In:
Frontiers in Oncology, Frontiers Media SA, Vol. 12 ( 2023-1-18)
Abstract:
Whole-lesion histogram analysis can provide comprehensive assessment of tissues by calculating additional quantitative metrics such as skewness and kurtosis; however, few studies have evaluated its value in the differential diagnosis of lung lesions. Purpose To compare the diagnostic performance of conventional diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and diffusion kurtosis imaging (DKI) in differentiating lung cancer from focal inflammatory lesions, based on whole-lesion volume histogram analysis. Methods Fifty-nine patients with solitary pulmonary lesions underwent multiple b -values DWIs, which were then postprocessed using mono-exponential, bi-exponential and DKI models. Histogram parameters of the apparent diffusion coefficient (ADC), true diffusivity ( D ), pseudo-diffusion coefficient ( D* ), and perfusion fraction ( f ), apparent diffusional kurtosis (K app ) and kurtosis-corrected diffusion coefficient (D app ) were calculated and compared between the lung cancer and inflammatory lesion groups. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic performance. Results The ADC mean , ADC median , D mean and D median values of lung cancer were significantly lower than those of inflammatory lesions, while the ADC skewness , K app mean , K app median , K app SD , K app kurtosis and D app skewness values of lung cancer were significantly higher than those of inflammatory lesions (all p & lt; 0.05). ADC skewness ( p = 0.019) and D median ( p = 0.031) were identified as independent predictors of lung cancer. D median showed the best performance for differentiating lung cancer from inflammatory lesions, with an area under the ROC curve of 0.777. Using a D median of 1.091 × 10 -3 mm 2 /s as the optimal cut-off value, the sensitivity, specificity, positive predictive value and negative predictive value were 69.23%, 85.00%, 90.00% and 58.62%, respectively. Conclusions Whole-lesion histogram analysis of DWI, IVIM and DKI parameters is a promising approach for differentiating lung cancer from inflammatory lesions, and D median shows the best performance in the differential diagnosis of solitary pulmonary lesions.
Type of Medium:
Online Resource
ISSN:
2234-943X
DOI:
10.3389/fonc.2022.1082454
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2023
detail.hit.zdb_id:
2649216-7
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