Apparent diffusion coefficient measurements with diffusion-weighted imaging for differential diagnosis of soft-tissue tumor.

Abstract

To evaluate the diagnostic potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) in distinguishing malignant and benign soft-tissue tumors. Published studies were retrieved through comprehensive search in various computerized databases. High-quality studies relevant to ADC values of DWI in differential diagnosis of soft-tissue tumors were screened using our stringent inclusion and exclusion criteria for this meta-analysis. The standard mean difference with 95% confidence interval (95% CI) was estimated. Statistical analyses were performed using the STATA statistical software (Stata Co., College Station, TX, USA). Thirteen cohort studies were finally included, and these studies provided the required information on the diagnostic value of diffusion magnetic resonance imaging in soft-tissue tumors. The 13 studies contained a combined total of 344 malignant soft tumors and 315 benign soft tumors. The results of our meta-analysis revealed that mean ADC value in patients with malignant soft-tissue tumor decreased significantly in comparison with the ADC values obtained in patients with benign soft-tissue tumor (P < 0.001). Country-stratified analysis suggested that ADC value might play a predictive role in the differential diagnosis of soft-tissue tumors in China (P = 0.007), Egypt (P < 0.001), Germany (P = 0.001), Japan (P = 0.049), and The Netherlands (P < 0.001). Our results provide strong evidence that patients diagnosed with malignant soft-tissue tumors have low ADC values of DWI compared to those with benign soft-tissue tumors. Therefore, ADC measurements with DWI may be reliable in differential diagnosis of soft-tissue tumors.