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Apparent diffusion coefficient values of diffusion-weighted imaging for distinguishing focal pulmonary lesions and characterizing the subtype of lung cancer: a meta-analysis

  • Magnetic Resonance
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Abstract

Objectives

The potential performance of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign pulmonary lesions, further characterizing the subtype of lung cancer was assessed.

Methods

PubMed, EMBASE, Cochrane Library, EBSCO, and three Chinese databases were searched to identify eligible studies on diffusion-weighted imaging (DWI) of focal pulmonary lesions. ADC values of malignant and benign lesions were extracted by lesion type and statistically pooled based on a linear mixed model. Further analysis for subtype of lung cancer was also performed. The methodological quality was assessed using the quality assessment of diagnostic accuracy studies tool.

Results

Thirty-four articles involving 2086 patients were included. Malignant pulmonary lesions have significantly lower ADC values than benign lesions [1.21 (95 % CI, 1.19–1.22) mm2/s vs. 1.76 (95 % CI, 1.72–1.80) mm2/s; P < 0.05]. There is a significant difference between ADC values of small cell lung cancer and non-small cell lung cancer (P < 0.05), while the differences were not significant among histological subtypes of lung cancer. The methodological quality was relatively high, and the data points from Begg’s test indicated that there was probably no obvious publication bias.

Conclusions

The ADC value is helpful for distinguishing malignant and benign pulmonary lesions and provides a promising method for differentiation of SCLC from NSCLC.

Key Points

• This meta-analysis assesses the role of DWI in pulmonary lesions.

• Differentiation and classification subtype of lung cancer is essential for treatment decision-making.

• ADC values can help distinguish between malignant and benign lesions.

• ADC values might help characterize the subtype of lung cancer.

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Acknowledgments

The scientific guarantor of this publication is Zhiyun Jia. 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. This study has received funding by National Natural Science Foundation of China (Grant No. 81271532, 81171456, and 30900378) and the Fundamental Research Funds for the Central Universities (Project No. 2015SCU04B09). No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because we only performed data analysis based on the published studies. Written informed consent was not required for this study because it is a meta-analysis based on the studies that have been published. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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  1. Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People’s Republic of China

    Guohua Shen, Zhiyun Jia & Houfu Deng

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  1. Guohua Shen
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Shen, G., Jia, Z. & Deng, H. Apparent diffusion coefficient values of diffusion-weighted imaging for distinguishing focal pulmonary lesions and characterizing the subtype of lung cancer: a meta-analysis. Eur Radiol 26, 556–566 (2016). https://doi.org/10.1007/s00330-015-3840-y

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  • DOI: https://doi.org/10.1007/s00330-015-3840-y

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