Abstract
BackgroundConducted studies showed that the ADC (apparent diffusion coefficient) values of malignant mediastinal lesions are significantly lower than those of benign lesions. Investigators determined cut-off ADC values to differentiate the two; concluding that ADC value is a promising noninvasive, imaging parameter that helps assess and characterize mediastinal tumors.Taking this a step forward, the primary objective of our prospective study was to investigate the potential of DW-MRI (diffusion-weighted magnetic resonance imaging) to characterize malignant mediastinal lesions using their ADC values.Thirty-three patients that underwent MRI of the chest with DWI and latter pathologically diagnosed with a malignant mediastinal lesion were included in this study. Lesions’ ADC values were measured and correlated with the histopathological results. The statistical significance of differences between measurements was tested using the one-way ANOVA (analysis of variance) test; p values equal to or less than 0.05 were considered significant.ResultsThere was no statistically significant difference between the ADCmean values of the histopathological groups of lesions assessed with the overlap of their ADCmean values. The average ADCmean value of NHL (non-Hodgkin lymphoma) was evidently lower than that of HD (Hodgkin disease) with no overlap between their ADCmean values. DWI failed at characterizing one lesion in this study as a malignant tumor, namely an immature teratoma (germ-cell tumor). Again DWI could not be used to evaluate a mass, latter pathologically diagnosed as an angiosarcoma, because of its overall hemorrhagic nature showing no definite non-hemorrhagic soft tissue components. The aforementioned results did not differ considerably when minimum ADC was used instead of mean ADC.ConclusionThere was no statistically significant difference between the ADC values of the malignant mediastinal lesions evaluated. However, regarding lymphoma subtypes, our limited sample study of lymphoma suggested a considerable difference between the ADC values of Hodgkin disease and non-Hodgkin lymphoma.
Highlights
Conducted studies showed that the apparent diffusion coefficient (ADC) values of malignant mediastinal lesions are significantly lower than those of benign lesions
Conducted studies showed that the ADC values of malignant mediastinal lesions are significantly lower than those of benign lesions and determined cut-off ADC values to differentiate the two
Taking this a step forward, the main purpose of our prospective study was to investigate the potential of Diffusion-weighted magnetic resonance imaging (DW-Magnetic resonance imaging (MRI)) to characterize malignant mediastinal lesions using their ADC values
Summary
Conducted studies showed that the ADC (apparent diffusion coefficient) values of malignant mediastinal lesions are significantly lower than those of benign lesions. Investigators determined cut-off ADC values to differentiate the two; concluding that ADC value is a promising noninvasive, imaging parameter that helps assess and characterize mediastinal tumors. Taking this a step forward, the primary objective of our prospective study was to investigate the potential of DWMRI (diffusion-weighted magnetic resonance imaging) to characterize malignant mediastinal lesions using their ADC values. The mediastinum comprises the thoracic compartment anatomically bounded by the thoracic inlet superiorly, the diaphragm inferiorly, the posterior sternal border anteriorly, and posteriorly by the vertebral column. It is an intricate segment of the thorax that contains vital intra-thoracic structures. Assessment of preoperative relationships with the pericardium, heart cavities, spinal cord, and vascular involvement is a common indication of MR imaging of a mediastinal lesion [6]
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