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

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.

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Role of diffusion weighted MR imaging in diagnosis of acute pancreatitis

QJM ◽

10.1093/qjmed/hcaa068.009a ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

K A A Sabry ◽

O F Kamel ◽

A Y Ahmed ◽

H M Abuzeid

Keyword(s):

Acute Pancreatitis ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Adc Value ◽

Diffusion Weighted ◽

Significant Difference ◽

Apparent Diffusion ◽

Adc Values ◽

Normal Controls

Abstract Purpose to assess the role of Diffusion-weighted MRI in diagnosis of acute pancreatitis by measure the apparent diffusion coefficient (ADC) values detected by diffusion-weighted imaging (DWI) in acute pancreatitis and compare them with the control group Methods and Material sixteen patients with acute pancreatitis and sixteen normal controls underwent DWI with b values (0,200 & 800). Apparent diffusion coefficient (ADC) maps are generated from DWI and ADC values were calculated for pancreas and compared the results between the two groups Results The mean pancreatic ADC in the AP group (1.17 × 10(-3) mm(2)/s ± 0.2) was significantly lower than in the normal group (1.6 × 10(-3) mm(2)/s ± 0.32). There was no significant difference in mean ADCs between each of the pancreatic segments in the controls. A threshold ADC value of 1.38 × 10-3 mm(2)/s yielded a sensitivity of 93% and specificity of 87% for detecting acute pancreatitis. Pancreatic ADCs are significantly lower in patients with AP than normal controls. Conclusion MR diffusion imaging could be an important supportive tool in diagnosis of acute pancreatitis

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Diffusion-Weighted MRI of the Breast in Women with a History of Mantle Radiation: Does Radiation Alter Apparent Diffusion Coefficient?

Journal of Breast Imaging ◽

10.1093/jbi/wbz035 ◽

2019 ◽

Vol 1 (3) ◽

pp. 212-216

Author(s):

Punam Bajaj ◽

Chiara Iacconi ◽

David D Dershaw ◽

Elizabeth A Morris

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Breast Tissue ◽

Rank Test ◽

Control Group ◽

Adc Value ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Adc Values ◽

History Of

Abstract Objective Fibrosis from chest irradiation could lower the apparent diffusion coefficient (ADC) of breast tissue. ADC values of normal breast tissue in high-risk women who underwent mantle radiation before age 30 years were compared with a screening control group matched for breast fibroglandular tissue (FGT). Methods In this retrospective study, we reviewed 21 women with a history of mantle radiation who underwent breast MRI examinations between 2008 and 2013, and 20 nonirradiated patients (control group) imaged during the same period with matching FGT and similar age. The women were dichotomized into low FGT (10/20, 50%) and high-FGT (10/20, 50%) groups, based on BI-RADS descriptors. All MRI examinations included diffusion-weighted imaging (DWI) (b = 0, 1000); ADC maps were generated and evaluated on PACS workstations by two radiologists in agreement. Region of interest markers were placed on ADC maps in visualized breast tissue in the retroareolar region of each breast. The ADC value was averaged for the right and left breast in each patient included in the study. The Wilcoxon signed-rank test was used to compare the ADC values in the irradiated patients and the matched control patients. Results The median breast ADC was lower in the irradiated group (1.32 × 10-3mm2/sec) than in the control group (1.62 × 10-3mm2/sec; P = 0.0089). Low FGT in the irradiated group had a lower median ADC (1.25 × 10-3mm2/sec) than it did in the control group (1.53 × 10-3mm2/sec). Irradiated high-FGT breasts had a median ADC (1.52 × 10-3mm2/sec), as compared with nonirradiated control patients with high FGT (1.82 × 10-3mm2/sec). Conclusion Previously irradiated breasts have lower ADC values than do nonirradiated breasts.

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Decreased apparent diffusion coefficient in the pituitary and correlation with hypopituitarism in patients with traumatic brain injury

Journal of Neurosurgery ◽

10.3171/2014.12.jns132308 ◽

2015 ◽

Vol 123 (1) ◽

pp. 75-80 ◽

Cited By ~ 6

Author(s):

Ping Zheng ◽

Bin He ◽

Yijun Guo ◽

Jingsong Zeng ◽

Wusong Tong

Keyword(s):

