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Differentiating between malignant and benign solid solitary pulmonary lesions: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional diffusion-weighted imaging?

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Abstract

Objective

To quantitatively compare the diagnostic values of various diffusion parameters obtained from mono- and biexponential diffusion-weighted imaging (DWI) models and diffusion kurtosis imaging (DKI) in differentiating between benign and malignant solitary pulmonary lesions (SPLs).

Methods

Multiple b-value DWIs and DKIs were performed in 89 patients with SPL by using a 3-T magnetic resonance (MR) imaging unit. The apparent diffusion coefficient (ADC) of various b-value sets, true diffusivity (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), apparent diffusional kurtosis (Kapp), and kurtosis-corrected diffusion coefficient (Dapp) were calculated and compared between the malignant and benign groups using a Mann-Whitney U test. Receiver-operating characteristic analysis was performed for all parameters.

Result

The ADC(0, 150) values of malignant tumors were lower than those of the benign group (p = 0.01). The ADC(0, 300), ADC(0, 500), ADC(0, 600), ADC(0, 800), ADC(0, 1000), ADCtotal, D, and Dapp of malignant tumors were significantly lower than those of benign lesions (all p < 0.001). D*, f, and Kapp showed no statistically significant differences between the two groups. ADCtotal showed the highest area under the curve (AUC = 0.862), followed by ADC(0, 800)(AUC = 0.844), ADC(0, 600)(AUC = 0.843), D(AUC = 0.834), ADC(0, 1000)(AUC = 0.834) and ADC(0, 500)(AUC = 0.824), Dapp(AUC = 0.796), and ADC(0, 300) (AUC = 0.773). However, the difference in diagnostic efficacy among these parameters was not statistically significant (p > 0.05).

Conclusion

Intravoxel incoherent motion (IVIM) and DKI-derived parameters have similar performance compared with conventional ADC in differentiating SPLs.

Key Points

• Mono- and biexponential DWI and DKI are feasible for differentiating SPLs.

• ADC (0, ≥500) has better performance than ADC (0, <500) in assessing SPLs.

• IVIM and DKI have similar performance compared with conventional DWI in differentiating SPLs.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under curve

D:

True diffusivity

D*:

Pseudo-diffusion coefficient

Dapp :

Kurtosis corrected diffusion coefficient

DKI:

Diffusion kurtosis imaging

DWI:

Diffusion-weighted imaging

f:

Perfusion fraction

IVIM:

Intravoxel incoherent motion

Kapp :

Apparent diffusional kurtosis

ROC:

Receiver operating characteristic

ROI:

Region of interest

SPL:

Solitary pulmonary lesions

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Funding

This study has received funding from National Natural Science Foundation of China (81601457).

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151., Guangzhou, China

    Qi Wan, Ying-shi Deng, Qiang Lei, Ying-ying Bao, Yu-ze Wang, Jia-xuan Zhou, Qiao Zou & Xin-chun Li

Authors
  1. Qi Wan
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  2. Ying-shi Deng
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  3. Qiang Lei
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  4. Ying-ying Bao
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  5. Yu-ze Wang
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  6. Jia-xuan Zhou
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  7. Qiao Zou
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  8. Xin-chun Li
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Corresponding author

Correspondence to Xin-chun Li.

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Guarantor

The scientific guarantor of this publication is Xinchun Li.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• diagnostic study

• performed at one institution

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Cite this article

Wan, Q., Deng, Ys., Lei, Q. et al. Differentiating between malignant and benign solid solitary pulmonary lesions: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional diffusion-weighted imaging?. Eur Radiol 29, 1607–1615 (2019). https://doi.org/10.1007/s00330-018-5714-6

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  • DOI: https://doi.org/10.1007/s00330-018-5714-6

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