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  • Title: [Value of multiple b-value diffusion-weighted imaging for differentiation of benign and malignant pulmonary masses].
    Author: Wang XH, Duan JH, Yuan HS.
    Journal: Zhongguo Yi Xue Ke Xue Yuan Xue Bao; 2014 Oct; 36(5):510-5. PubMed ID: 25360649.
    Abstract:
    OBJECTIVE: To explore the value of multiple b-value diffusion-weighted imaging (DWI) for differentiation of benign and malignant pulmonary masses. METHODS: Thirty-eight patients were examined by routine sequences and DWI pulse sequence. DWI was acquired through a single-shot echo-planar imaging combined with a respiratory-triggered mode and parallel acquisition. Nine b values ranging from 0 to 1500 s/mm(2) (0, 50, 100, 150, 200, 400, 600, 1000, 1500 s/mm(2)) were used. The intravoxel incoherent motion model was applied to estimate pure diffusion coefficient D, perfusion-related diffusion coefficient D(*), and perfusion fraction f. Mann-Whitney U test was used to compare all measured parameters between benign and malignant groups. The diagnostic performance of the related parameters was evaluated with receiver operating characteristics (ROC) analysis. RESULTS: Of these 38 patients, 30 were pathologically confirmed and 8 were diagnosed based on clinical data. There were 23 lung malignant masses and 15 benign lesions. A significant reduction of D was found in malignant group than in benign group (Z=3.308, P=0.001), while no significant differences in D(*)(Z=1.646, P=0.100) and f(Z=1.254, P=0.210) were observed between the two groups. The area under the ROC curve for D value (0.839) was largest. When the cutoff value was selected as 0.90×10(-3) mm(2)/s, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of diagnosing malignant masses were 95.7%, 80.0%, 90.9%, 91.7%, and 88.9%,respectively. CONCLUSION: The D value in multiple b-value DWI has certain significance in differentiating the benign and malignant pulmonary masses and has the best diagnostic efficiency.
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