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.

scholarly journals High resolution diffusion weighted imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma

2020 ◽  
Author(s):  
Tiebo Meng ◽  
Feixiang Wang ◽  
Jia Liu ◽  
Wei Dai ◽  
Lanlan Zhi ◽  
...  
Keyword(s):  
High Resolution ◽  
Neoadjuvant Chemotherapy ◽  
Diffusion Weighted Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Imaging Biomarker ◽  
Diagnostic Efficacy ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values

Abstract Background To evaluate the feasibility of high resolution diffusion weighted imaging (DWI) for the prediction about the response of neoadjuvant chemotherapy (NAC) in patients. Methods 119 NPC patients who underwent magnetic resonance imaging (MRI) including readout-segmented diffusion weighted imaging (RESOLVE-DWI) before treatment enrolled in this study from September 2017 to December 2019, and all patients underwent follow-up MRI at 3 month after two cycles of NAC. Patients were classified into stable disease (SD), partial response (PR) or completed response (CR) based on Response Evaluation Criteria in Solid Tumors (RECIST). Apparent diffusion coefficient (ADC) values were measured from RESOLVE-DWI in the first MRI examination. The ADC values were compared between responders (CR and PR) and non-responders (SD) using Independent samples t-test, and the receiver operating characteristic curve (ROC) was calculated to assess the diagnostic efficacy. Results The ADC value of responders was significantly higher than that of non-responders (719.73 ± 100.44 × 10− 3 mm2/s and 583.28 ± 53.15 × 10− 3 mm2/s, p < 0.001, respectively). The area under the curve (AUC) was 0.879 with a sensitivity at 82.8%, and specificity at 84.6%. Conclusions The ADC value obtained by RESOLVE-DWI, with a high diagnostic accuracy for NAC assessment, could be used as a pretreatment imaging biomarker to predict the early response to NAC in NPC patients.

MRI findings, including diffusion-weighted imaging, in seven cats with nasal lymphoma and two cats with nasal adenocarcinoma

2020 ◽  
pp. 1098612X2093281
Author(s):  
Toshiyuki Tanaka ◽  
Kazuna Ashida ◽  
Yasumasa Iimori ◽  
Hiroki Yamazaki ◽  
Keiichiro Mie ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Case Series ◽  
Mri Findings ◽  
Post Contrast ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Nasal Adenocarcinoma ◽  
Nasal Lymphoma ◽  
Heterogeneous Enhancement

Objectives Case series summary Primary nasal tumours in cats are rare, with lymphoma being the most common feline nasal tumour, followed by adenocarcinoma. Although CT can reliably detect feline nasal tumours, there are no specific CT features that identify each tumour type. To our knowledge, there have been no reports describing MRI findings, including diffusion-weighted imaging (DWI), for nasal lymphomas and adenocarcinomas in cats. Therefore, this retrospective study aimed to evaluate the MRI findings of nasal lymphoma and adenocarcinoma, including qualitative and quantitative analysis of DWI. Methods MRI examination was performed on seven cats with histologically confirmed lymphoma and on two with adenocarcinoma. The MRI protocol included T2-weighted imaging (T2WI), T1-weighted imaging (T1WI) and DWI. Apparent diffusion coefficient (ADC) values were measured using DWI. Contrast agent was not used in one cat with lymphoma. Results In those with lymphoma, three (43%) were iso- and hyperintense on T2WI, seven (100%) were iso-intense on T1WI, five (83%) exhibited mild heterogeneous enhancement, including a prominent region of non-enhancement on post-contrast T1WI, and seven (100%) cats exhibited hyperintensity on DWI. The median ADC values were 0.45 × 10−3 mm2/s (range 0.37–0.53 × 10−3 mm2/s). For adenocarcinoma, two (100%) were iso- and hyperintense on T2WI, two (100%) were iso-intense on T1WI, two (100%) exhibited marked heterogeneous enhancement on post-contrast T1WI and two (100%) were iso-intense on DWI. The median ADC values were 1.08 × 10−3 mm2/s (range 0.88–1.27 × 10−3 mm2/s). The median ADC values of lymphoma tended to be lower than adenocarcinoma ( P = 0.056). Conclusions and relevance Determining ADC value and tumours with a large area of non-enhancement may be helpful in differentiating nasal lymphoma from nasal adenocarcinoma.

scholarly journals A Comparative Analysis of Diffusion-weighted Imaging and Ultrasound in Thyroid Nodules

2019 ◽  
Author(s):  
Weidan Kong ◽  
Xiuhui Yue ◽  
Jiliang Ren ◽  
xiaofeng tao
Keyword(s):  
Signal Intensity ◽  
Diffusion Weighted Imaging ◽  
Thyroid Nodules ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
High Specificity ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Sensitivity Specificity

