Diagnostic Performance of Diffusion - Weighted Imaging for Multiple Hilar and Mediastinal Lymph Nodes with FDG Accumulation

Katsuo Usuda, Sumiko Maeda, Nozomu Motono, Masakatsu Ueno, Makoto Tanaka, Yuichiro Machida, Munetaka Matoba, Naoto Watanabe, Hisao Tonami, Yoshimichi Ueda, Motoyasu Sagawa
2015 Asian Pacific Journal of Cancer Prevention  
Asian Pac J Cancer Prev, 16 (15), 6401-6406 Recently diffusion-weighted magnetic resonance imaging (DWI) has been used to detect the restricted diffusion of water molecules. The principals of DWI exploit the random motion, or so-called Brownian Abstract Background: It is sometimes difficult to assess patients who have multiple hilar and mediastinal lymph nodes (MHMLN) with FDG accumulation in PET-CT. Since it is uncertain whether diffusion-weighted magnetic resonance imaging (DWI) is useful in
more » ... (DWI) is useful in the assessment of such patients, its diagnostic performance was assessed. Materials and Methods: Twenty-three patients who had three or more stations of hilar and mediastinal lymph nodes with SUVmax of 3 or more in PET-CT were included in this study. Results: For diagnosis of disease, there were 20 malignancies (lung cancers 17, malignant lymphomas 2 and metastatic lung tumor 1), and 3 benign cases (sarcoidosis 2 and benign disease 1). For diagnosis of lymph nodes, there were 7 malignancies (metastasis of lung cancer 7 and malignant lymphoma 1) and 16 benign lymphadenopathies (pneumoconiosis/silicosis 7, sarcoidosis 4, benign disease 4, and atypical lymphocyte infiltration 1). The ADC value (1.57±0.29 ×10 -3 mm 2 / sec) of malignant MHMLN was significantly lower than that (1.99±0.24 ×10 -3 mm 2 /sec) of benign MHMLN (P=0.0437). However, the SUVmax was not significantly higher (10.0±7.34 as compared to 6.38±4.31) (P=0.15). The sensitivity (86%) by PET-CT was not significantly higher than that (71%) by DWI for malignant MHMLN (P=1.0). The specificity (100%) by DWI was significantly higher than that (31%) for benign MHMLN (P=0.0098). Furthermore, the accuracy (91%) with DWI was significantly higher than that (48%) with PET-CT for MHMLN (P=0.0129). Conclusions: Evaluation by DWI for patients with MHMLN with FDG accumulation is useful for distinguishing benign from malignant conditions.
doi:10.7314/apjcp.2015.16.15.6401 fatcat:pq2fkkmfgzesdnjavqau32lme4