scholarly journals Whole-body diffusion-weighted MRI of normal lymph nodes: prospective apparent diffusion coefficient histogram and nodal distribution analysis in a healthy cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ricardo Donners ◽  
Raphael Shih Zhu Yiin ◽  
Matthew Blackledge ◽  
Dow-Mu Koh
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Lymph Nodes ◽  
Healthy Volunteers ◽  
The Body ◽  
Whole Body ◽  
Distribution Analysis ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Global Mean

Abstract Background Whole body DWI (WB-DWI) enables the identification of lymph nodes for disease evaluation. However, quantitative data of benign lymph nodes across the body are lacking to allow meaningful comparison of diseased states. We evaluated apparent diffusion coefficient (ADC) histogram parameters of all visible lymph nodes in healthy volunteers on WB-DWI and compared differences in nodal ADC values between anatomical regions. Methods WB-DWI was performed on a 1.5 T MR system in 20 healthy volunteers (7 female, 13 male, mean age 35 years). The b900 images were evaluated by two radiologists and all visible nodes from the neck to groin areas were segmented and individual nodal median ADC recorded. All segmented nodes in a patient were summated to generate the total nodal volume. Descriptors of the global ADC histogram, derived from individual node median ADCs, including mean, median, skewness and kurtosis were obtained for the global volume and each nodal region per patient. ADC values between nodal regions were compared using one-way ANOVA with Bonferroni post hoc tests and a p-value ≤0.05 was deemed statistically significant. Results One thousand sixty-seven lymph nodes were analyzed. The global mean and median ADC of all lymph nodes were 1.12 ± 0.27 (10− 3 mm2/s) and 1.09 (10− 3 mm2/s). The average median ADC skewness was 0.25 ± 0.02 and average median ADC kurtosis was 0.34 ± 0.04. The ADC values of intrathoracic, portal and retroperitoneal nodes were significantly higher (1.53 × 10− 3, 1.75 × 10− 3 and 1.58 × 10− 3 mm2/s respectively) than in other regions. Intrathoracic, portal and mesenteric nodes were relatively uncommon, accounting for only 3% of the total nodes segmented. Conclusions The global mean and median ADC of all lymph nodes were 1.12 ± 0.27 (10− 3 mm2/s) and 1.09 (10− 3 mm2/s). Intrathoracic, portal and retroperitoneal nodes display significantly higher ADCs. Normal intrathoracic, portal and mesenteric nodes are infrequently visualized on WB-DWI of healthy individuals. Trial registration Royal Marsden Hospital committee for clinical research registration number 09/H0801/86, 19.10.2009.

scholarly journals Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

2021 ◽  
Author(s):  
Alexey Surov ◽  
Hans-Jonas Meyer ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Jasan Omari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Lymph Nodes ◽  
Meta Analysis ◽  
Adc Value ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background Our aim was to provide data regarding use of diffusion-weighted imaging (DWI) for distinguishing metastatic and non-metastatic lymph nodes (LN) in rectal cancer. Methods MEDLINE library, EMBASE, and SCOPUS database were screened for associations between DWI and metastatic and non-metastatic LN in rectal cancer up to February 2021. Overall, 9 studies were included into the analysis. Number, mean value, and standard deviation of DWI parameters including apparent diffusion coefficient (ADC) values of metastatic and non-metastatic LN were extracted from the literature. The methodological quality of the studies was investigated according to the QUADAS-2 assessment. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian, and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean DWI values including 95% confidence intervals were calculated for metastatic and non-metastatic LN. Results ADC values were reported for 1376 LN, 623 (45.3%) metastatic LN, and 754 (54.7%) non-metastatic LN. The calculated mean ADC value (× 10−3 mm2/s) of metastatic LN was 1.05, 95%CI (0.94, 1.15). The calculated mean ADC value of the non-metastatic LN was 1.17, 95%CI (1.01, 1.33). The calculated sensitivity and specificity were 0.81, 95%CI (0.74, 0.89) and 0.67, 95%CI (0.54, 0.79). Conclusion No reliable ADC threshold can be recommended for distinguishing of metastatic and non-metastatic LN in rectal cancer.

scholarly journals Evaluating Spinal Canal Lesions Using Apparent Diffusion Coefficient Maps with Diffusion-Weighted Imaging

2020 ◽  
Vol 14 (3) ◽  
pp. 312-319 ◽  
Author(s):  
Hirohito Kanamoto ◽  
Masaki Norimoto ◽  
Yawara Eguchi ◽  
Yasuhiro Oikawa ◽  
Sumihisa Orita ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Healthy Volunteers ◽  
Spinal Canal ◽  
Decompression Surgery ◽  
Cross Sectional ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Apparent Diffusion ◽  
Adc Values

Study Design: Observational study.Purpose: To evaluate healthy volunteers and patients with spinal canal lesions using apparent diffusion coefficient (ADC) maps with diffusion-weighted imaging.Overview of Literature: Decompression surgery for lumbar spinal stenosis (LSS) is selected on the basis of subjective assessment and cross-sectional magnetic resonance imaging (MRI). However, there is no objective standard for this procedure.Methods: We performed 3T MRI in 10 healthy volunteers and 13 patients with LSS. The ADC values in the spinal canal were evaluated at 46 vertebrae (L4/5 and L5/S1 for each participant), and the reduced and conventional fields of view were compared.Results: The ADC values were 2.72±0.12 at L4/5 in healthy volunteers, 2.76±0.19 at L5/S1 in healthy volunteers, 1.77±0.58 at L4/5 in patients with LSS, and 2.35±0.29 at L5/S1 in patients with LSS. The ADC value at L4/5 in patients with LSS was significantly lower than that at L5/S1 in patients with LSS and that at L4/5 and L5/S1 in healthy volunteers (<i>p</i> <0.05). With an ADC cutoff value of 2.46 to identify LSS, this approach provided an area under the curve of 0.81, sensitivity of 0.92, and specificity of 0.76 (<i>p</i> <0.05).Conclusions: Preoperative examination using ADC maps permits visualization and quantification of spinal canal lesions, thus proving the utility of ADC maps in the selection of decompression surgery for LSS.

