All that glitters are not gold: holds true in female adnexal lesions

Abstract Background Adnexal mass lesions are commonly encountered pathologies that creates diagnostic challenges for radiologist. Diffusion weighted imaging is a vital tool in the radiologist armamentarium for improving the diagnostic accuracy of adnexal lesions other than routine spine echo sequences. Main body Functional information about the lesion regarding the mobility of the water molecules in its tissue is assessed by diffusion weighted imaging. In addition to the solid malignant neoplasm, normal blood, fat, necrosis and pus also shows restricted diffusion. Conclusion All the lesion that shows restriction in the DWI are not malignant, but converse is mostly true. Knowledge regarding the non-malignant lesion in the ovary that shows restricted diffusion will give a clue in diagnosis, management and treatment of the adnexal lesions.

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Diffusion-Weighted Imaging in Oncology: An Update

Cancers ◽

10.3390/cancers12061493 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1493 ◽

Cited By ~ 2

Author(s):

Carmelo Messina ◽

Rodolfo Bignone ◽

Alberto Bruno ◽

Antonio Bruno ◽

Federico Bruno ◽

...

Keyword(s):

Diffusion Weighted Imaging ◽

Water Molecules ◽

Non Invasive ◽

Diffusion Weighted ◽

Routine Magnetic Resonance Imaging ◽

Treatment Responses ◽

Magnetic Resonance Imaging Mri ◽

Almost All

To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the “functional” information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.

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LIMITATIONS OF DIFFUSION-WEIGHTED IMAGING IN THE DIAGNOSIS OF POSTOPERATIVE INFECTIONS

Neurosurgery ◽

10.1227/01.neu.0000311349.25281.bd ◽

2008 ◽

Vol 62 (3) ◽

pp. 577-583 ◽

Cited By ~ 18

Author(s):

Christopher J. Farrell ◽

Brian L. Hoh ◽

Mary L. Pisculli ◽

John W. Henson ◽

Fred G. Barker ◽

...

Keyword(s):

False Positive ◽

Diffusion Weighted Imaging ◽

Postoperative Infection ◽

False Negative ◽

False Negative Rate ◽

Restricted Diffusion ◽

Postoperative Infections ◽

Negative Rate ◽

Diffusion Weighted ◽

Diagnosis Of Infection

Abstract OBJECTIVE Diffusion-weighted imaging (DWI) has assumed a rapidly emerging role in the diagnosis of intracranial infection; however, its usefulness in the recognition of postoperative infection has been largely unexplored. We sought to determine the ability of DWI to accurately detect a broad range of postneurosurgical infections as well as identify individual factors that may limit its applicability. METHODS We retrospectively identified 65 patients who had undergone surgery for the confirmed diagnosis of infection between August 2001 and February 2005 and had received preoperative magnetic resonance imaging evaluation, including DWI. Fifty patients developed infections after a primary neurosurgical procedure (“postoperative” infections), whereas 15 infections occurred without antecedent intervention (“spontaneous” infections). Logistic regression analysis was used to identify factors associated with false-negative DWI findings. Additionally, we investigated the false-positive rate of DWI by retrospectively reviewing a series of 30 consecutive patients who underwent craniotomy and received postoperative DWI. RESULTS Spontaneously developing cranial infections exhibited evidence of restricted diffusion in 14 out of 15 (93%) patients; however, infections that occurred postoperatively were associated with a significant false-negative rate using DWI (36%; P < 0.01). Within the subset of patients with postoperative infection, location of infection significantly correlated with the DWI false-negative rate. Infections located extradurally were less likely to demonstrate restricted diffusion compared with those located primarily within the subdural or intraparenchymal spaces. Additionally, false-positive DWI findings were observed in 11 of the 30 patients (37%) who had DWI obtained postoperatively in the absence of infection. CONCLUSION Utilization of DWI for the diagnosis of infection after primary neurosurgical intervention is associated with an elevated false-negative rate. The absence of restricted diffusion is not sufficient to exclude the presence of pyogenic postcraniotomy infection and should not be used as the principle determinant of patient management in this clinical setting.

