Diagnostic accuracy of apparent diffusion coefficient (ADC) value in differentiating malignant from benign solid liver lesions: a systematic review and meta-analysis

2021 ◽  
pp. 20210059
Author(s):  
Farhad Nalaini ◽  
Fatemeh Shahbazi ◽  
Seyedeh Maryam Mousavinezhad ◽  
Ali Ansari ◽  
Mohammadgharib Salehi
Keyword(s):  
Systematic Review ◽  
Diffusion Coefficient ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Liver Lesions ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Malignant Lesions ◽  
Malignant Liver ◽  
Malignant Liver Lesions

Objectives: We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted (DW)-MRI in the characterization of solid benign and malignant liver lesions, and to assess their value in discriminating these lesions in daily routine practice. Methods: A systematic review of PubMed, Embase, Scopus, and Web of Science was conducted to retrieve studies that used ADC values for differentiating solid benign/dysplastic nodules and malignant liver lesions. A bivariate random-effects model with pooled sensitivity and specificity values with 95% CI (confidence interval) was used. This meta-analysis was performed on the per-lesion basis. Summary receiver operating characteristic (SROC) plot and area under curve (AUC) were created. Results: A total of 14 original articles were retrieved. The combined (95% CI) sensitivity and specificity of mean ADC values for differentiating solid benign from malignant lesions were 78% (67 to 86%) and 74% (64 to 81%), respectively. The pooled (95% CI) positive and negative LRs were respectively 3 (2.3 to 3.8) and 0.3 (0.21 to 0.43). The DOR (95% CI) was 10 (7 to 15). The AUC (95% CI) of the SROC plot was 82% (78 to 85%). Reporting bias was negligible (P value of regression test = 0.36). Mean size of malignant lesions and breathing pattern of MRI were found to be sources of heterogeneity of pooled sensitivity. Conclusion: ADC measurement independently may not be an optimal diagnostic imaging method for differentiating solid malignant from solid benign hepatic lesions. The meta-analysis showed that ADC measurement had moderate diagnostic accuracy for characterizing solid liver lesions. Further prospective and comparative studies with pre-specified ADC thresholds could be performed to investigate the best MRI protocol and ADC threshold for characterizing solid liver lesions. Advances in knowledge: ADC measurement by DW-MRI does not have a good diagnostic performance to differentiate solid malignant from solid benign lesions. Therefore, we suggest not using ADC values in clinical practice to evaluate solid liver lesions.

scholarly journals Can apparent diffusion coefficient (ADC) distinguish breast cancer from benign breast findings? A meta-analysis based on 13 847 lesions

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexey Surov ◽  
Hans Jonas Meyer ◽  
Andreas Wienke
Keyword(s):  
Diffusion Coefficient ◽  
Meta Analysis ◽  
Mean Value ◽  
Breast Lesions ◽  
Benign Lesions ◽  
B Values ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Malignant Lesions ◽  
The Mean

Abstract Background The purpose of the present meta-analysis was to provide evident data about use of Apparent Diffusion Coefficient (ADC) values for distinguishing malignant and benign breast lesions. Methods MEDLINE library and SCOPUS database were screened for associations between ADC and malignancy/benignancy of breast lesions up to December 2018. Overall, 123 items were identified. The following data were extracted from the literature: authors, year of publication, study design, number of patients/lesions, lesion type, mean value and standard deviation of ADC, measure method, b values, and Tesla strength. The methodological quality of the 123 studies was checked according to the QUADAS-2 instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without any further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malign lesions. Results The acquired 123 studies comprised 13,847 breast lesions. Malignant lesions were diagnosed in 10,622 cases (76.7%) and benign lesions in 3225 cases (23.3%). The mean ADC value of the malignant lesions was 1.03 × 10− 3 mm2/s and the mean value of the benign lesions was 1.5 × 10− 3 mm2/s. The calculated ADC values of benign lesions were over the value of 1.00 × 10− 3 mm2/s. This result was independent on Tesla strength, choice of b values, and measure methods (whole lesion measure vs estimation of ADC in a single area). Conclusion An ADC threshold of 1.00 × 10− 3 mm2/s can be recommended for distinguishing breast cancers from benign lesions.

scholarly journals Apparent Diffusion Coefficient Quantification in Determining the Histological Diagnosis of Malignant Liver Lesions

2016 ◽  
Vol 7 (6) ◽  
pp. 730-735 ◽  
Author(s):  
Konstantinos Drevelegas ◽  
Katerina Nikiforaki ◽  
Manolis Constantinides ◽  
Nickolas Papanikolaou ◽  
Lavrentios Papalavrentios ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Histological Diagnosis ◽  
Liver Lesions ◽  
Apparent Diffusion ◽  
Malignant Liver ◽  
Malignant Liver Lesions

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 Apparent diffusion coefficient can predict therapy response of hepatocellular carcinoma to transcatheter arterial chemoembolization

2021 ◽  
Author(s):  
Ralph Drewes ◽  
Constanze Heinze ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Katja Woidacki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Transcatheter Arterial Chemoembolization ◽  
Meta Analysis ◽  
Therapy Response ◽  
Adc Value ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Arterial Chemoembolization

Aim: The goal of this meta-analysis was to assess the apparent diffusion coefficient (ADC) as a pre- and posttreatment (ΔADC) predictive imaging biomarker of response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: SCOPUS database, EMBASE database and MEDLINE library were scanned for connections between pre- and posttreatment ADC values of HCC and response to TACE. Six studies qualified for inclusion. The following parameters were collected: authors, publication year, study design, number of patients, drugs for TACE, mean ADC value, standard deviation, measure method, b-values and Tesla-strength. The QUADAS-2 instrument was employed to check the methodological quality of each study. The meta-analysis was performed by utilizing RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance were used to regard heterogeneity. Mean ADC values and 95% confidence intervals were computed. Results: Six studies (n=271 patients with 293 HCC nodules) were included. The pretreatment mean ADC in the responder group was 1.20 x 10-3 mm2/s (0.98, 1.42) and 1.14 x 10-3 mm2/s (0.89, 1.39) in the non-responder group. The analysis of post TACE ADC value changes (ΔADC) revealed a threshold of ≥ 20% to identify treatment responders. No suitable pretreatment ADC threshold to predict therapy response or discriminate between responders and non-responders before therapy could be discovered. Conclusion: ΔADC can facilitate early objective response evaluation through post-therapeutic ADC alterations ≥ 20%. Pretreatment ADC cannot predict response to TACE.

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