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

摘要

ObjectiveTo 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).MethodsMultiple 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 (K-app), and kurtosis-corrected diffusion coefficient (D-app) 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.ResultThe 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),) ADC(total), D, and D-app of malignant tumors were significantly lower than those of benign lesions (all p 0.001). D*, f, and K-app showed no statistically significant differences between the two groups. ADC(total) 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), D-app(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).ConclusionIntravoxel incoherent motion (IVIM) and DKI-derived parameters have similar performance compared with conventional ADC in differentiating SPLs.Key Points center dot Mono- and biexponential DWI and DKI are feasible for differentiating SPLs.center dot ADC((0, 500))has better performance than ADC((0, 500))in assessing SPLs.center dot IVIM and DKI have similar performance compared with conventional DWI in differentiating SPLs.