Abstract
Apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) has gained wide attention as potential tool for differentiating between malignant and benign solitary pulmonary lesions (SPLs). The overall effects of multiple histopathological parameters on ADC have not been elucidated, which may help to explain the overlapping of ADC between malignant and benign SPLs. The study sought to explore associations between ADC and histopathological parameters in SPLs, and to compare diagnostic capability of ADC among different types of SPLs. Multiple histopathological parameters (cell density, nuclear-to-cytoplasm ratio, necrotic fraction, presence of mucus and grade of differentiation) were quantified in 52 malignant and 13 benign SPLs with surgical pathology available. Cell density (β = −0.40) and presence of mucus (β = 0.77) were independently correlated with ADC in malignant SPLs. The accurate diagnosis rate of squamous carcinomas, adenocarcinomas without mucus and malignant tumors with mucus was 100%, 82% and 0%, respectively. Our study suggested that cell density and presence of mucus are independently correlated with ADC in malignant SPLs. Squamous carcinoma maybe more accurately diagnosed as malignancy by ADC value. Malignant SPLs with mucus and adenocarcinomas with low cell density should be kept in mind in differentiating SPLs using ADC because of insufficient diagnostic capability.
Highlights
Apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) has gained wide attention as potential tool for differentiating between malignant and benign solitary pulmonary lesions (SPLs)
We found that cell density and presence of mucus were independently correlated with ADC value in malignant SPLs, but nuclear-to-cytoplasm ratio (NCR), necrotic fraction and grade of differentiation were not
In terms of the diagnostic capability of ADC value in benign SPLs, we found that it was better in noninflammatory SPLs than in inflammatory SPLs which maybe caused by the overlap of ADC value between active inflammatory lesions and malignant lesions
Summary
Apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) has gained wide attention as potential tool for differentiating between malignant and benign solitary pulmonary lesions (SPLs). Cell density (β = −0.40) and presence of mucus (β = 0.77) were independently correlated with ADC in malignant SPLs. The accurate diagnosis rate of squamous carcinomas, adenocarcinomas without mucus and malignant tumors with mucus was 100%, 82% and 0%, respectively. Diffusion-weighted imaging (DWI) has gained wide attention as potential tool for differentiating between malignancy and benignity[11,12], assessment of therapy response[13,14], improving CT-guided transthoracic biopsy[15] and evaluating N stage in patients with lung cancer[16]. Asymptomatic Cough with bloody sputum Cough without bloody sputum Pyrexia Chest pain Hemoptysis Hoarseness Diagnostic method—no. (%) Surgical resection Percutaneous puncture biopsy Bronchoscopy biopsy Mediastinoscopic biopsy Pleural or distant metastasis Follow-up
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