Traumatic Brain Injury ◽

Diffusion Coefficient ◽

Brain Injury ◽

Apparent Diffusion Coefficient ◽

Neurological Outcome ◽

Pituitary Function ◽

Adc Value ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Adc Values

OBJECT The relationship between microstructural abnormality in patients with traumatic brain injury (TBI) and hormone-secreting status remains unknown. In this study, the authors aimed to identify the role of the apparent diffusion coefficient (ADC) using a diffusion-weighted imaging (DWI) technique and to evaluate the association of such changes with hypopituitarism in patients with TBI. METHODS Diffusion-weighted images were obtained in 164 consecutive patients with TBI within 2 weeks after injury to generate the pituitary ADC as a measure of microstructural change. Patients with TBI were further grouped into those with and those without hypopituitarism based on the secretion status of pituitary hormones at 6 months postinjury. Thirty healthy individuals were enrolled in the study and underwent MRI examinations for comparison. Mean ADC values were compared between this control group, the patients with TBI and hypopituitarism, and the patients with TBI without hypopituitarism; correlational studies were also performed. Neurological outcome was assessed with the Glasgow Outcome Scale (GOS) for all TBI patients 6 months postinjury. RESULTS In the TBI group, 84 patients had hypopituitarism and 80 had normal pituitary function. The pituitary ADC in TBI patients was significantly less than that in controls (1.83 ± 0.16 vs 4.13 ± 0.33, p < 0.01). Furthermore, the mean ADC was much lower in TBI patients with hypopituitarism than in those without pituitary dysfunction (1.32 ± 0.09 vs 2.28 ± 0.17, p < 0.05). There was also a significant difference in ADC values between patients with hyperprolactinemia and those with normal prolactin levels (p < 0.05). Additionally, the receiver operating characteristic curve analysis showed that the pituitary ADC could predict hypopituitarism with a sensitivity of 90.0% and a specificity of 90.1% at the level of 1.720 (ADC value). Finally, the ADC value was positively correlated with neurological outcome at 6 months following TBI (r = 0.602, p < 0.05). CONCLUSIONS Use of DWI demonstrated that the pituitary ADC is correlated with hormone-secreting status in TBI patients. The authors suggest that pituitary ADC may be a useful biomarker to predict pituitary function in patients with TBI.

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Role of MR Morphology and Diffusion-Weighted Imaging in the Evaluation of Meningiomas: Radio-Pathologic Correlation

Journal of Nepal Medical Association ◽

10.31729/jnma.3968 ◽

2019 ◽

Vol 57 (215) ◽

Author(s):

Kajan Ranabhat ◽

Suresh Bishokarma ◽

Prity Agrawal ◽

Pratyush Shrestha ◽

Ram Kumar Ghimire ◽

...

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Histological Grade ◽

Cross Sectional ◽

Who Grade ◽

Adc Value ◽

Diffusion Weighted Images ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Brain Interface

Introduction: Preoperative differentiation of benign, atypical and malignant meningiomas would significantly help in surgical planning and treatment. The aim of this study is to look at radio- morphologic behavior of various histopathological types and grades of meningiomas and their diffusion characteristics.Methods: We performed an analytical cross-sectional study including all patients operated on for meningiomas at our hospital during January 2016 to July 2018. We studied 38 meningiomas in 38 patients aged 14 to 73 years old. All patients underwent MRI prior to surgery, including diffusion- weighted sequences, in a 1.5T scanner. Signal intensity in T2-weighted images, diffusion-weighted images (b=0, 90 and 1,000), and Apparent Diffusion Coefficient maps within the tumors and in the normal parietal white matter as a reference were evaluated. Results: There was female predilection with male:female ratio of 1:2.4. Most meningiomas were supratentorial with most common origin being parafalcine and convexity. Of the 38 meningiomas, 31 were WHO grade I, 6 were WHO grade II (apalstic) and one was WHO grade III (anaplastic). Similarly, tumors showing pial invasion, breached tumor-brain interface, no capsular enhancement and parenchyma invasion showed significantly low NADC. Mean ADC value was 0.722±7.7x10-3 mm2/s (normalized ADC 0.9±0.1) in the atypical group and 0.876±24.56x10-3 mm2/s (normalized ADC 1.11±0.31) in the typical group. No statistically significant differences of ADC/NADC were found between histologic subtypes. Two subtypes of typical meningiomas, metaplastic and angiomatous meningioma had the highest values in the ADC maps.Conclusions: MR morphology like pial invasion, breached tumors brain interface, parenchymal invasion can predict aggressiveness and atypical nature of meningiomas. Meningioma shows moderately restricted diffusion. The signal on the ADC map is associated with tumors cellularity and aggressiveness suggesting its usefulness for predicting the histological grade. Keywords: apparent diffusion coefficient; atypical; histopathology; meningioma; MR morphology.

