Diagnostic performance of diffusion weighted imaging of malignant and benign pulmonary nodules and masses: Comparison with positron emission tomography

Katsuo Usuda, Motoyasu Sagawa, Nozomu Motono, Masakatsu Ueno, Makoto Tanaka, Yuichiro Machida, Sumiko Maeda, Munetaka Matoba, Yasuaki Kuginuki, Mitsuru Taniguchi, Hisao Tonami, Yoshimichi Ueda, Tsutomu Sakuma

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23 Citations (Scopus)

Abstract

Background: Diffusion-weighted imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. However, it is uncertain whether DWI has advantages over FDG-PET for distinguishing malignant from benign pulmonary nodules and masses. Materials and Methods: One hundred-forty-three lung cancers, 17 metastatic lung tumors, and 29 benign pulmonary nodules and masses were assessed in this study. DWI and FDG-PET were performed. Results: The apparent diffusion coefficient (ADC) value (1.27±0.35 ×10-3 mm2/sec) of malignant pulmonary nodules and masses was significantly lower than that (1.66±0.58 ×10-3 mm2/sec) of benign pulmonary nodules and masses. The maximum standardized uptake value (SUVmax: 7.47±6.10) of malignant pulmonary nodules and masses were also significantly higher than that (3.89±4.04) of benign nodules and masses. By using optimal cutoff values for ADC (1.44×10-3 mm2/sec) and for SUVmax (3.43), which were determined with receiver operating characteristics curves (ROC curves), the sensitivity (80.0%) of DWI was significantly higher than that (70.0%) of FDG-PET. The specificity (65.5%) of DWI was equal to that (65.5%) of FDG-PET. The accuracy (77.8%) of DWI was not significantly higher than that (69.3%) of FDG-PET for pulmonary nodules and masses. As the percentage of bronchioloalveolar carcinoma (BAC) component in adenocarcinoma increased, the sensitivity of FDG-PET decreased. DWI could not help in the diagnosis of mucinous adenocarcinomas as malignant, and FDG-PET could help in the correct diagnosis of 5 out of 6 mucinous adenocarcinomas as malignant. Conclusions: DWI has higher potential than PET in assessing pulmonary nodules and masses. Both diagnostic approaches have their specific strengths and weaknesses which are determined by the underlying pathology of pulmonary nodules and masses.

Original languageEnglish
Pages (from-to)4629-4635
Number of pages7
JournalAsian Pacific Journal of Cancer Prevention
Volume15
Issue number11
DOIs
Publication statusPublished - 2014

Keywords

  • Diffusion weighted imaging
  • Lung cancer
  • Positron emission tomography
  • Pulmonary nodules and masses

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

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    Usuda, K., Sagawa, M., Motono, N., Ueno, M., Tanaka, M., Machida, Y., Maeda, S., Matoba, M., Kuginuki, Y., Taniguchi, M., Tonami, H., Ueda, Y., & Sakuma, T. (2014). Diagnostic performance of diffusion weighted imaging of malignant and benign pulmonary nodules and masses: Comparison with positron emission tomography. Asian Pacific Journal of Cancer Prevention, 15(11), 4629-4635. https://doi.org/10.7314/APJCP.2014.15.11.4629