Apparent Diffusion Coefficient Measurement in Mediastinal Lymphadenopathies: Differentiation between Benign and Malignant Lesions

Ustabasioglu F. E. , SAMANCI C., Alis D. C. , ŞENGÜL SAMANCI N., Kula O., Olgun D. C.

JOURNAL OF CLINICAL IMAGING SCIENCE, vol.7, pp.1-5, 2017 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 7
  • Publication Date: 2017
  • Doi Number: 10.4103/jcis.jcis_84_16
  • Page Numbers: pp.1-5
  • Keywords: Apparent diffusion coefficient, diffusion, lymph node, mediastinum, magnetic resonance imaging, CELL LUNG-CANCER, LYMPH-NODES, MR, CT, CARCINOMA, NECK, DIAGNOSIS, HEAD, SIZE, PET
  • Acibadem Mehmet Ali Aydinlar University Affiliated: No


Objectives: We aimed to prospectively assess the diagnostic value of apparent diffusion coefficient (ADC) measurement in the differentiation of benign and malignant mediastinal lymphadenopathies. Materials and Methods: The study included 63 consecutive patients (28 women, 35 men; mean age 59.3 years) with 125 mediastinal lymphadenopathies. Echoplanar diffusion-weighted magnetic resonance imaging of the mediastinum was performed with b-factors of 0 and 600 mm(2)/s before mediastinoscopy and mediastinotomy, and ADC values were measured. The ADC values were compared with the histological results, and statistical analysis was done. P < 0.05 was considered statistically significant. Results: The mean ADC value of malignant mediastinal lymphadenopathy (1.030 +/- 0.245 x 10(-3) mm(2)/s) was significantly lower (P < 0.05) when compared to benign lymphadenopathies (1.571 +/- 0.559 x 10(-3) mm(2)/s). For differentiating malignant from benign mediastinal lymphadenopathy, the best result was obtained when an ADC value of 1.334 x 10(-3) mm(2)/s was used as a threshold value; area under the curve 0.848, accuracy 78.4%, sensitivity 66%, specificity of 86%, positive predictive value 76.7%, and negative predictive value of 79.2%. Interobserver agreement was excellent for ADC measurements. Conclusions: ADC measurements could be considered an important supportive method in differentiating benign from malignant mediastinal lymphadenopathies.