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MRI findings, including diffusion-weighted imaging and apparent diffusion coefficient value, in two cats with nasopharyngeal polyps and one cat with lymphoma

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/2055116918812254 ◽

2018 ◽

Vol 4 (2) ◽

pp. 205511691881225 ◽

Cited By ~ 1

Author(s):

Toshiyuki Tanaka ◽

Hideo Akiyoshi ◽

Keiichiro Mie ◽

Hidetaka Nishida

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Diffusion Weighted Imaging ◽

Mri Findings ◽

Adc Value ◽

Mri Examination ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Adc Values ◽

Adc Map

Objectives Most nasopharyngeal masses in cats are lymphomas or polyps. To our knowledge, there is no report of MRI findings, including diffusion-weighted imaging (DWI) or apparent diffusion coefficient (ADC) values, of nasopharyngeal lymphomas and nasopharyngeal polyps in cats. This study aimed to evaluate the MRI findings of nasopharyngeal lymphomas and nasopharyngeal polyps, including DWI and ADC values. Methods MRI examination was performed on two cats with a histologically confirmed nasopharyngeal polyp and one cat with lymphoma. The magnetic resonance scanning protocol included T2-weighted imaging (T2WI), T1-weighted imaging (T1WI) and DWI. An ADC map was created based on DWI. ADC values were then calculated. Results MRI of the nasopharyngeal polyps revealed well-defined masses with strong rim enhancement, mass-associated stalk-like structures and asymmetric tympanic bulla lesions. The polyps appeared hyperintense on T2WI, hypo- to isointense on T1WI, and of mixed intensity or hypointense on DWI. On the ADC map, the masses appeared hyperintense. The ADC values of the polyps were 2.07 × 10−3 mm2/s and 2.28 × 10−3 mm2/s. MRI examination of the nasopharyngeal lymphoma revealed a strongly enhancing heterogeneous lesion. The mass appeared mildly hyperintense on T2WI, isointense on T1WI and hyperintense on DWI. On the ADC map, the mass appeared hypointense. The ADC value of the mass was 0.46 ×10−3 mm2/s. The ADC values of the nasopharyngeal polyps were higher than the ADC value of the nasopharyngeal lymphoma. Conclusions and relevance Measurement of ADC values may be useful for differentiating between nasopharyngeal polyps and nasopharyngeal lymphomas.

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

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03986-8 ◽

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.

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Influence of menstrual status and pathological type on the apparent diffusion coefficient in cervical cancer: a primary study

Acta Radiologica ◽

10.1177/0284185120926897 ◽

2020 ◽

pp. 028418512092689

Author(s):

Yue Dong ◽

Rui Tong Dong ◽

Xiao Miao Zhang ◽

Qing Ling Song ◽

Tao Yu ◽

...

Keyword(s):

Cervical Cancer ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Primary Study ◽

Adc Value ◽

Cervical Cancers ◽

Menstrual Status ◽

Pathological Type ◽

Apparent Diffusion ◽

Adc Values

Background Apparent diffusion coefficient (ADC) value is an important quantitative parameter in the research of cervical cancer, affected by some factors. Purpose To investigate the effect of pathological type and menstrual status on the ADC value of cervical cancer. Material and Methods A total of 352 individuals with pathologically confirmed cervical cancer between January 2015 to December 2017 were retrospectively enrolled in this study, including 317 cases with squamous cell carcinomas (SCC) and 35 cases with adenocarcinomas (AC); 177 patients were non-menopausal and 175 were menopausal. All patients underwent a routine 3.0-T magnetic resonance imaging (MRI) scan and diffusion-weighted imaging (DWI) examination using b-values of 0, 800, and 1000 s/mm2. Three parameters including mean ADC (ADCmean), maximum ADC (ADCmax), and minimum ADC (ADCmin) of cervical cancer lesions were measured and retrospectively analyzed. Independent samples t-test was used to compare the difference of ADC values in different menstrual status and pathological types. Results In all menopausal and non-menopausal patients, the ADCmean and ADCmin values of SCC were lower than those of AC ( P<0.05), the ADCmax of two pathological types showed no statistical difference ( P > 0.05). In menopausal patients, the ADCmean, ADCmax, and ADCmin values of SCC were not statistically different compared with those of AC ( P > 0.05). The ADCmean, ADCmax, and ADCmin values of different pathological types cervical cancers in non-menopausal patients were all higher than those in menopausal patients ( P<0.05). Conclusion The ADC values of the cervical cancers were different in different pathological types and were also affected by menstrual status.

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Assessment of Apparent Diffusion Coefficient Values as Predictor of Aggressiveness in Peripheral Zone Prostate Cancer: Comparison with Gleason Score

ISRN Radiology ◽

10.1155/2014/263417 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Shayan Sirat Maheen Anwar ◽

Zahid Anwar Khan ◽

Rana Shoaib Hamid ◽

Fahd Haroon ◽

Raza Sayani ◽

...