Abstract Background: Diffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules. Methods: A total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests. Results: There was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10 -3 mm 2 /s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9%, 92.2%, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1%, 80.4%, and 86.9%. Conclusions: Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules. Keywords Thyroid nodules, Ultrasound, Diffusion-weighted imaging

scholarly journals Diffusion Kurtosis MR Imaging versus Conventional Diffusion-Weighted Imaging for Distinguishing Hepatocellular Carcinoma from Benign Hepatic Nodules

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Yingmei Jia ◽  
Huasong Cai ◽  
Meng Wang ◽  
Yanji Luo ◽  
Ling Xu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diffusion Weighted Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Hepatocellular Adenoma ◽  
Diffusion Kurtosis Imaging ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Benign Nodules ◽  
Diffusion Kurtosis

Objectives. To assess the efficacy of diffusion kurtosis imaging (DKI) and compare DKI-derived parameters with conventional diffusion-weighted imaging (DWI) for distinguishing hepatocellular carcinoma (HCC) from benign hepatic nodules including focal nodular hyperplasia (FNH), hemangioma, and hepatocellular adenoma (HCA). Materials and Methods. 151 patients with 182 hepatic nodules (114 HCCs and 68 benign nodules including 33 FNHs, 29 hemangiomas, and 6 HCAs) were analyzed. Preoperative MRI examinations including DKI (b values: 0, 200, 500, 800, 1500, and 2000 sec/mm2) were performed, and kurtosis (K), diffusivity (D), and apparent diffusion coefficient (ADC) were calculated. The efficacy of DKI-derived parameters K, D, and ADC for distinguishing HCC from these benign nodules was analyzed. Results. ROC (receiver operating characteristic curve) analysis showed the optimal cutoff values of ADC, D, and K for identification of these benign nodules, and HCCs were 1.295 (area under the curve (AUC): 0.826; sensitivity 80.6%; specificity 70.8%), 1.787 (AUC: 0.770; sensitivity 83.6%; specificity 59.6%), and 1.002 (AUC: 0.761; sensitivity 65.5%; specificity 79.0%), respectively. Statistically significant differences were found in ADC, D, and K values between groups of HCC-FNH and HCC-hemangioma (P<0.05). There were significant differences in K and ADC values between groups of FNH-hemangioma and HCA-hemangioma (P<0.05), respectively. Using logistic regression analysis, a regression equation was obtained: LogitP=−1.982X1+1.385X3+1.948(X1: ADC; X3: K), and odds ratios (OR) were 0.138 (95% confidence interval (CI): 0.052, 0.367), and 8.996 (95% CI: 0.970, 16.460), respectively. Conclusion. Both ADC value and DKI-derived parameters K and D values have demonstrated a higher preoperative efficacy in distinguishing HCC from FNH, hemangioma, and HCA. No evidence was shown to suggest D or K value was superior to the ADC value.

scholarly journals A comparative analysis of diffusion-weighted imaging and ultrasound in thyroid nodules

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weidan Kong ◽  
Xiuhui Yue ◽  
Jiliang Ren ◽  
Xiaofeng Tao
Keyword(s):  
Signal Intensity ◽  
Diffusion Weighted Imaging ◽  
Thyroid Nodules ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
High Specificity ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Sensitivity Specificity

Abstract Background Diffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules. Methods A total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests. Results There was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10− 3 mm2/s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9, 92.2, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1, 80.4, and 86.9%. Conclusions Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules.

scholarly journals MRI findings, including diffusion-weighted imaging and apparent diffusion coefficient value, in two cats with nasopharyngeal polyps and one cat with lymphoma

2018 ◽  
Vol 4 (2) ◽  
pp. 205511691881225 ◽  
Author(s):  
Toshiyuki Tanaka ◽  
Hideo Akiyoshi ◽  
Keiichiro Mie ◽  
Hidetaka Nishida
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Diffusion Weighted Imaging ◽  
Mri Findings ◽  
Adc Value ◽  
Mri Examination ◽  
Diffusion Weighted ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Adc Map

Objectives Most nasopharyngeal masses in cats are lymphomas or polyps. To our knowledge, there is no report of MRI findings, including diffusion-weighted imaging (DWI) or apparent diffusion coefficient (ADC) values, of nasopharyngeal lymphomas and nasopharyngeal polyps in cats. This study aimed to evaluate the MRI findings of nasopharyngeal lymphomas and nasopharyngeal polyps, including DWI and ADC values. Methods MRI examination was performed on two cats with a histologically confirmed nasopharyngeal polyp and one cat with lymphoma. The magnetic resonance scanning protocol included T2-weighted imaging (T2WI), T1-weighted imaging (T1WI) and DWI. An ADC map was created based on DWI. ADC values were then calculated. Results MRI of the nasopharyngeal polyps revealed well-defined masses with strong rim enhancement, mass-associated stalk-like structures and asymmetric tympanic bulla lesions. The polyps appeared hyperintense on T2WI, hypo- to isointense on T1WI, and of mixed intensity or hypointense on DWI. On the ADC map, the masses appeared hyperintense. The ADC values of the polyps were 2.07 × 10−3 mm2/s and 2.28 × 10−3 mm2/s. MRI examination of the nasopharyngeal lymphoma revealed a strongly enhancing heterogeneous lesion. The mass appeared mildly hyperintense on T2WI, isointense on T1WI and hyperintense on DWI. On the ADC map, the mass appeared hypointense. The ADC value of the mass was 0.46 ×10−3 mm2/s. The ADC values of the nasopharyngeal polyps were higher than the ADC value of the nasopharyngeal lymphoma. Conclusions and relevance Measurement of ADC values may be useful for differentiating between nasopharyngeal polyps and nasopharyngeal lymphomas.

