Amide proton transfer-weighted imaging to differentiate malignant from benign pulmonary lesions: Comparison with diffusion-weighted imaging and FDG-PET/CT.
J Magn Reson Imaging
; 47(4): 1013-1021, 2018 04.
Article
in En
| MEDLINE
| ID: mdl-28799280
ABSTRACT
PURPOSE:
To compare the capability of amide proton transfer-weighted (APTw) imaging, diffusion-weighted imaging (DWI), and FDG-PET/CT for the differentiation of malignant from benign pulmonary nodules. MATERIALS ANDMETHODS:
In all, 82 consecutive patients with pulmonary nodules underwent APTw imaging and DWI with a 3T system, and FDG-PET/CT. All nodules were divided as either malignant (n = 49) or benign (n = 39) groups based on pathological and follow-up examinations. To evaluate the capability for differentiation of malignant from benign nodules, magnetization transfer ratio asymmetry (MTRasym )(3.5ppm) on APTw imaging, apparent diffusion coefficient (ADC), and maximum value of standard uptake value (SUVmax ) were assessed. Receiver operating characteristic (ROC) analyses were performed to computationally determine each feasible threshold value. Next, McNemar's test was used for comparing diagnostic performance with each other as well as with a combination of the significant factors determined by multivariate logistic regression analysis.RESULTS:
Although sensitivity of ADC was significantly higher than that of MTRasym (3.5 ppm) (P = 0.002) and SUVmax (P = 0.004), specificity of MTRasym (3.5 ppm) and SUVmax was significantly higher than that of ADC (P < 0.05). Sensitivity of combined MTRasym (3.5ppm) with SUVmax was significantly higher than that of MTRasym (3.5ppm) (P = 0.001) and SUVmax (P = 0.002) alone. Moreover, specificity and accuracy of combined MTRasym (3.5ppm) with SUVmax were significantly higher than that of ADC (specificity P = 0.002, accuracy P = 0.008).CONCLUSION:
APTw imaging appears to be as useful as DWI and FDG-PET/CT for differentiation of malignant from benign nodules. LEVEL OF EVIDENCE 2 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2018;471013-1021.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Solitary Pulmonary Nodule
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Fluorodeoxyglucose F18
/
Diffusion Magnetic Resonance Imaging
/
Multiple Pulmonary Nodules
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Positron Emission Tomography Computed Tomography
/
Lung Neoplasms
Type of study:
Diagnostic_studies
/
Observational_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Magn Reson Imaging
Journal subject:
DIAGNOSTICO POR IMAGEM
Year:
2018
Document type:
Article
Affiliation country: