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1.
Marius E. Mayerhoefer Ahmed Ba-Ssalamah Michael Weber Markus Mitterhauser Harald Eidherr Wolfgang Wadsak Markus Raderer Siegfried Trattnig Andreas Herneth Georgios Karanikas 《European radiology》2013,23(7):1978-1985
Objectives
To compare fused gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI (diffusion-weighted imaging) for the assessment of abdominal neuroendocrine tumours (NETs).Methods
Eighteen patients with suspected or histologically proven NETs of the abdomen were enrolled in this retrospective study. All patients underwent Ga-68-DOTANOC PET/CT for a primary search, staging, or restaging, and received an additional MRI, including dynamic gadoxetate-enhanced T1-weighted sequences and DWI (b-values 50, 300 and 600). Co-registered gadoxetate-enhanced PET/MRI and PET/DWI were separately analysed for NET lesions by a nuclear medicine physician and a radiologist in consensus. Sensitivity and specificity were calculated on a per-region, per-organ and per-patient basis.Results
Eighty-seven out of 684 anatomical regions, and 23 out of 270 organs, were NET-positive in 14 out of 18 patients. Region-based sensitivities and specificities were 97.7 % and 99.7 % for gadoxetate-enhanced PET/MRI and 98.9 % and 99.7 % for PET/DWI. Organ-based sensitivities and specificities were 91.3 % and 99.6 % for gadoxetate-enhanced PET/MRI and 95.7 % and 99.6 % for PET/DWI. Finally, patient-based sensitivities and specificities were 100 % and 100 % for gadoxetate-enhanced PET/MRI and 100 % and 75 % for PET/DWI. Sensitivities and specificities of the two methods did not differ significantly.Conclusions
Gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI are equally useful for the assessment of abdominal NETs.Key Points
? Positron emission tomography and magnetic resonance imaging can both assess neuroendocrine tumours. ? Fusion of PET/MR imaging provides helpful information. ? Gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI assess neuroendocrine tumours equally well. ? PET/DWI is inherently simpler than gadoxetate-enhanced PET/MRI. ? Only benign hepatic lesions pose a potential diagnostic dilemma for PET/DWI. 相似文献2.
Purpose
To evaluate the diagnostic performance of 18F–FDG PET/MRI for whole-body staging and potential changes in therapeutic management of women with suspected recurrent pelvic cancer in comparison with MRI alone.Methods
Seventy-one consecutive women (54?±?13 years, range: 25–80 years) with suspected recurrence of cervical (32), ovarian (26), endometrial (7), vulvar (4), and vaginal (2) cancer underwent PET/MRI including a diagnostic contrast-enhanced MRI protocol. PET/MRI and MRI datasets were separately evaluated regarding lesion count, localization, categorization (benign/malignant), and diagnostic confidence (3-point scale; 1–3) by two physicians. The reference standard was based on histopathology results and follow-up imaging. Diagnostic accuracy and proportions of malignant and benign lesions rated correctly were retrospectively compared using McNemar’s chi2 test. Differences in diagnostic confidence were assessed by Wilcoxon test.Results
Fifty-five patients showed cancer recurrence. PET/MRI correctly identified more patients with cancer recurrence than MRI alone (100% vs. 83.6%, p?<?0.01). In contrast to PET/MRI, MRI alone missed 4/15 patients with pelvic recurrence and miscategorized 8/40 patients with distant metastases as having local recurrence only. Based on the reference standard, 241 lesions were detected in the study cohort (181 malignant, 60 benign). While PET/MRI provided correct identification of 181/181 (100%) malignant lesions, MRI alone correctly identified 135/181 (74.6%) malignant lesions, which was significantly less compared to PET/MRI (p?<?0.001). PET/MRI offered superior diagnostic accuracy (99.2% vs. 79.3%, p?<?0.001) and diagnostic confidence in the categorization of malignant lesions compared with MRI alone (2.7?±?0.5 vs. 2.4?±?0.7, p?<?0.001).Conclusion
PET/MRI demonstrates excellent diagnostic performance and outperforms MRI alone for whole-body staging of women with suspected recurrent pelvic cancer, indicating potential changes in therapy management based on evaluation of local recurrence and distant metastatic spread.3.
Diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) compared to FDG PET/CT for whole-body breast cancer staging 总被引:1,自引:0,他引:1
Till-Alexander Heusner Sherko Kuemmel Angela Koeninger Monia E. Hamami Steffen Hahn Anton Quinsten Andreas Bockisch Michael Forsting Thomas Lauenstein Gerald Antoch Alexander Stahl 《European journal of nuclear medicine and molecular imaging》2010,37(6):1077-1086
Purpose
The aim of the study was to prospectively compare the diagnostic value of whole-body diffusion-weighted imaging (DWI) and FDG PET/CT for breast cancer (BC) staging.Methods
Twenty BC patients underwent whole-body FDG PET/CT and 1.5-T DWI. Lesions with qualitatively elevated signal intensity on DW images (b?=?800 s/mm2) were rated as suspicious for tumour and mapped to individual lesions and different compartments (overall 552 lesions). The apparent diffusion coefficient (ADC) value was determined for quantitative evaluation. Histopathology, MRI findings, bone scan findings, concordant findings between FDG PET/CT and DWI, CT follow-up scans and plausibility served as the standards of reference defining malignancy.Results
According to the standards of reference, breasts harboured malignancy in 11, regional lymph nodes in 4, M1 lymph nodes in 3, bone in 7, lung in 2, liver in 3 and other tissues in 3 patients. On a compartment basis, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the detection of malignancies were 94, 99, 98, 97 and 98% for FDG PET/CT and 91, 72, 76, 50 and 96% for DWI, respectively. Of the lesions seen on DWI only, 348 (82%) turned out to be false-positive compared to 23 (11%) on FDG PET/CT. The average lesion ADC was 820?±?300 with true-positive lesions having 929?±?252 vs 713?±?305 in false-positive lesions (p?<?0.0001).Conclusion
Based on these initial data DWI seems to be a sensitive but unspecific modality for the detection of locoregional or metastatic BC disease. There was no possibility to quantitatively distinguish lesions using ADC. DWI alone may not be recommended as a whole-body staging alternative to FDG PET(/CT). Further studies are necessary addressing the question of whether full-body MRI including DWI may become an alternative to FDG PET/CT for whole-body breast cancer staging. 相似文献4.
Shigeki Nagamachi Ryuichi Nishii Hideyuki Wakamatsu Youichi Mizutani Shogo Kiyohara Seigo Fujita Shigemi Futami Tatefumi Sakae Eiji Furukoji Shozo Tamura Hideo Arita Kazuo Chijiiwa Keiichi Kawai 《Annals of nuclear medicine》2013,27(6):554-563
Purpose
This study aimed at demonstrating the feasibility of retrospectively fused 18F FDG-PET and MRI (PET/MRI fusion image) in diagnosing pancreatic tumor, in particular differentiating malignant tumor from benign lesions. In addition, we evaluated additional findings characterizing pancreatic lesions by FDG-PET/MRI fusion image.Methods
We analyzed retrospectively 119 patients: 96 cancers and 23 benign lesions. FDG-PET/MRI fusion images (PET/T1 WI or PET/T2WI) were made by dedicated software using 1.5 Tesla (T) MRI image and FDG-PET images. These images were interpreted by two well-trained radiologists without knowledge of clinical information and compared with FDG-PET/CT images. We compared the differential diagnostic capability between PET/CT and FDG-PET/MRI fusion image. In addition, we evaluated additional findings such as tumor structure and tumor invasion.Results
FDG-PET/MRI fusion image significantly improved accuracy compared with that of PET/CT (96.6 vs. 86.6 %). As additional finding, dilatation of main pancreatic duct was noted in 65.9 % of solid types and in 22.6 % of cystic types, on PET/MRI-T2 fusion image. Similarly, encasement of adjacent vessels was noted in 43.1 % of solid types and in 6.5 % of cystic types. Particularly in cystic types, intra-tumor structures such as mural nodule (35.4 %) or intra-cystic septum (74.2 %) were detected additionally. Besides, PET/MRI-T2 fusion image could detect extra benign cystic lesions (9.1 % in solid type and 9.7 % in cystic type) that were not noted by PET/CT.Conclusions
In diagnosing pancreatic lesions, FDG-PET/MRI fusion image was useful in differentiating pancreatic cancer from benign lesions. Furthermore, it was helpful in evaluating relationship between lesions and surrounding tissues as well as in detecting extra benign cysts. 相似文献5.