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.

scholarly journals Diffusion-weighted magnetic resonance imaging in cystic renal masses

2017 ◽  
Vol 11 (1-2) ◽  
pp. 8 ◽  
Author(s):  
Fikret Balyemez ◽  
Ahmet Aslan ◽  
Ibrahim Inan ◽  
Ercan Ayaz ◽  
Vildan Karagöz ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Renal Cysts ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Renal Masses ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri

Introduction: We aimed to introduce the diagnostic value of diffusion-weighted (DWI) magnetic resonance imaging (MRI) for distinguishing benign and malignant renal cystic masses.Methods: Abdominal DWI-MRIs of patients with Bosniak categories 2F, 3, and 4 cystic renal masses were evaluated retrospectively. Cystic masses were assigned as benign or malignant according to histopathological or followup MRI findings and compared with apparent diffusion coefficient (ADC) values.Results: There were 30 patients (18 males and 12 females, mean age was 59.23 ± 12.08 years [range 38‒83 years]) with cystic renal masses (eight Bosniak category 2F, 12 Bosniak category 3, 10 Bosniak category 4). Among them, 14 cysts were diagnosed as benign and 16 as malignant by followup imaging or histopathological findings. For the malignant lesions, the mean ADC values were lower than for benign lesions (p=0.001). An ADC value of ≤2.28 x10-6 mm2/s or less had a sensitivity of 75% and a specificity of 92.86% for detecting malignancy.Conclusions: ADC can improve the diagnostic performance of MRI in the evaluation of complex renal cysts when used together with conventional MRI sequences.

Combining tumor size and diffusion-weighted imaging to diagnose normal-sized metastatic pelvic lymph nodes in cervical cancers

2018 ◽  
Vol 60 (3) ◽  
pp. 388-395 ◽  
Author(s):  
Jiacheng Song ◽  
Qiming Hu ◽  
Junwen Huang ◽  
Zhanlong Ma ◽  
Ting Chen
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Size ◽  
Diffusion Weighted Imaging ◽  
Area Under The Curve ◽  
Adc Value ◽  
Cervical Cancers ◽  
Pelvic Lymph Nodes ◽  
Diffusion Weighted

Background Detecting normal-sized metastatic pelvic lymph nodes (LNs) in cervical cancers, although difficult, is of vital importance. Purpose To investigate the value of diffusion-weighted-imaging (DWI), tumor size, and LN shape in predicting metastases in normal-sized pelvic LNs in cervical cancers. Material and Methods Pathology confirmed cervical cancer patients with complete magnetic resonance imaging (MRI) were documented from 2011 to 2016. A total of 121 cervical cancer patients showed small pelvic LNs (<5 mm) and 92 showed normal-sized (5–10 mm) pelvic LNs (39 patients with 55 nodes that were histologically metastatic, 53 patients with 71 nodes that were histologically benign). Preoperative clinical and MRI variables were analyzed and compared between the metastatic and benign groups. Results LN apparent diffusion coefficient (ADC) values and short-to-long axis ratios were not significantly different between metastatic and benign normal-sized LNs (0.98 ± 0.15 × 10−3 vs. 1.00 ± 0.18 × 10−3 mm2/s, P = 0.45; 0.65 ± 0.16 vs. 0.64 ± 0.16, P = 0.60, respectively). Tumor ADC value of the metastatic LNs was significantly lower than the benign LNs (0.98 ± 0.12 × 10−3 vs. 1.07 ± 0.21 × 10−3 mm2/s, P = 0.01). Tumor size (height) was significantly higher in the metastatic LN group (27.59 ± 9.18 mm vs. 21.36 ± 10.40 mm, P < 0.00). Spiculated border rate was higher in the metastatic LN group (9 [16.4%] vs. 3 [4.2%], P = 0.03). Tumor (height) combined with tumor ADC value showed the highest area under the curve of 0.702 ( P < 0.00) in detecting metastatic pelvic nodes, with a sensitivity of 59.1% and specificity of 78.8%. Conclusions Tumor DWI combined with tumor height were superior to LN DWI and shape in predicting the metastatic state of normal-sized pelvic LNs in cervical cancer patients.

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.

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