scholarly journals The value of the added diffusion-weighted images to multiparametric MRI in the early diagnosis of uterine cervix cancers and nodal assessment

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Nasr Mohamed Osman ◽  
Mohamed Aboul-fotouh Mourad
Keyword(s):  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Multiparametric Mri ◽  
Lesion Group ◽  
Cervical Lesions ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Group I ◽  
Malignant Lesions ◽  
The Mean

Abstract Background Cervical cancer still one of the most common causes of tumor-related death in developing countries presented in younger women. In this study, we aimed to evaluate the value of diffusion-weighted MRI in early diagnosis of malignant cervical lesions, to assess metastatic adenopathy, peritoneal dissemination, and possible tumor recurrence, and determine treatment response. This study included 60 patients with abnormal vaginal bleeding and suspected cervical lesion by US. A histopathological biopsy was done. Pelvic MR with DWI and dynamic contrast-enhanced MRI were done for all patients. Results According to the histopathological findings, we divided our studied 60 patents into two groups: group I, malignant lesions (46 lesions; 76.7%), and group II, benign lesions (14 lesions; 23.3%). Multiparametric MRI could detect all cervical lesions but with poor pathologic characterization, achieving 72.37% sensitivity, 37.50% specificity, 63.33% accuracy, 76.19% PPV, and 33.33% NPV. When compared with DWI with ADC value measurements at high b value (b = 800) to MRI exam, it showed a higher diagnostic accuracy with good lesion pathological characterization that achieved 95.65% sensitivity, 71.43% specificity, 90% accuracy, 91.67 PPV, and 83.33% NPV. The mean ADC value for malignant lesions was 0.86–1.1, mean = 0.92 ± 0.71 × 10−3 mm2/s, while the mean ADC value in the benign lesion group was 1.18 ± 0.1 × 10–3 mm2/s. Conclusion Comparing DWI with ADC values measurements at high b value to the multiparametric MRI examination of the female pelvis increases the sensitivity, specificity, and diagnostic accuracy of characterization and early diagnosis of cervical malignant focal lesions and reduces the need for intravenous contrast administration.

scholarly journals Role of MRI diffusion weighted imaging in differentiation between benign and malignant ovarian masses

2019 ◽  
Vol 13 (2) ◽  
pp. 26-33
Author(s):  
Mohammed Abd Kadhim ◽  
Lina Saad Jaafer
Keyword(s):  
Signal Intensity ◽  
Diffusion Weighted Imaging ◽  
Solid Component ◽  
Fluid Viscosity ◽  
Benign Lesions ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Malignant Lesions ◽  
The Mean ◽  
Ovarian Masses

Background: Characterization of the ovarian masses preoperatively is important to inform the surgeon about the possible management strategies. MRI may be of great help in identifying malignant lesion before surgery. Diffusion Weighted Imaging (DWI) is a sensitive method for changes in proton of water mobility caused by pathological alteration of tissue cellularity, cellular membrane integrity, extracellular space perfusion, and fluid viscosity. Objective: to study the diagnostic accuracy of DWI in differentiation between benign and malignant ovarian masses. Type of the study:Cross-sectional study. Methods: this study included  53with complex ovarian mass or masses ,Diffusion Weighted Imaging was obtained to all these patient with correlation to the histopathological results; the Signal Intensity (SI) of the solid and cystic part of the lesions was evaluated on T2 and Diffusion Weighted Imaging  ,with Apparent Diffusion Coefficient (ADC) values were also obtained . Results: 22 masses out of the total 53 were malignant and 31 were benign .On DWI the high SI intensity observed more frequently in the malignant lesions than the benign lesions (p value 0.0293) .There was significant difference between the mean ADC value of the malignant and benign ovarian lesions, with the mean ADC value for the benign lesions solid component =1.05 x10 -3, and the mean ADC value for the malignant lesions solid component =0.91 x10-3. The ROC study reveals that 0.926 x 10 -3  may be the optimal cutoff value  with sensitivity 54.8 %, specificity 59.1%, NPV 48.15 %, PPV 63.39%  , Accuracy 56.6%. With exclusion of the teratoma and endometriomas from statistical analysis the ROC reveals that 0.99 x10 -3  may be the optimal cut off value with sensitivity 76.9 % , specificity 77.3% , PPV 66.67% , NPP 85% and  accuracy 77.14% Conclusions: Combined with conventional pelvic MRI, DWI is a helpful tool in differentiation between benign and malignant ovarian masses, with high signal intensity on DWI more frequently observed in the malignant than benign ovarian lesions.