Keyword(s):

Prostate Cancer ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Gleason Score ◽

Case Series ◽

Adc Value ◽

Apparent Diffusion Coefficient Values ◽

Apparent Diffusion Coefficient Value ◽

Apparent Diffusion ◽

Adc Values

Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants were positive for malignancy. 89 lesions with proven malignancy showed diffusion restriction. The mean ADC value for disease with a Gleason score of 6 was 935 mm2/s (SD=248.4 mm2/s); Gleason score of 7 was 837 mm2/s (SD=208.5 mm2/s); Gleason score of 8 was 614 mm2/s (SD=108 mm2/s); and Gleason score of 9 was 571 mm2/s (SD=82 mm2/s). Inverse relationship was observed between Gleason score and mean ADC values. Conclusion. DWI and specifically quantitative ADC values may help differentiate between low-risk (Gleason score, 6), intermediate-risk (Gleason score, 7), and high-risk (Gleason score 8 and 9) prostate cancers, indirectly determining the aggressiveness of the disease.

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Effects of contrast-enhancement on diffusion weighted imaging and apparent diffusion coefficient measurements in 3-T magnetic resonance imaging of breast lesions

Acta Radiologica ◽

10.1177/0284185117740759 ◽

2017 ◽

Vol 59 (8) ◽

pp. 902-908

Author(s):

Valentina Cipolla ◽

Daniele Guerrieri ◽

Giacomo Bonito ◽

Simone Celsa ◽

Carlo de Felice

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Diffusion Weighted Imaging ◽

Breast Lesions ◽

Post Contrast ◽

Diffusion Weighted ◽

Signed Rank ◽

Apparent Diffusion ◽

Malignant Breast ◽

Adc Values

Background The effect of gadolinium-based contrast agents on diffusion-weighted imaging (DWI) measurements of breast lesions is still not clear. Purpose To investigate gadolinium effects on DWI and apparent diffusion coefficient (ADC) in breast lesions and normal parenchyma with 3 Tesla contrast-enhanced MRI. Material and Methods Pre- and post-contrast DWI (b = 0 and b = 1000 s/mm2) were acquired in 47 patients. Measured ADC values, pre- and post-contrast T2 signal intensity (T2 SI) and contrast-to-noise ratio (CNR) were compared with Wilcoxon signed-rank and rank-sum test ( P < 0.05). Results Post-contrast ADC was reduced only in malignant lesions (−34%), T2 SI was reduced both in malignant (−50%) and benign (−36%) lesions. Post-contrast CNR was reduced in all groups except for benign lesions. Conclusion Gadolinium-based contrast agent causes a significant reduction in ADC values of malignant breast lesions.

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The diagnostic value of apparent diffusion coefficient to differentiate benign and malignant meningiomas

Zinc supplementation improves heme biosynthesis in rats exposed to lead ◽

10.18051/univmed.2021.v40.141-150 ◽

2021 ◽

Vol 40 (2) ◽

pp. 141-150

Author(s):

Risa Marissa ◽

Rachmi Fauziah Rahayu ◽

Hari Wujoso ◽

Subandi Subandi ◽

Prasetyo Sarwono Putro ◽

...

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Predictive Value ◽

Diagnostic Value ◽

Cross Sectional Study ◽

High Morbidity ◽

Cross Sectional ◽

Adc Value ◽

Flair Sequence ◽

Apparent Diffusion

BACKGROUNDMeningiomas are the most common primary extra-axial non-glial intracranial tumors. The severe grade of meningioma, according to WHO, has the highest recurrence rate accompanied by high morbidity and mortality rates. Therefore, it is imperative to perform pre-operative assessments so the clinician can give prompt treatment to gain a better prognosis. It is a novel alternative way of predicting meningioma’s malignancy by calculating the tumor’s apparent diffusion coefficient (ADC) value. The objective of the study was to determine the value of ADC for differentiating benign and malignant meningiomas. METHODSThis cross-sectional study involved 32 subjects with clinically diagnosed or histologically verified meningioma (21 benign and 11 malignant). They underwent a head-magnetic resonance imaging (MRI) examination and biopsy. We calculated the ADC value by creating regions of interest (ROIs) on the solid part of the tumor, guided by contrast and fluid-attenuated inversion recovery (FLAIR) sequence. We analyzed the ADC value with independent t-test and Bland-Altman graphs, calculated the average difference, CI 95%, limit of agreement between observers, and ROC. RESULTSMean ADC of malignant meningiomas (0.877 ± 0.167 x 10-3 mm2/s) was significantly lower than that of benign meningiomas (0.990 ± 0.105 x 10-3 mm2/s) (p<0.05). The ADC threshold is 0.886 x 10-3 mm2/s with sensitivity 63.6%, specificity 85.7%, positive predictive value 70% and negative predictive value 81.8%. CONCLUSIONThe ADC value measurement provides a discriminative feature to differentiate between benign and malignant meningiomas. However, the clinical applicability still needs to be elucidated, as histopathological confirmation remains the mainstay of definitive diagnosis.

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