Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T
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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.
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.
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.
The addition of DWI to standard MRI improves the diagnostic accuracy for differentiation of malignant from benign soft tissue tumours at 3.0 T.
• 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.
KeywordsMRI Diffusion magnetic resonance imaging Sarcoma Soft tissue neoplasms Differential diagnosis
apparent diffusion coefficient
minimum value of ADC
average value of ADC
The scientific guarantor of this publication is Won-Hee Jee. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Mi Yeon Lee kindly provided statistical advice for this manuscript. One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology:
Retrospective, diagnostic or prognostic study, performed at one institution.
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