scholarly journals Role of diffusion weighted MR imaging in differentiating benign from malignant prostate lesions

2019 ◽  
Vol 7 (6) ◽  
pp. 2341
Author(s):  
Sachin . ◽  
Kirti Chaturvedy ◽  
R. N. Gehlot ◽  
Prateek Sihag ◽  
Suman Kumari ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Diagnostic Accuracy ◽  
Chronic Prostatitis ◽  
Benign Lesion ◽  
Malignant Lesion ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values ◽  
The Mean ◽  
Sensitivity Specificity

Background: The purpose of the study was to determine the diagnostic accuracy of diffusion weighted MR imaging and to propose a cut off ADC value in differentiating benign from malignant prostatic lesions considering histopathology as gold standard.Methods: It is a descriptive type of observational study done on 40 patients with clinical suspicion of prostate carcinoma and elevated PSA level more than 4ng/ml. The patients underwent Multiparametric prostate MRI and ADC values were calculated using ADC maps.Results: Of the 40 cases included in the study histopathology revealed a diagnosis of abscess (1), chronic prostatitis (2), BPH with chronic prostatitis (4), BPH (12), and malignancy (21). The mean and standard deviation (SD) of ADC values for the abscess (0.59), CP (0.83+0.16), BPH with CP (0.94+0.22), BPH (1.14+0.14) and malignancy (0.72+0.15) (x10-3mm2/s) were found in our study. The mean ADC value of malignant lesion was lower (0.727+0.149) as compare to benign lesion (1.034+0.216) and this difference was found to be statistically significant with p<0.001. By using ROC curve, ADC cut off value was calculated as 0.92 x 10-3mm2/s and sensitivity, specificity at this cut off value of ADC were 95.24% and 73.68% respectively. The PPV, NPV, diagnostic accuracy of at this cut off value of ADC were 80%, 93.33%, 85% respectively.Conclusions: Our study shows that DWI with ADC calculation helps in differentiation of Benign from Malignant prostatic lesions with high accuracy and this quantitative analysis should be incorporated in routine MRI evaluation of prostatic lesions

scholarly journals Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ali Elsorougy ◽  
Hashim Farg ◽  
Dalia Bayoumi ◽  
Mohamed Abou El-Ghar ◽  
Magda Shady
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Multiparametric Mri ◽  
Histopathological Analysis ◽  
Adc Value ◽  
Intensity Index ◽  
Apparent Diffusion ◽  
The Mean

Abstract Background MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma. Results There were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001). Conclusion Our study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.

scholarly journals Role of diffusion-weighted magnetic resonance imaging in assessment of mammographically detected asymmetric densities

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Zidan ◽  
Shimaa Ali Saad ◽  
Eman Abo Elhamd ◽  
Hosam Eldin Galal ◽  
Reem Elkady
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Benign Lesions ◽  
Adc Value ◽  
Dce Mri ◽  
Diffusion Weighted ◽  
Breast Asymmetries ◽  
Malignant Lesions

