Application of MR-IVIM in the diagnosis of benign and malignant lung tumors and the evaluation of chemotherapeutic efficacy in lung cancer(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2019年第6期
- Page:
- 682-688
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Application of MR-IVIM in the diagnosis of benign and malignant lung tumors and the evaluation of chemotherapeutic efficacy in lung cancer
- Author(s):
- WANG Yi1; LAI Qingquan1; HUANG Meiling2; HUANG Qiming1
- 1. Department of CT/MRI, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, China; 2. Department of Radiotherapy, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, China
- Keywords:
- ; Keywords: lung cancer; magnetic resonance imaging; intravoxel incoherent motion
- PACS:
- R318；R445.2；R734.2
- DOI:
- DOI:10.3969/j.issn.1005-202X.2019.06.012
- Abstract:
- Abstract: Objective To study the efficacy of magnetic resonance-intravoxel incoherent motion (MR-IVIM) parameters in the differential diagnosis of benign and malignant lung tumors, and analyze the changes of IVIM parameters before and after chemotherapy for lung cancer, so as to find out the optimal evaluation parameters. Methods Thirty cases of lung cancer and 20 cases of benign lung tumor were scanned with pulmonary MR-IVIM. The evaluation of RECIST evaluation criteria showed that the chemotherapy for 30 patients with lung cancer was effective and the lesions shrank to varying degrees. Pulmonary MR-IVIM scans were performed before and after chemotherapy. The IVIM parameters of lung cancer and benign lung tumor, and the IVIM parameters before and after chemotherapy for lung cancer were measured. The IVIM parameters included apparent diffusion coefficient (ADC), tissue diffusivity, pseudo-diffusion coefficient and perfusion fraction. The diagnostic efficacy of IVIM in the differential diagnosis of lung cancer and benign lung tumor was analyzed, so as to determine the optimal critical value for diagnosis. Moreover, the change of IVIM parameters before and after chemotherapy was analyzed. Results The intraclass correlation coefficients of tissue diffusivity, ADC, pseudo-diffusion coefficient and perfusion fraction measured by two observers were 0.825, 0.793, 0.704 and 0.697, respectively. The ADC and tissue diffusivity of lung cancer were significantly lower than those of benign lung tumor, with statistical differences (P<0.05), while the pseudo-diffusion coefficient and perfusion fraction of lung cancer were higher than those of benign lung tumor, without significant differences (P>0.05). The area under ROC curve of tissue diffusivity and ADC in the differential diagnosis of lung cancer and benign lung tumor were 0.888 and 0.847, respectively, which were larger than 0.500. Both tissue diffusivity and ADC were useful for differential diagnosis, and the diagnostic efficiency of tissue diffusivity was superior to that of ADC. The sensitivity and specificity of tissue diffusivity were higher than those of ADC (88.8% vs 84.7%; 75.2% vs 71.5%). The optimal critical values of tissue diffusivity and ADC in differential diagnosis were (1.185×10-3) and (1.265×10-3) mm2/s, respectively. Compared with those before chemotherapy, tissue diffusivity and ADC after chemotherapy were increased, while pseudo-diffusion coefficient and perfusion fraction were decreased. The area under ROC curve of tissue diffusivity and ADC of lung cancer were 0.743 and 0.654, respectively, which were larger than 0.500. Both tissue diffusivity and ADC were valuable in the evaluation of chemotherapeutic efficacy, and the evaluation efficiency of the former was better than that of the latter. Conclusion The tissue diffusivity and ADC in MR-IVIM can be used as effective indicators to differentiate benign and malignant lung tumors. The diagnostic value of tissue diffusivity is superior to that of ADC. Moreover, tissue diffusivity and ADC can also be used as auxiliary indexes to evaluate the chemotherapeutic efficacy in lung cancer.
Last Update: 2019-06-25