Whole-lesion histogram analysis of mono-exponential and bi-exponential diffusion-weighted imaging in differentiating lung cancer from benign pulmonary lesions using 3 T MRI.

Abstract

AIM\nTo investigate whether whole-lesion histogram analysis of apparent diffusion coefficient (ADC) values derived from mono-exponential and bi-exponential diffusion-weighted imaging (DWI) can differentiate lung cancer from benign pulmonary lesions.\n\n\nMATERIALS AND METHODS\nThirty-two patients with lung cancer and 17 patients with benign pulmonary lesions were included retrospectively. All patients underwent DWI before surgery or biopsy. ADC histogram parameters, including mean, percentile values (10th and 90th), kurtosis, and skewness, were calculated independently by two radiologists. The histogram parameters were compared between patients with lung cancer and benign lesions. Receiver operating characteristic curves were constructed to evaluate the diagnostic performance.\n\n\nRESULTS\nThe ADCMean, ADC10th, DMean, D10th were significantly lower in lung cancer (1.187\xa0±\xa00.144\xa0×\xa010-3; 0.440\xa0±\xa00.062\xa0×\xa010-3; 1.068\xa0±\xa00.108\xa0×\xa010-3; and 0.422\xa0±\xa00.049\xa0×\xa010-3 mm/s) compared to benign lesions (1.418\xa0±\xa00.274\xa0×\xa010-3; 0.555\xa0±\xa00.113\xa0×\xa010-3; 1.216\xa0±\xa00.149\xa0×\xa010-3; and 0.490\xa0±\xa00.044\xa0×\xa010-3 mm/s; p<0.05). The ADCSkewness and DSkewness were significantly different between lung cancer (2.35\xa0±\xa00.72; 2.58\xa0±\xa01.14) and benign lesions (1.85\xa0±\xa00.54; 1.59\xa0±\xa01.47; p<0.05). D10th was robust in differentiating lung cancer from benign lesions. Using 0.453\xa0×\xa010-3 mm/s as the optimal threshold, the sensitivity, specificity, and accuracy of D10th were 78.12%, 82.35%, and 79.6%, respectively.\n\n\nCONCLUSION\nWhole-lesion histogram analysis of ADC values derived by mono-exponential and bi-exponential DWI using 3 T magnetic resonance imaging helps distinguish lung cancer from benign pulmonary lesions.