Arthur Varoquaux Olivier Rager Antoine Poncet Bénédicte M. A. Delattre Osman Ratib Christoph D. Becker Pavel Dulguerov Nicolas Dulguerov Habib Zaidi Minerva Becker 《European journal of nuclear medicine and molecular imaging》2014,41(3):462-475
Purpose
Our objectives were to assess the quality of PET images and coregistered anatomic images obtained with PET/MR, to evaluate the detection of focal uptake and SUV, and to compare these findings with those of PET/CT in patients with head and neck tumours.Methods
The study group comprised 32 consecutive patients with malignant head and neck tumours who underwent whole-body 18F-FDG PET/MR and PET/CT. PET images were reconstructed using the attenuation correction sequence for PET/MR and CT for PET/CT. Two experienced observers evaluated the anonymized data. They evaluated image and fusion quality, lesion conspicuity, anatomic location, number and size of categorized (benign versus assumed malignant) lesions with focal uptake. Region of interest (ROI) analysis was performed to determine SUVs of lesions and organs for both modalities. Statistical analysis considered data clustering due to multiple lesions per patient.Results
PET/MR coregistration and image fusion was feasible in all patients. The analysis included 66 malignant lesions (tumours, metastatic lymph nodes and distant metastases), 136 benign lesions and 470 organ ROIs. There was no statistically significant difference between PET/MR and PET/CT regarding rating scores for image quality, fusion quality, lesion conspicuity or anatomic location, number of detected lesions and number of patients with and without malignant lesions. A high correlation was observed for SUVmean and SUVmax measured on PET/MR and PET/CT for malignant lesions, benign lesions and organs (ρ?=?0.787 to 0.877, p?<?0.001). SUVmean and SUVmax measured on PET/MR were significantly lower than on PET/CT for malignant tumours, metastatic neck nodes, benign lesions, bone marrow, and liver (p?<?0.05). The main factor affecting the difference between SUVs in malignant lesions was tumour size (p?<?0.01).Conclusion
In patients with head and neck tumours, PET/MR showed equivalent performance to PET/CT in terms of qualitative results. Comparison of SUVs revealed an excellent correlation for measurements on both modalities, but underestimation of SUVs measured on PET/MR as compared to PET/CT. 相似文献6.
Wolfgang Peter Mueller Henriette Ingrid Melzer Irene Schmid Eva Coppenrath Peter Bartenstein Thomas Pfluger 《European journal of nuclear medicine and molecular imaging》2013,40(3):356-363
Purpose
To analyse the diagnostic value of 18F-FDG PET and MRI for the evaluation of active lesions in paediatric Langerhans cell histiocytosis.Methods
We compared 21 18F-FDG PET scans with 21 MRI scans (mean time interval 17 days) in 15 patients (11 male, 4 female, age range 4 months to 19 years) with biopsy-proven histiocytosis. Primary criteria for the lesion-based analysis were signs of vital histiocyte infiltrates (bone marrow oedema and contrast enhancement for MRI; SUV greater than the mean SUV of the right liver lobe for PET). PET and MR images were analysed separately and side-by-side. The results were validated by biopsy or follow-up scans after more than 6 months.Results
Of 53 lesions evaluated, 13 were confirmed by histology and 40 on follow-up investigations. The sensitivity and specificity of PET were 67 % and 76 % and of MRI were 81 % and 47 %, respectively. MRI showed seven false-positive bone lesions after successful chemotherapy. PET showed five false-negative small bone lesions, one false-negative lesion of the skull and three false-negative findings for intracerebral involvement. PET showed one false-positive lesion in the lymphoid tissue of the head and neck region and two false-positive bone lesions after treatment. Combined PET/MR analysis decreased the number of false-negative findings on primary staging, whereas no advantage over PET alone was seen in terms of false-positive or false-negative results on follow-up.Conclusion
Our retrospective analysis suggests a pivotal role of 18F-FDG PET in lesion follow-up due to a lower number of false-positive findings after chemotherapy. MRI showed a higher sensitivity and is indispensable for primary staging, evaluation of brain involvement and biopsy planning. Combined MRI/PET analysis improved sensitivity by decreasing the false-negative rate during primary staging indicating a future role of simultaneous whole-body PET/MRI for primary investigation of paediatric histiocytosis. 相似文献7.
Hyun Jeong Park Seong Hyun Kim Kyung Mi Jang Seo-youn Choi Soon Jin Lee Dongil Choi 《European radiology》2014,24(4):947-958
Objectives
To assess the added value of diffusion-weighted imaging (DWI) to conventional magnetic resonance imaging (MRI) for differentiating benign from malignant bile duct strictures.Methods
Twenty-seven patients with a benign stricture and 42 patients with a malignant stricture who had undergone gadoxetic acid-enhanced MRI with DWI were enrolled. Qualitative (signal intensity, dynamic enhancement pattern) and quantitative (wall thickness and length) analyses were performed. Two observers independently reviewed a set of conventional MRI and a combined set of conventional MRI and DWI, and receiver operating characteristic (ROC) curve analysis was assessed.Results
Benign strictures showed isointensity (18.5–70.4 %) and a similar enhancement pattern (22.2 %) to that of normal bile duct more frequently than malignant strictures (0–40.5 % and 0 %) on conventional MRI (P?<?0.05). Malignant strictures (90.5–92.9 %) showed hypervascularity on arterial and portal venous phase images more frequently than benign strictures (37.0–70.4 %) (P?<?0.01) On DWI, all malignant strictures showed hyperintensity compared with benign cases (70.4 %) (P?<?0.001). Malignant strictures were significantly thicker and longer than benign strictures (P?<?0.001). The diagnostic performance of both observers improved significantly after additional review of DWI.Conclusions
Adding DWI to conventional MRI is more helpful for differentiating benign from malignant bile duct strictures than conventional MRI alone.Key points
? Accurate diagnosis and exclusion of benign strictures of bile duct are important. ? Diffusion-weighted MRI helps to distinguish benign from malignant bile duct strictures. ? DWI plus conventional MRI provides superior diagnostic accuracy to conventional MRI alone. 相似文献8.
K. Kubiessa S. Purz M. Gawlitza A. Kühn J. Fuchs K. G. Steinhoff A. Boehm O. Sabri R. Kluge T. Kahn P. Stumpp 《European journal of nuclear medicine and molecular imaging》2014,41(4):639-648
Purpose
The aim of this study was to evaluate the diagnostic capability of simultaneous 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI compared to 18F-FDG PET/CT as well as their single components in head and neck cancer patients.Methods
In a prospective study 17 patients underwent 18F-FDG PET/CT for staging or follow-up and an additional 18F-FDG PET/MRI scan with whole-body imaging and dedicated examination of the neck. MRI, CT and PET images as well as PET/MRI and PET/CT examinations were evaluated independently and in a blinded fashion by two reader groups. Results were compared with the reference standard (final diagnosis determined in consensus using all available data including histology and follow-up). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.Results
A total of 23 malignant tumours were found with the reference standard. PET/CT showed a sensitivity of 82.7 %, a specificity of 87.3 %, a PPV of 73.2 % and a NPV of 92.4 %. Corresponding values for PET/MRI were 80.5, 88.2, 75.6 and 92.5 %. No statistically significant difference in diagnostic capability could be found between PET/CT and PET/MRI. Evaluation of the PET part from PET/CT revealed highest sensitivity of 95.7 %, and MRI showed best specificity of 96.4 %. There was a high inter-rater agreement in all modalities (Cohen’s kappa 0.61–0.82).Conclusion
PET/MRI of patients with head and neck cancer yielded good diagnostic capability, similar to PET/CT. Further studies on larger cohorts to prove these first results seem justified. 相似文献9.
Atsushi Hanamoto Yukinori Takenaka Eku Shimosegawa Yoshifumi Ymamamoto Tadashi Yoshii Susumu Nakahara Jun Hatazawa Hidenori Inohara 《Annals of nuclear medicine》2013,27(10):880-885
Objective
Patients with head and neck squamous cell carcinoma (HNSCC) often develop synchronous multiple primary cancers. It is important to detect second primary cancer in HNSCC patients, because it influences treatment selection of primary cancer. The aim of this study was to evaluate the utility of 2-deoxy-2-[F-18]fluoro-d-glucose (FDG)-positron emission tomography (PET) for detecting synchronous primary cancers at the initial staging of patients with HNSCC.Methods
Three hundred and forty-seven patients with untreated HNSCC underwent FDG-PET with or without computed tomography fusion and other routine workups, including upper gastrointestinal Lugol chromoendoscopy, for the initial staging. We examined the prevalence of second primary cancer in these patients and the utility of PET.Results
We identified 57 synchronous primary cancers in 53 patients, of which only 33 % were detected with PET. The most common site for the second primary cancer was the esophagus (49 %), followed by stomach (14 %) and head and neck (11 %). Most early-stage esophageal cancers and stomach cancers were detected using Lugol chromoendoscopy but not PET.Conclusion
Although PET is useful for detecting synchronous primary cancers, it is not a sensitive technique for detecting early esophageal cancers and gastric cancers. Therefore, Lugol chromoendoscopy is indispensable for detecting synchronous upper gastrointestinal cancers in HNSCC patients. 相似文献10.