Abstract Background Asymmetric breast density is a potentially perplexing finding; it may be due to normal hormonal variation of the parenchymal pattern and summation artifact or it may indicate an underlying true pathology. The current study aimed to identify the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) values in the assessment of breast asymmetries. Results Fifty breast lesions were detected corresponding to the mammographic asymmetry. There were 35 (70%) benign lesions and 15 (30%) malignant lesions. The mean ADC value was 1.59 ± 0.4 × 10–3 mm2/s for benign lesions and 0.82 ± 0.3 × 10–3 mm2/s for malignant lesions. The ADC cutoff value to differentiate between benign and malignant lesions was 1.10 × 10–3 mm2/s with sensitivity 80%, specificity 88.6%, positive predictive value 75%, negative predictive value 91%, and accuracy 86%. Best results were achieved by implementation of the combined DCE-MRI and DWI protocol, with sensitivity 93.3%, specificity 94.3%, positive predictive value 87.5%, negative predictive value 97.1%, and accuracy 94%. Conclusion Dynamic contrast-enhanced MRI (DCE-MRI) was the most sensitive method for the detection of the underlying malignant pathology of breast asymmetries. However, it provided a limited specificity that may cause improper final BIRADS classification and may increase the unnecessary invasive procedures. DWI was used as an adjunctive method to DCE-MRI that maintained high sensitivity and increased specificity and the overall diagnostic accuracy of breast MRI examination. Best results can be achieved by the combined protocol of DCE-MRI and DWI.

Diffusion-weighted magnetic resonance imaging of cervical cancer

2011 ◽  
Vol 18 (4) ◽  
pp. 139-146
Author(s):  
Vaida ATSTUPĖNAITĖ ◽  
Algidas BASEVIČIUS ◽  
Adrijus KRIMELIS ◽  
Artūras INČIŪRA ◽  
Daiva VAITKIENĖ
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Chemoradiation Therapy ◽  
Cervical Tissue ◽  
Resonance Imaging ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging ◽  
The Mean

Background. Diffusion-weighted magnetic resonance imaging (DW–MRI) has been employed in the diagnostics of malignant tumors of abdomen and pelvis relatively recently. Nowadays, there exists a particular interest in adaptation DW–MRI for assessing the response of tumors to chemoradiaton therapy. The aim of our study was to compare the mean value of the apparent diffusion coefficient (ADC) in a healthy cervix, cancer-affected cervix and a cervix after chemoradiation therapy, as well as to identify the ADC range typical of cervical cancer. Materials and methods. The study enrolled 108 female patients who underwent pelvic MRI in the Lithuanian University of Health Sciences Kaunas Clinics Hospital in 2008–2010. The study group consisted of 65 patients in whom cervical cancer had been clinically suspected and confirmed by biopsy before MRI examination. All these patients underwent pelvic MRI twice: before the chemoradiation therapy and 6 months after the therapy. The control group consisted of 43 patients in whom cervical cancer had been not suspected and MRI was performed because of other pelvic diseases. Results. The mean ADC value of the study group (0.658 ± 0.118 × 10–3 mm2/s) was lower than of the control group (1.171 ± 0.143 × 10–3 mm2/s) (t = 20.315, p = 0.03). The ADC threshold value of 0.945 × 10–3 mm2/s was defined, differentiating the cancer-affected cervical tissue from the normal. The mean ADC value of the patients who responded to chemoradiation therapy (1.111 ± 0.138 × 10–3 mm2/s) increased and in those who did not respond it remained lower (0.733 ± 0.073 × 10–3 mm2/s) (t = 9.518, p = 0.04). The ADC threshold value of 0.830 × 10–3 mm2/s was defined, differentiating the residual tumor tissue from the healthy cervical tissue after chemoradiation therapy. Conclusions. The ADC value in the case of cervical cancer was significantly lower than in the non-affected cervical tissue. The ADC value increases after effective chemoradiation therapy and becomes closer to the coefficient value of non-affected cervical tissue, but still remains lower. The 0.945 × 10–3 mm2/s ADC threshold was detected while differentiating between cancer-affected and normal cervical tissues, while the ADC threshold was 0.830 × 10–3 mm2/s when differentiating between residual tumor tissue and healthy cervical tissue after chemoradiation therapy at a high sensitivity and specificity. Keywords: diffusion-weighted magnetic resonance imaging, apparent diffusion coefficient, cervical cancer, chemoradiation therapy

scholarly journals Analysis of Cerebrospinal Fluid (CSF) – Adenosine Deaminase (ADA) in Meningitis

2021 ◽  
Vol 10 (16) ◽  
pp. 1102-1105
Author(s):  
Akkamahadevi V. Nipanal ◽  
Madhukumar M.H ◽  
Nagappa H
Keyword(s):  
Cerebrospinal Fluid ◽  
Early Diagnosis ◽  
Adenosine Deaminase ◽  
Viral Meningitis ◽  
Tubercular Meningitis ◽  
Acid Fast Bacilli ◽  
Group I ◽  
Adenosine Deaminase Activity ◽  
Function Test ◽  
The Mean