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Indeterminate Orbital Masses: Restricted Diffusion at MR Imaging with Echo-planar Diffusion-weighted Imaging Predicts Malignancy

Yearbook of Ophthalmology ◽

10.1016/j.yoph.2011.02.034 ◽

2011 ◽

Vol 2011 ◽

pp. 210-212

Author(s):

K. Talekar ◽

A.E. Flanders

Keyword(s):

Mr Imaging ◽

Diffusion Weighted Imaging ◽

Restricted Diffusion ◽

Diffusion Weighted ◽

Orbital Masses ◽

Echo Planar

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Differential diagnosis of intracranial ring enhancing cystic mass lesions—Role of diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI)

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2009.11.016 ◽

2010 ◽

Vol 112 (3) ◽

pp. 218-225 ◽

Cited By ~ 49

Author(s):

Werner Reiche ◽

Volker Schuchardt ◽

Thomas Hagen ◽

Kamil A. Il’yasov ◽

Peter Billmann ◽

...

Keyword(s):

Differential Diagnosis ◽

Diffusion Tensor Imaging ◽

Diffusion Weighted Imaging ◽

Diffusion Tensor ◽

Cystic Mass ◽

Diffusion Weighted ◽

Mass Lesions ◽

And Diffusion ◽

Diffusion Tensor Imaging Dti

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Diffusion-weighted imaging of suspicious (BI-RADS 4) breast lesions: stratification based on histopathology

Radiologia Brasileira ◽

10.1590/0100-3984.2015.0224 ◽

2017 ◽

Vol 50 (3) ◽

pp. 154-161 ◽

Cited By ~ 6

Author(s):

João Ricardo Maltez de Almeida ◽

André Boechat Gomes ◽

Thomas Pitangueira Barros ◽

Paulo Eduardo Fahel ◽

Mario de Souza Rocha

Keyword(s):

High Risk ◽

Coefficient Of Variation ◽

Diffusion Weighted Imaging ◽

Roc Curves ◽

Sampling Period ◽

Breast Lesions ◽

Real Difference ◽

Diffusion Weighted ◽

Adc Values ◽

Mass Lesions

Abstract Objective: To test the use of diffusion-weighted imaging (DWI) in stratifying suspicious breast lesions (BI-RADS 4), correlating them with histopathology. We also investigated the performance of DWI related to the main enhancement patterns (mass and non-mass) and tested its reproducibility. Materials and Methods: Seventy-six patients presented 92 lesions during the sampling period. Two independent examiners reviewed magnetic resonance imaging studies, described the lesions, and determined the apparent diffusion coefficient (ADC) values. Differences among benign, indeterminate- to high-risk, and malignant findings, in terms of the ADCs, were assessed by analysis of variance. Using receiver operating characteristic (ROC) curves, we compared the performance of ADC values in masses and non-mass lesions, and tested the reproducibility of measurements by determining the coefficient of variation and smallest real difference. Results: Among the 92 lesions evaluated, the histopathology showed that 37 were benign, 11 were indeterminate- to high-risk, and 44 were malignant. The mean ADC differed significantly among those histopathological groups, the value obtained for the malignant lesions (1.10 × 10-3 mm2/s) being significantly lower than that obtained for the other groups (p < 0.001). ROC curves demonstrated that DWI performed better when applied to masses than when applied to non-mass lesions (area under the curve, 0.88 vs. 0.67). Reproducibility was good (coefficient of variation, 7.03%; and smallest real difference, ± 0.242 × 10-3 mm2/s). Conclusion: DWI can differentiate between malignant and nonmalignant (benign or indeterminate- to high-risk) lesions, showing better performance for masses. Nevertheless, stratification based on histopathological criteria that are more refined has yet to be achieved.

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