Tomohiro Ishikita Noboru Oriuchi Tetsuya Higuchi Go Miyashita Yukiko Arisaka Bishnuhari Paudyal Pramila Paudyal Hirofumi Hanaoka Mitsuyuki Miyakubo Yoshiki Nakasone Akihide Negishi Satoshi Yokoo Keigo Endo 《Annals of nuclear medicine》2010,24(2):77-82
Objective
Clinical application of FDG-PET in head and neck cancer includes identification of metastases, unknown primary head and neck malignancy, or second primary carcinoma, and also recurrent tumor after treatment. In this study, the additional value of PET/CT fusion images over PET images alone was evaluated in patients with initial staging and follow up of head and neck malignancy.Methods
Forty patients with suspected primary head and neck malignancy and 129 patients with suspected relapse after treatment of head and neck malignancy were included. FDG-PET/CT study was performed after the intravenous administration of FDG (5 MBq/kg). Target of evaluation was set at primary tumor, cervical lymph node, and whole body. PET images and PET with CT fusion images were compared. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results of PET and PET/CT were compared with postoperative histopathological examination, and case by case comparison of PET and PET/CT results for each region was performed. The additional value of CT images over PET only images was assessed. Statistical differences in sensitivity and specificity were evaluated.Results
In the comparative evaluation of 507 targets by PET alone and PET/CT, 401 targets showed agreement of the results. Of the 106 discordant targets, 103 showed a positive result on PET alone and negative result on PET/CT. These results showed a significant difference (p < 0.01). Sensitivity of PET/CT was slightly higher than that of PET without statistical significance, while specificity of PET/CT was significantly higher than that of PET alone (Initial staging: 90.5% vs. 62.2%, p < 0.01; Follow up: 97.2% vs. 74.4%, p < 0.01). In Fisher’s direct probability test, a significant difference was noted in the sensitivity (Initial staging: 91.3% vs. 87.0%, p < 0.01; Follow up: 93.9% vs. 91.4%, p < 0.01).Conclusions
Combined PET/CT showed improved diagnostic performance than PET alone by decreasing the number of false positive findings in patients with initial staging and follow up of head and neck malignancy. 相似文献11.
Claudio Spick Katja Pinker-Domenig Margaretha Rudas Thomas H. Helbich Pascal A. Baltzer 《European radiology》2014,24(6):1204-1210
Objective
To assess if the application of diffusion-weighted imaging (DWI) obviates unnecessary MR-guided biopsies in suspicious breast lesions visible only on contrast-enhanced MRI (CE-MRI).Methods
This institutional review board (IRB)-approved, retrospective, single-centre study included 101 patients (mean age, 49.5; SD 13.9 years) who underwent additional DWI at 1.5 T prior to MRI-guided biopsy of 104 lesions classified as suspicious for malignancy and visible on CE-MRI only. An experienced radiologist, blinded to histopathologic and follow-up results, measured apparent diffusion coefficient (ADC) values obtained from DWI. Diagnostic accuracy was investigated using receiver operating characteristics (ROC) analysis.Results
Histopathology revealed 20 malignant and 84 benign lesions. Lesions were masses in 61 (15 malignant, 24.6 %) and non-masses in 43 cases (five malignant, 11.6 %). Mean ADC values were 1.53?±?0.38?×?10?3 mm2/s in benign lesions and 1.06?±?0.27?×?10?3 mm2/s in malignant lesions. ROC analysis revealed exclusively benign lesions if ADC values were greater than 1.58?×?10?3 mm2/s. As a consequence, 29 false-positive biopsies (34.5 %) could have been avoided without any false-negative findings. Both in mass and in non-mass lesions, rule-in and rule-out criteria were identified using flexible ADC thresholds based on ROC analysis.Conclusion
Additional application of DWI in breast lesions visible only on MRI can avoid false-positive, MR-guided biopsies. Thus, DWI should be an integral part of breast MRI protocols.Key Points
? DWI measurements are a fast and helpful technique for improved breast lesion diagnosis ? DWI application in breast lesions visible only on MRI obviates false-positive, MR-guided biopsies ? Flexible ADC thresholds provide rule-in and rule-out criteria for breast lesion malignancy 相似文献12.
