Diffusion-weighted magnetic resonance imaging for the initial characterization of non-fatty soft tissue tumors: correlation between T2 signal intensity and ADC values

• Published in: Skeletal radiology Vol. 45; no. 2; pp. 263 - 271
• Main Authors: Gondim Teixeira, Pedro Augusto, Gay, Frederique, Chen, Bailiang, Zins, Marie, Sirveaux, François, Felblinger, Jacques, Blum, Alain
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2016; Springer; Springer Nature B.V; Springer Verlag
• Subjects: Adult; Aged; Cancer; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging - methods; Drunk driving; Female; Human health and pathology; Humans; Image Interpretation, Computer-Assisted - methods; Imaging; Life Sciences; Magnetic resonance imaging; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Nuclear Medicine; Orthopedics; Pathology; Prospective Studies; Radiology; Reproducibility of Results; Scientific Article; Sensitivity and Specificity; Soft Tissue Neoplasms - pathology; Characterization; MR imaging; ADC values; Diffusion weighted imaging; Soft-tissue tumors
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-015-2302-6

Objective To evaluate the performance of quantitative diffusion-weighted imaging (DWI) correlated with T2 signal in differentiating non-fatty benign from malignant tumors. Material and methods A total of 76 patients with a histologically confirmed non-fatty soft tissue tumors (46 benign and 30 malignant) were prospectively included in this ethics committee approved study. All patients signed an informed consent and underwent MRI with DWI with two b values (0 and 600). ADC values from the solid components of these tumors were obtained and were correlated with the lesion’s signal intensity on T2-weighted fat-saturated sequences. ADC values were obtained from adjacent normal muscle to allow calculation of tumor/muscle ADC ratios. Results There were 58 hyperintense and 18 iso or hypointense lesions. All hypointense lesions were benign. The mean ADC values for benign and malignant tumors were 1.47 ± 0.54 × 10 −3 and 1.17 ± 0.38 × 10 −3 mm 2 /s respectively ( p  < 0.005). The mean ADC ratio in benign iso or hypointense tumors was significantly lower than that of hyperintense ones (0.76 ± 0.21 versus 1.58 ± 0.82 – p  < 0.0001). An ADC ratio lower than 0.915 was highly specific for malignancy (96.4 %), whereas an ADC ratio higher than 1.32 was highly sensitive for benign lesions (90 %). Conclusion ADC analysis can be useful in the initial characterization of T2 hyperintense non-fatty soft tissue masses, although this technique alone is not likely to change patient management.