The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI

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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THE ROLE OF DIFFUSION-WEIGHTED MRI IN DIFFERENTIAL DIAGNOSIS AND PREDICTION OF SURVIVAL IN PATIENTS WITH BRAIN METASTASES

Annals of the Russian academy of medical sciences ◽

10.15690/vramn890 ◽

2017 ◽

Vol 72 (6) ◽

pp. 442-449 ◽

Cited By ~ 2

Author(s):

V. A. Byvaltsev ◽

I. A. Stepanov ◽

A. I. Kichigin ◽

V. V. Kanigin ◽

V. V. Stupak

Keyword(s):

Overall Survival ◽

Differential Diagnosis ◽

Survival Rate ◽

Brain Metastases ◽

Overall Survival Rate ◽

Diffusion Weighted Mri ◽

Adc Value ◽

Diffusion Weighted ◽

Adc Values

Background: Brain metastases are observed in up to 40% of all intracranial tumors. Some types of metastatic tumors cause difficulties in differential diagnosis, since they have similar signal characteristics with other pathological entities in neuroimaging. Obviously, the additional diagnostic methods to determine the prognosis and tactics of further management of this group of patients should be implemented.Aim: To study the role of diffusion-weighted magnetic resonance imaging (MRI) in differential diagnostics and predicting the survival rate in patients with brain metastases. Materials and methods: The study included data from MRI and morphological studies of 23 patients with brain metastases. The obtained values of the apparent diffusion coefficient (ADC) of tumors were compared with their histological type, cell density, and the index of proliferative activity Ki-67. In addition, the influence of ADC values on the overall survival rate was assessed.Results: A reliable inverse correlation of ADC values and the index of proliferative activity for various types of brain metastases (r=-0.74, p=0.014) was established. The dependence of ADC values and overall survival rate of patients with metastases in the brain is presented. The overall survival rate in patients with an ADC value greater than 947.2 mm2/sec was 9.8 months (95% CI: 8.6−11.3), and with ADC value less than 947.2 mm2/sec ― 6.4 months (95% CI: 3.7−9.1).Conclusion: The technique of diffusion-weighted MRI plays an important role in the differential diagnosis of brain metastases; it can be used as a tool of comprehensive preoperative assessment when planning the surgery and as a prognostic factor of overall survival rate for this group of patients.

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Role of Quantitative Diffusion-Weighted Imaging in Differentiating Benign and Malignant Orbital Masses

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1730120 ◽

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.

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

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00361-5 ◽

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.

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3T diffusion-weighted MRI in the response assessment of colorectal liver metastases after chemotherapy: Correlation between ADC value and histological tumour regression grading

European Journal of Radiology ◽

10.1016/j.ejrad.2017.03.020 ◽

2017 ◽

Vol 91 ◽

pp. 57-65 ◽

Cited By ~ 8

Author(s):

Francescamaria Donati ◽

Piero Boraschi ◽

Federica Pacciardi ◽

Rosa Cervelli ◽

Maura Castagna ◽

...

Keyword(s):

Liver Metastases ◽

Colorectal Liver Metastases ◽

Response Assessment ◽

Tumour Regression ◽

Diffusion Weighted Mri ◽

Adc Value ◽

Regression Grading ◽

Diffusion Weighted

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Diffusion weighted MRI of mediastinal masses: Can measurement of ADC value help in the differentiation between benign and malignant lesions

The Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1016/j.ejrnm.2015.12.002 ◽

2016 ◽

Vol 47 (1) ◽

pp. 119-125 ◽

Cited By ~ 2

Author(s):

A. Nasr ◽

H. Elshahat ◽

H. Safwat ◽

R. Alsaif ◽

D. Alshehab ◽

...

Keyword(s):

Diffusion Weighted Mri ◽

Adc Value ◽

Diffusion Weighted ◽

Mediastinal Masses ◽

Malignant Lesions

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Role of Diffusion Weighted Imaging in Differentiating Benign from Pathological Vertebral Compression

QJM ◽

10.1093/qjmed/hcab106.010 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Faten Mohammed Mahmoud Kamel ◽

Hazem Ibrahim Abdel Rahman ◽

Amany Sayed Khaleel Ahmed Elkhayat

Keyword(s):

Vertebral Fractures ◽

Diffusion Weighted Imaging ◽

Laboratory Evaluation ◽

Vertebral Collapse ◽

Adc Value ◽

Conventional Mri ◽

Diffusion Weighted ◽

Significant Difference

Abstract Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p < 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference <0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

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ROLE OF DIFFUSION WEIGHTED MRI IN ASSESSMENT OF BENIGN AND MALIGNANT HEPATIC FOCAL LESIONS IN ADULT AGE GROUP

QJM ◽

10.1093/qjmed/hcab106.042 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hanan Mohammed Hanafy ◽

Ayman Mohammed Ibrahim ◽

Haytham Mohamed Nasser ◽

Moataz Metwally Elsayed

Keyword(s):

Focal Lesions ◽

Adc Value ◽

Adult Age ◽

Conventional Mri ◽

Diffusion Weighted ◽

Adc Values ◽

Weighted Magnetic Resonance Imaging ◽

Mri Sequences ◽

Value Measurement

Abstract Purpose of this study is: To evaluate the role of diffusion weighted magnetic resonance imaging in differentiation between malignant & benign hepatic focal lesions. Methods The study included 38 patients all of them were with hepatic focal lesions detected by ultrasound (between 20 and 85 years of age) referred from GIT and oncology departments. Each patient included in the study was subjected to full history taking, ultrasonography and conventional MRI sequences, post Gd- DTPA dynamic and Diffusion Weighted imaging as well as ADC value measurement. Technique was performed using a standard 1.5 Tesla unit (Ingenia, Philips). Detailed MRI and laboratory investigations were done. Results The study showed significant results were obtained between ADC values of benign and malignant hepatic focal lesions (p < 0.001). Conclusion We concluded in this study according to the obtained results that DWI sequence together with quantitative ADC values should be used as an essential sequence to supplement the conventional MRI sequences for proper detection and characterization of hepatic focal lesions.

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