Kim YN Yi CA Lee KS Kwon OJ Lee HY Kim BT Choi JY Kim SW Chung MP Han J Kim TS Chung MJ Shim YM 《European radiology》2012,22(7):1537-1546
Objectives
To determine the positive reading criteria for malignant nodes when interpreting combined MRI and PET/CT images for preoperative nodal staging in non-small-cell lung cancer (NSCLC).Methods
Forty-nine patients with biopsy-proven NSCLC underwent both PET/CT and thoracic MRI [diffusion weighted imaging (DWI)]. Each nodal station was evaluated for the presence of metastasis by applying either inclusive (positive if either one read positive) or exclusive (positive if both read positive) criteria in the combined interpretation of PET/CT and MRI. Nodal stage was confirmed pathologically. The combined diagnostic accuracy of PET/CT and MRI was determined on per-nodal station and per-patient bases and compared with that of PET/CT alone.Results
In 49 patients, 39 (19%) of 206 nodal stations harboured malignant cells. Out of 206 nodal stations, 186 (90%) had concordant readings, while the rest (10%) had discordant readings. Inclusive criteria of combined PET/CT and MRI helped increase sensitivity for detecting nodal metastasis (69%) compared with PET/CT alone (46%; P?=?0.003), while specificity was not significantly decreased.Conclusion
Inclusive criteria in combined MRI and PET/CT readings help improve significantly the sensitivity for detecting nodal metastasis compared with PET/CT alone and may decrease unnecessary open thoracotomy. Key Points ? Combined interpretation of MRI and PET/CT enhances the detection of nodal metastasis. ? Inclusive criteria of combined MRI/PET/CT improved the sensitivity for detecting nodal metastasis. ? Combined interpretation of MRI and PET/CT may reduce unnecessary open thoracotomies. 相似文献13.
Luc A. Heijnen Doenja M. J. Lambregts Dipanjali Mondal Milou H. Martens Robert G. Riedl Geerard L. Beets Regina G. H. Beets-Tan 《European radiology》2013,23(12):3354-3360
Objectives
To evaluate the performance of diffusion-weighted MRI (DWI) for the detection of lymph nodes and for differentiating between benign and metastatic nodes during primary rectal cancer staging.Methods
Twenty-one patients underwent 1.5-T MRI followed by surgery (± preoperative 5?×?5 Gy). Imaging consisted of T2-weighted MRI, DWI (b0, 500, 1000), and 3DT1-weighted MRI with 1-mm isotropic voxels. The latter was used for accurate detection and per lesion histological validation of nodes. Two independent readers analysed the signal intensity on DWI and measured the mean apparent diffusion coefficient (ADC) for each node (ADCnode) and the ADC of each node relative to the mean tumour ADC (ADCrel).Results
DWI detected 6 % more nodes than T2W-MRI. The signal on DWI was not accurate for the differentiation of metastatic nodes (AUC 0.45–0.50). Interobserver reproducibility for the nodal ADC measurements was excellent (ICC 0.93). Mean ADCnode was higher for benign than for malignant nodes (1.15?±?0.24 vs. 1.04?±?0.22 *10-3 mm2/s), though not statistically significant (P?=?0.10). Area under the ROC curve/sensitivity/specificity for the assessment of metastatic nodes were 0.64/67 %/60 % for ADCnode and 0.67/75 %/61 % for ADCrel.Conclusions
DWI can facilitate lymph node detection, but alone it is not reliable for differentiating between benign and malignant lymph nodes.Key Points
? Diffusion-weighted (DW) magnetic resonance imaging (MRI) offers new information in rectal cancer. ? DW MRI demonstrates more lymph nodes than standard T2-weighted MRI. ? Visual DWI assessment does not discriminate between benign and metastatic nodes. ? Apparent diffusion coefficients do not discriminate between benign and metastatic nodes. 相似文献14.
