationship between T2* values at 3T and 1.5T. Methods: 38 transfusion-dependent patients underwent MRI for T2* assessment at 1.5T and 3T. Twenty healthy subjects were studied at 3T to determine the normal cut off for the T2* values at 3T. For the heart segmental and global T2* values were calculated after developing a correction map to compensate the artefactual T2* variations at 3T. In the liver the T2* value was determined over a circular region of interest. Results: The intra- and inter-operator reproducibility for T2* measurements at 3T was good (ICC>0.949). Segmental correction factors were significantly higher at 3T vs 1.5T (P=0.002). A strong linear relationship was found between patients' R2* values at 3T and 1.5T. For both liver and heart, the R2* values at 3T were about twice that at 1.5 T with an intercept depending on the non-iron component of the tissue. The concordance between global and mid-ventricular septum values confirmed the consistence of measurements. A conversion formula returning the T2* values at 1.5T from T2* values at 3T was proposed for clinical use (Table 1). At 3T we found a full diagnostic reliability to evaluate myocardial iron burden in the mid-ventricular septum (sensitivity, specificity and accuracy 100%), reflecting the non significant difference in the susceptibility artefacts in this region at 1.5T and at 3T. Also for the global heart T2* value the diagnostic reliability was high after the application of an appropriate correction procedure (sensitivity 100%, specificity and accuracy 97%). For the segmental measurement of iron levels at 3T, the accuracy was no optimal, reflecting the significant difference in the susceptibility artefacts at 1.5T and at 3T. The accuracy was high to identify patients with mild to no liver iron burden (97%) but dropped to 94% in the identification of patients with heavy- moderate liver iron burden. The sensitivity was unsatisfactory (67%) to detect patients with heavy liver iron burden. Lower limits of normal for T2* values at 3T were 23.3 ms, 21.1 ms 11.7 ms, for the global heart, mid-ventricular septum and liver, respectively. Conclusion: T2* quantification of iron burden in the mid-ventricular septum, global heart and no heavy-moderate livers resulted to be feasible, reproducible and reliable at 3T. Challenge was the segmental heart T2* analysis due to significantly higher susceptibility artefacts at 3T. Disclosures: No relevant conflicts of interest to declare.

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The Value of Subjective Visual Vertical in Diagnosis of Vestibular Migraine

Current Medical Science ◽

10.1007/s11596-021-2418-y ◽

2021 ◽

Vol 41 (4) ◽

pp. 654-660

Author(s):

Fei Li ◽

Jin Xu ◽

Gen-ru Li ◽

Rui Gao ◽

Chen-yong Shang ◽

...

Keyword(s):

Normal Subjects ◽

Diagnostic Value ◽

Upright Position ◽

Vestibular Migraine ◽

Subjective Visual Vertical ◽

Vestibular Evoked Myogenic Potential ◽

Significant Difference ◽

Visual Vertical ◽

High Level ◽

Sensitivity Specificity

Abstract Objective To study the value of the subjective visual vertical (SVV) in the diagnosis of vestibular migraine (VM). Methods This study recruited 128 VM patients and 64 age-matched normal subjects. We detected the SVV during the interval between attacks in both groups, in sitting upright, and the head tilted at 45° to the left or right. We then examined the correlation between the SVV results with the vestibular evoked myogenic potential (VEMP) and canal paresis (CP). Results It was found there was a significant difference in SVV at the upright position between VM patients and normal controls (P=0.006) and no significant difference was found at the tilts of 45° to the left or right between the two groups. The SVV results at the upright position were significantly correlated with cervical VEMP (P=0.042) whereas not significantly correlated with CP and VEMP. There existed no significant difference in the conformity to the Müller effect (M effect) between the two groups. ROC analysis exhibited that the sensitivity, specificity of SVVs at the upright were 67.200% and 62.500% respectively. The diagnostic value of SVV at the upright position was significantly higher than that at tilts of 45° to the left and right (P=0.006). Nonetheless the diagnostic accuracy was relatively low. Conclusion Abnormality in SVV possibly stems from the lasting functional disorder of cerebellar or high-level cortical centers in VM patients or is linked to the vestibular compensation. The SVV is of low diagnostic value for VM and the value of SVV in VM warrants further study.

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Diagnostic value of DWI-MRI for the detection of acute plaques in the relapse phase of multiple sclerosis

Romanian Journal of Neurology ◽

10.37897/rjn.2021.1.5 ◽

2021 ◽

Vol 20 (1) ◽

pp. 35-40

Author(s):

Mehran Yousefi ◽

◽

Mehdi Panahali ◽

Kamran Azarkhish ◽

Nazanin Azizi Shalbaf ◽

...

Keyword(s):

Multiple Sclerosis ◽

Predictive Value ◽

Brain Mri ◽

Diagnostic Value ◽

Gadolinium Contrast ◽

Mcdonald Criteria ◽

Contrast Enhanced ◽

Gadolinium Contrast Agents ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Background. The 2010 revision of the McDonald criteria, widely used for the diagnosis of multiple sclerosis (MS), has established that dissemination in time (DIT) can be demonstrated by the simultaneous presence of asymptomatic gadolinium-enhancing and non-enhancing plaques on a single magnetic resonance imaging (MRI). When the use of gadolinium contrast agents is contraindicated, diffusion-weighted imaging (DWI) is utilized to confirm diffusion alterations in active inflammatory plaques. This study intended to examine whether DWI can be a viable alternative to contrast-enhanced T1-weighted imaging for demonstrating DIT in MS. Material and methods.We assessed 30 previously diagnosed MS patients during acute relapse (based on the 2010 McDonald criteria) and evaluated their brain MRI via DWI‚ contrast-enhanced T1-weighted imaging, and FLAIR sequences. Asymptomatic plaques were defined as either hyperintense or non-hyperintense in DWI and enhancing or non-enhancing in T1GAD-MRI. Statistical indices for the prediction of plaque enhancement in T1 GAD-MRI via DWI-MRI were calculated and compared. Results. The 30 participants in our study had a total of 925 demyelinating plaques that were larger than 3mm in size and presented to be hyperintense in FLAIR-MRI. Diffusion hyperintensity and plaque enhancement were significantly correlated. The sensitivity‚ specificity, positive predictive value‚ negative predictive value, and accuracy of DWI were calculated to be 69.66%‚ 99.76%‚ 96.88%‚ 96.86%, and 96.86%, respectively. Conclusions. Hyperintense DWI findings do not necessarily overlap with contrast enhancements in T1 GAD-MRI. DWI was shown to produce a higher rate of false-positive results. Our study concludes that although T1 GAD-MRI should not be replaced by DWI to determine DIT due to its lower specificity, DWI’s continued use as a surrogate screening imaging sequence whenever the use of T1GAD-MRI is of concern is not without its merits.

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