BACKGROUND Acute infections of the nervous system are generally widespread and cause significant problems in the field medicine and therefore early detection, right decision making, and early initiation of therapy can be lifesaving. Meningitis is the inflammation of the membranes that cover the brain and spinal cord. It is a general clinical problem during infancy and childhood. Delay in differentiating between bacterial, tubercular & viral meningitis and institution of its treatment may have irreparable consequences that lead to significant morbidity & mortality. The present study was conducted to find out the utility of cerebrospinal fluid-adenosine deaminase (CSF-ADA) for the early diagnosis & differentiation of tubercular & viral meningitis in adults. METHODS 50 meningitis patients who met the inclusion criteria were selected. Investigations including complete haemogram, liver function test (LFT), renal function test (RFT), random blood sugar (RBS), serum electrolytes, human immunodeficiency virus (HIV) test, chest x-ray and computed tomography (CT) brain (plain) were done. CSF cytology, biochemistry, gram stain, acid-fast bacteria (AFB) stain & culture were done. These cases were further divided in to two groups based on clinical and CSF laboratory findings as group I: tubercular meningitis, group II: viral meningitis. An estimation of CSF-ADA was done in all patients. RESULTS The mean age of the 50 patients studied was 37.76 + 15.58 years, with the maximum number of patients suffering from tubercular meningitis. The incidence of meningitis was more in males. CSF-adenosine deaminase activity was found to be higher in tubercular meningitis, the mean value was 17.67 ± 8.13 IU / L. CONCLUSIONS Assessment of CSF-ADA will be helpful for early diagnosis and differentiation of tubercular and viral meningitis. This is needed when gold standard investigations for meningitis like smear and / or culture for acid fast bacilli are not available or negative or are time consuming. KEY WORDS CSF-Cerebrospinal Fluid, ADA-Adenosine Deaminase, AFB-Acid Fast Bacilli.

scholarly journals Role of diffusion-weighted MRI in diagnosis and post therapeutic follow-up of colorectal cancer

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mina Sameh Sabry ◽  
Amany Emad Eldeen Rady ◽  
Gamal Eldeen Mohamed Niazi ◽  
Susan Adil Ali
Keyword(s):  
Colorectal Cancer ◽  
Initial Assessment ◽  
Diffusion Weighted Mri ◽  
Response Evaluation ◽  
Adc Value ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Response To Chemotherapy ◽  
The Mean

Abstract Background The colorectal cancer (CRC) is one of the deadliest cancers in the world. Local tumor stage, vascular or lymphatic invasion, and tumor grade are essential for accurate management. The main imaging modality for initial assessment and therapeutic response evaluation of CRC is magnetic resonance imaging (MRI). The purpose of this prospective study was to illustrate the role of diffusion-weighted MRI (DWI) and apparent diffusion coefficient (ADC) value in initial assessment and grading of colorectal carcinoma as well as evaluation of its response to chemotherapy or combined chemoradiation. Results Restricted diffusion in DWI was found in 37 out of 40 patients with sensitivity of about 92.5%. In the studied group, the median ADC value was 1.21 (min 0.80, max 1.31) and the average ADC value was 1.14 ± 0.161. The mean ADC value in poorly differentiated tumors was 0.979 × 10−3mm2/s. The mean ADC value in moderately differentiated tumors was 1.112 × 10−3mm2/s. The mean ADC value in well-differentiated tumors was 1.273 × 10−3mm2/s. The sensitivity, specificity, PPV, NPV, and accuracy were higher with addition of DWI and ADC value to conventional MRI reaching 100%, 80%, 83.3%, 100%, and 90%, respectively. Conclusion Adding DW imaging with ADC value to conventional MRI yields better diagnostic accuracy than using conventional MR imaging alone in detection, correlation with tumor histologic grade, initial staging, and response evaluation to neoadjuvant chemoradiotherapy in patients with locally advanced colorectal cancer.

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