Nam Kyung Lee Suk Kim Hyung Il Seo Dong Uk Kim Hyun Young Woo Tae Un Kim 《European radiology》2013,23(5):1288-1296
Objectives
To investigate the value of DWI for differentiating malignant from benign strictures in the periampullary region.Methods
We retrospectively analysed data from 78 patients who had undergone magnetic resonance cholangiopanreatography (MRCP) and diffusion-weighted imaging (DWI), in whom biliary strictures in the periampullary region were suspected. Twenty-two malignant and 56 benign lesions were included. One radiologist compared the signal intensity of malignant and benign periampullary lesions on DWI using b?=?500 and 800 s/mm2. The signal intensity of bile was also compared, and an optimal b value was determined for periampullary lesions. Two other radiologists reviewed MRCP alone and combined DWI and MRCP for the possibility of malignant periampullary lesions. Diagnostic accuracy was calculated for each reviewer by receiver operating characteristic (ROC) curve analysis.Results
Malignant periampullary lesions more frequently appeared hyperintense than benign lesions on DWI using the two b values (P?<?0.001). Bile more frequently appeared hyperintense on DWI using b?=?500 s/mm2 (87.2 %) than b?=?800 s/mm2 (24.4 %). Therefore, b?=?800 s/mm2 was determined as the preferred sequence. Diagnostic accuracy for malignant periampullary lesions improved for both reviewers after adding DWI; from 0.714 to 0.924 (P?=?0.006, for reviewer 1) and from 0.714 to 0.919 (P?=?0.007, reviewer 2).Conclusions
Combined DWI with MRCP can improve the diagnostic accuracy for differentiating malignant from benign strictures in the periampullary region.Key Points
? Diffusion-weighted magnetic resonance imaging provides yet more information about hepatobiliary structures. ? Diffusion-weighted imaging (DWI) has now been applied to the biliary tree. ? Most periampullary carcinomas appear hyperintense on high b value DWI. ? DWI can help differentiate between malignant and benign periampullary lesions. 相似文献15.
P. Belli M. Costantini E. Bufi A. Magistrelli G. La Torre L. Bonomo 《La Radiologia medica》2010,115(1):51-69
Purpose
The purpose of this study was to investigate the ability of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) in the detection and characterisation of breast lesions.Materials and methods
From September 2005 to September 2007, 86 patients with breast lesions who underwent magnetic resonance imaging (MRI) in our department were included in our study. MRI was performed with a 1.5-T unit using a standard protocol including DWI sequence. For each breast lesion, the ADC value was calculated and compared with that of normal breast tissue and to the definitive pathological diagnosis. Mann-Whitney U and Kruskal-Wallis tests were used for statistical analysis.Results
A total of 126 breast lesions were detected. Pathology results revealed 100 malignant and 26 benign lesions. Mean diameter of lesions was 26.02 mm (range 4–90 mm), including 52 lesions ≤15 mm in size. Mean ADC value of normal glandular tissue was 1.55×10?3 mm2/s. Mean ADC value of malignant lesions was 0.97×10?3 mm2/s. Mean ADC value for benign lesions was 1.66×10?3 mm2/s. Benign lesions showed ADC values significantly higher than malignant lesions (p<0.0001).Conclusions
DWI provides reliable information to support MRI diagnosis of breast masses. ADC value appears a promising adjunctive parameter in distinguishing malignant from benign breast lesions. 相似文献16.
Chieh Lin Alain Luciani Emmanuel Itti Taoufik El-Gnaoui Alexandre Vignaud Pauline Beaussart Shih-jui Lin Karim Belhadj Pierre Brugières Eva Evangelista Corinne Haioun Michel Meignan Alain Rahmouni 《European radiology》2010,20(8):2027-2038
Objective
To design a whole-body MR protocol using exclusively diffusion-weighted imaging (DWI) with respiratory gating and to assess its value for lesion detection and staging in patients with diffuse large B-cell lymphoma (DLBCL), with integrated FDG PET/CT as the reference standard.Methods
Fifteen patients underwent both whole-body DWI (b?=?50, 400, 800 s/mm2) and PET/CT for pretreatment staging. Lymph node and organ involvement were evaluated by qualitative and quantitative image analysis, including measurement of the mean apparent diffusion coefficient (ADC).Results
A total of 296 lymph node regions in the 15 patients were analysed. Based on International Working Group size criteria alone, DWI findings matched PET/CT findings in 277 regions (94%) (kappa score?=?0.85, P?<?0.0001), yielding sensitivity and specificity for DWI lymph node involvement detection of 90% and 94%. Combining visual ADC analysis with size measurement increased DWI specificity to 100% with 81% sensitivity. For organ involvement, the two techniques agreed in all 20 recorded organs (100%). All involved organ lesions showed restricted diffusion. Ann Arbor stages agreed in 14 (93%) of the 15 patients.Conclusion
Whole-body DWI with ADC analysis can potentially be used for lesion detection and staging in patients with DLBCL. 相似文献17.
