European Radiology

, Volume 24, Issue 3, pp 581–586 | Cite as

Diffusivity of intraorbital lymphoma vs. IgG4-related DISEASE: 3D turbo field echo with diffusion-sensitised driven-equilibrium preparation technique

  • Akio HiwatashiEmail author
  • Takashi Yoshiura
  • Osamu Togao
  • Koji Yamashita
  • Kazufumi Kikuchi
  • Yoko Fujita
  • Hiroshi Yoshikawa
  • Takaomi Koga
  • Makoto Obara
  • Hiroshi Honda
Head and Neck



3D turbo field echo with diffusion-sensitised driven-equilibrium preparation (DSDE-TFE) is a novel non-echo planar technique for diffusion-weighted (DW) imaging. The purpose of this study was to differentiate intraorbital lymphoma from immunoglobulin G4-related disease (IgG4-RD) using the apparent diffusion coefficient (ADC) derived from DSDE-TFE.


Fifteen patients with lymphomas and 8 with IgG4-RDs underwent imaging. ADC and signal intensities compared with normal grey matter on T1-weighted images, fat-suppressed T2-weighted images and fat-suppressed postcontrast T1-weighted images were measured. Statistical analyses were performed using the Mann–Whitney U test and receiver operating characteristic (ROC) analysis.


Intraorbital lesions were clearly visualised on DSDE-TFE without obvious geometrical distortion. The ADC of lymphoma (1.25 ± 0.50 × 10−3 mm2/s; mean ± standard deviation) was significantly lower than that of IgG4-RD (1.67 ± 0.84 × 10−3 mm2/s; P < 0.05). Conventional sequences could not separate lymphoma from IgG4-RD (0.93 ± 0.18 vs. 0.94 ± 0.21 on T1-weighted images, 0.92 ± 0.17 vs. 0.95 ± 0.14 on T2-weighted images and 2.03 ± 0.35 vs. 2.30 ± 0.58 on postcontrast T1-weighted images, for lymphoma and IgG4-RD, respectively; P > 0.05). ROC analysis showed the best diagnostic performance with ADC.


The apparent diffusion coefficient derived from diffusion-sensitised driven-equilibrium preparation techniques may help to differentiate lymphoma from immunoglobulin G4-related disease.

Key Points

Distinguishing between orbital lymphoma and immunoglobulin G4-related disease can be difficult

Intraorbital lesions were clearly visualised on diffusion-sensitised driven-equilibrium preparation magnetic resonance techniques.

Variations in field homogeneity do not affect DSDE-TFE techniques all that much.

ADCs derived from DSDE-TFE may help differentiate lymphoma from IgG4-RD.


Diffusion-weighted imaging Apparent diffusion coefficient Lymphoma Immunoglobulin G4-related disease Orbit 



Makoto Obara is an employee of Philips Electronics Japan. He is not involved in data analysis in this study.


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Akio Hiwatashi
    • 1
    Email author
  • Takashi Yoshiura
    • 1
  • Osamu Togao
    • 1
    • 2
  • Koji Yamashita
    • 1
  • Kazufumi Kikuchi
    • 1
  • Yoko Fujita
    • 3
  • Hiroshi Yoshikawa
    • 3
  • Takaomi Koga
    • 4
  • Makoto Obara
    • 5
  • Hiroshi Honda
    • 1
  1. 1.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Department of Molecular Imaging and Diagnosis, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  3. 3.Department of Ophthalmology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  4. 4.Department of Pathophysiological and Experimental Pathology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  5. 5.MR Clinical SciencePhilips Electronics JapanTokyoJapan

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