Diagnostic value of apparent diffusion coefficient in differentiating between high-grade gliomas and brain metastases

2017 ◽  
Vol 59 (5) ◽  
pp. 599-605 ◽  
Author(s):  
Ionut Caravan ◽  
Cristiana Augusta Ciortea ◽  
Alexandra Contis ◽  
Andrei Lebovici
Keyword(s):  
Diffusion Coefficient ◽  
Brain Metastases ◽  
Apparent Diffusion Coefficient ◽  
Curve Analysis ◽  
High Grade ◽  
Peritumoral Edema ◽  
Roc Curve Analysis ◽  
Apparent Diffusion ◽  
Adc Values ◽  
The Mean

Background High-grade gliomas (HGGs) and brain metastases (BMs) can display similar imaging characteristics on conventional MRI. In HGGs, the peritumoral edema may be infiltrated by the malignant cells, which was not observed in BMs. Purpose To determine whether the apparent diffusion coefficient values could differentiate HGGs from BMs. Material and Methods Fifty-seven patients underwent conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) before treatment. The minimum and mean ADC in the enhancing tumor (ADCmin, ADCmean) and the minimum ADC in the peritumoral region (ADCedema) were measured from ADC maps. To determine whether there was a statistical difference between groups, ADC values were compared. A receiver operating characteristic (ROC) curve analysis was used to determine the cutoff ADC value for distinguishing between HGGs and BMs. Results The mean ADCmin values in the intratumoral regions of HGGs were significantly higher than those in BMs. No differences were observed between groups regarding ADCmean values. The mean ADCmin values in the peritumoral edema of HGGs were significantly lower than those in BMs. According to ROC curve analysis, a cutoff value of 1.332 × 10−3 mm2/s for the ADCedema generated the best combination of sensitivity (95%) and specificity (84%) for distinguishing between HGGs and BMs. The same value showed a sensitivity of 95.6% and a specificity of 100% for distinguishing between GBMs and BMs. Conclusion ADC values from DWI were found to distinguish between HGGs and solitary BMs. The peritumoral ADC values are better than the intratumoral ADC values in predicting the tumor type.

The Potential Role of Peritumoral Apparent Diffusion Coefficient Evaluation in Differentiating Glioblastoma and Solitary Metastatic Lesions of the Brain

2021 ◽  
Vol 17 ◽  
Author(s):  
Murat Tepe ◽  
Suzan Saylisoy ◽  
Ugur Toprak ◽  
Ibrahim Inan
Keyword(s):  
Diffusion Coefficient ◽  
White Matter ◽  
Apparent Diffusion Coefficient ◽  
Sensitivity And Specificity ◽  
Brain Mri ◽  
Solitary Metastasis ◽  
Metastatic Lesions ◽  
Institutional Review ◽  
Apparent Diffusion ◽  
Adc Values

Objective: Differentiating glioblastoma (GBM) and solitary metastasis is not always possible using conventional magnetic resonance imaging (MRI) techniques. In conventional brain MRI, GBM and brain metastases are lesions with mostly similar imaging findings. In this study, we investigated whether apparent diffusion coefficient (ADC) ratios, ADC gradients, and minimum ADC values in the peritumoral edema tissue can be used to discriminate between these two tumors. Methods: This retrospective study was approved by the local institutional review board with a waiver of written informed consent. Prior to surgical and medical treatment, conventional brain MRI and diffusion-weighted MRI (b = 0 and b = 1000) images were taken from 43 patients (12 GBM and 31 solitary metastasis cases). Quantitative ADC measurements were performed on the peritumoral tissue from the nearest segment to the tumor (ADC1), the middle segment (ADC2), and the most distant segment (ADC3). The ratios of these three values were determined proportionally to calculate the peritumoral ADC ratios. In addition, these three values were subtracted from each other to obtain the peritumoral ADC gradients. Lastly, the minimum peritumoral and tumoral ADC values, and the quantitative ADC values from the normal appearing ipsilateral white matter, contralateral white matter and ADC values from cerebrospinal fluid (CSF) were recorded. Results: For the differentiation of GBM and solitary metastasis, ADC3 / ADC1 was the most powerful parameter with a sensitivity of 91.7% and specificity of 87.1% at the cut-off value of 1.105 (p < 0.001), followed by ADC3 / ADC2 with a cut-off value of 1.025 (p = 0.001), sensitivity of 91.7%, and specificity of 74.2%. The cut-off, sensitivity and specificity of ADC2 / ADC1 were 1.055 (p = 0.002), 83.3%, and 67.7%, respectively. For ADC3 – ADC1, the cut-off value, sensitivity and specificity were calculated as 150 (p < 0.001), 91.7% and 83.9%, respectively. ADC3 – ADC2 had a cut-off value of 55 (p = 0.001), sensitivity of 91.7%, and specificity of 77.4 whereas ADC2 – ADC1 had a cut-off value of 75 (p = 0.003), sensitivity of 91.7%, and specificity of 61.3%. Among the remaining parameters, only the ADC3 value successfully differentiated between GBM and metastasis (GBM 1802.50 ± 189.74 vs. metastasis 1634.52 ± 212.65, p = 0.022). Conclusion: The integration of the evaluation of peritumoral ADC ratio and ADC gradient into conventional MR imaging may provide valuable information for differentiating GBM from solitary metastatic lesions.

Sign in / Sign up

Export Citation Format

Share Document