Purpose
The role of diffusion-weighted MR imaging (DWI) in the differential diagnosis of pulmonary malignant tumours and solid benign lesions was investigated.Methods
Sixty-two patients with 66 lesions underwent conventional MRI and DWI (diffusion factor of 0 and 500 s/mm2) examinations with 1.5-T MRI. The signal intensity of DWI images was observed and the apparent diffusion coefficient (ADC) values of the lesions were measured. Statistical analyses were performed with the independent samples t test, Pearson’s chi-square test and receiver operating characteristic (ROC) analysis.Results
The signal intensities of pulmonary malignant tumours and solid benign lesions were not significantly different, but the ADC value of benign lesions was statistically higher than that of malignant tumours (p?=?0.001). By ROC analysis, the optimal threshold of ADC was 1.400?×?10–3 mm2/s and the sensitivity and specificity were 83.3% and 74.1%, respectively. There were statistical differences between small cell carcinoma (SCLC) and non-small cell carcinoma (NSCLC) as well; the former was lower than the latter (p?=?0.007).Conclusion
Our data indicate that quantitative analysis of ADC values may help diagnose or distinguish pulmonary lesions, and it also provides a promising method for characterising the pulmonary masses. 相似文献18.
Objectives
To determine the added value of diffusion-weighted imaging (DWI) to standard magnetic resonance imaging (MRI) to differentiate malignant from benign soft tissue tumours at 3.0 T.Methods
3.0 T MR images including DWI in 63 patients who underwent surgery for soft tissue tumours were retrospectively analyzed. Two readers independently interpreted MRI for the presence of malignancy in two steps: standard MRI alone, standard MRI and DWI with qualitative and quantitative analysis combined.Results
There were 34 malignant and 29 non-malignant soft tissue tumours. In qualitative analysis, hyperintensity relative to skeletal muscle was more frequent in malignant than benign tumours on DWI (P=0.003). In quantitative analysis, ADCs of malignant tumours were significantly lower than those of non-malignant tumours (P≤0.002): 759±385 vs. 1188±423 μm2/sec minimum ADC value, 941±440 vs. 1310±440 μm2/sec average ADC value. The mean sensitivity, specificity and accuracy of both readers were 96 %, 72 %, and 85 % on standard MRI alone and 97 %, 90 %, and 94 % on standard MRI with DWI.Conclusions
The addition of DWI to standard MRI improves the diagnostic accuracy for differentiation of malignant from benign soft tissue tumours at 3.0 T.Key Points
? DWI has added value for differentiating malignant from benign soft tissue tumours. ? Addition of DWI to standard MRI at 3.0 T improves the diagnostic accuracy. ? Measurements of both ADC min within solid portion and ADC av are helpful.19.
Genovese E Canì A Rizzo S Angeretti MG Leonardi A Fugazzola C 《La Radiologia medica》2011,116(4):644-656
Purpose
Our aim was to assess the usefulness of magnetic resonance imaging (MRI) with spin-echo echo-planar diffusion-weighted sequences (SE-EPI-DWI) in the study of primary and secondary soft-tissue tumours by correlating the results of imaging and histology.Material and methods
We retrospectively studied 23 patients (14 men, 9 women; age range 25?C87 years) affected by soft-tissue lesions. The MRI study was performed with baseline and contrast-enhanced SE-T1, proton density/T2-weighted (PD/T2), fat-saturated (FATSAT) DP/T2 and single-shot SE-EPI-DWI (b value 50-400- 800s/mm2) sequences.Results
We identified 7/23 benign lesions (three myxoid, four nonmyxoid) and 16/23 malignant tumours (four myxoid, 12 nonmyxoid) with a mean diameter between 21 mm and 20 cm. Qualitative analysis of DWI showed persistence of high signal intensity for increasing b-values in all malignant tumours. Quantitative DWI analysis of the apparent diffusion coefficient (ADC) maps showed a statistical difference between benign and malignant lesions.Conclusions
In our experience, DWI with qualitative and quantitative analysis correlated well with histology. 相似文献20.
Soo Jin Lee Hyo Jung Seo Gi Jeong Cheon Ji Hoon Kim E. Edmund Kim Keon Wook Kang Jin Chul Paeng June-Key Chung Dong Soo Lee 《Nuclear Medicine and Molecular Imaging》2014,48(2):98-105