Jin Wei Qiang

Utility of diffusion-weighted imaging in differentiating malignant from benign thyroid nodules with magnetic resonance imaging and pathologic correlation.

Objective The objective of this study was to evaluate the role of magnetic resonance diffusion-weighted imaging (DWI) in differentiating malignant from benign thyroid nodules. Methods The prospective study included 111 consecutive patients with solitary thyroid nodules (23 malignant and 88 benign nodules) who underwent DWI. The DWI signal and apparent diffusion coefficient (ADC) values of the nodules were determined and correlated with the histopathologic findings. Results The majority (65%) of malignant thyroid nodules showed slightly hyperintense, and the majority (69%) of benign nodules were hyperintense on DWI (P < 0.01). The ADC values were lower in the thyroid cancer than in the adenoma and nodular goiter (P < 0.05). When the b factor was 500 s/mm2, an ADC value of 1.704 × 10−3 mm2/s can be threshold differentiating malignant from benign nodules, with 92% sensitivity, 88% specificity, and 87% accuracy. The higher cell density and more severe desmoplastic response were the causes of the lower ADC value of thyroid cancer. Conclusion Diffusion-weighted imaging can be a promising noninvasive imaging to discriminate malignant from benign nodules.

MRI for differentiating primary fallopian tube carcinoma from epithelial ovarian cancer

To compare potential discriminatory magnetic resonance imaging (MRI) features of primary fallopian tube carcinoma (PFTC) and primary epithelial ovarian cancer (EOC).

MRI appearances of ovarian serous borderline tumor: pathological correlation.

To investigate the spectrum of MRI appearances of ovarian serous borderline tumor (SBT).

Diffusion kurtosis imaging for differentiating between the benign and malignant sinonasal lesions

The study aimed to evaluate diffusion kurtosis imaging (DKI) in the differentiation between benign and malignant sinonasal lesions, and to compare the diagnostic performance of DKI with diffusion weighted imaging (DWI).

MRI appearances of mucinous borderline ovarian tumors: Pathological correlation

The purpose of this study is to evaluate the MRI features of mucinous borderline ovarian tumors (MBOT).

MRI in differentiating ovarian borderline from benign mucinous cystadenoma: pathological correlation.

To investigate MRI in differentiating borderline mucinous cystadenoma (MC) from benign MC of the ovary.

Diffusion-Weighted Imaging for Differentiating Uterine Leiomyosarcoma From Degenerated Leiomyoma.

Purpose The study aimed to investigate magnetic resonance diffusion-weighted imaging (DWI) in the differentiation of uterine leiomyosarcoma (ULMS) from degenerated leiomyoma (DLM). Methods Sixteen patients with ULMSs and 26 patients with DLMs confirmed by surgery and pathology underwent conventional magnetic resonance imaging and DWI. The mean apparent diffusion coefficient (ADC) values of the 2 groups’ tumors were measured and compared using an independent-sample t test (b = 0.1000 s/mm2 [ADC1]; b = 0.800 s/mm2 [ADC2], respectively). A receiver operating characteristic curve was used to evaluate the diagnostic performance of DWI in the differentiation of ULMS from DLM. Intraobserver and interobserver agreements were evaluated using an intraclass correlation coefficient and Bland-Altman analysis. Results The mean ADC value in ULMSs (0.81 ± 0.14 × 10−3mm2/s [ADC1], 0.90 ± 0.11 × 10−3mm2/s [ADC2]) was significantly lower than that in DLMs (1.22 ± 0.22 × 10−3mm2/s [ADC1], 1.50 ± 0.22 × 10−3mm2/s [ADC2]) (P < 0.001, <0.001, respectively). The sensitivity, specificity, accuracy, and positive and negative predictive values for characterizing ULMS were 100%, 90%, 93%, and 83% and 100% [ADC1] and 100%, 93%, 96%, and 90% and 100% [ADC2]; respectively. Intraobserver and interobserver reproducibilities were excellent (intraclass correlation coefficient = 0.967–0.988; small variability and 95% limits of agreement). Conclusions Diffusion-weighted imaging is helpful in differentiating ULMS from DLM.

MR Spectroscopy for Differentiating Benign From Malignant Solid Adnexal Tumors

OBJECTIVE The purpose of this article is to investigate the proton MR spectroscopy ((1)H-MRS) features of solid adnexal tumors and to evaluate the efficacy of (1)H-MRS for differentiating benign from malignant solid adnexal tumors. MATERIALS AND METHODS Sixty-nine patients with surgically and histologically proven solid adnexal tumors (27 benign and 42 malignant) underwent conventional MRI and (1)H-MRS. Single-voxel spectroscopy was performed using the point-resolved spectroscopy localization technique with a voxel size of 2 × 2 × 2 cm(3). Resonance peak integrals of choline, N-acetyl aspartate (NAA), creatine, lactate, and lipid were analyzed, and the choline-tocreatine, NAA-to-creatine, lactate-to-creatine, and lipid-to-creatine ratios were recorded and compared between benign and malignant tumors. RESULTS A choline peak was detected in all 69 cases (100%), NAA peak in 67 cases (97%, 25 benign and 42 malignant), lipid peak in 47 cases (17 benign and 30 malignant), and lactate peak in eight cases (four benign and four malignant). The mean (± SD) choline-tocreatine ratio was 5.13 ± 0.6 in benign tumors versus 8.90 ± 0.5 in malignant solid adnexal tumors, a statistically significant difference (p = 0.000). There were no statistically significant differences between benign and malignant tumors in the NAA-to-creatine and lipid-to-creatine ratios (p = 0.263 and 0.120, respectively). When the choline-to-creatine threshold was 7.46 for differentiating between benign and malignant tumors, the sensitivity, specificity, and accuracy were 94.1%, 97.1%, and 91.2%, respectively. CONCLUSION Our preliminary study shows that the (1)H-MRS patterns of benign and malignant solid adnexal tumors differ. The choline-to-creatine ratio can help clinicians differentiate benign from malignant tumors.

Diffusion kurtosis imaging for differentiating borderline from malignant epithelial ovarian tumors: A correlation with Ki‐67 expression

To investigate the use of diffusion kurtosis imaging (DKI) in differentiating borderline from malignant epithelial ovarian tumors (MEOTs) and to correlate DKI parameters with Ki‐67 expression.

Minimum apparent diffusion coefficient for predicting lymphovascular invasion in invasive cervical cancer

To investigate the diagnostic performance of minimum apparent diffusion coefficient (mini‐ADC) for predicting lymphovascular invasion (LVI) in invasive cervical cancer.