Diffusion-weighted magnetic resonance imaging to differentiate malignant from benign gallbladder disorders. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Kitazume, Yoshio; Taura, Shin-ichi; Nakaminato, Shuichiro; Noguchi, Osamu; Masaki, Yukiyoshi; Kasahara, Ichiro; Kishino, Mitsuhiro; Tateishi, Ukihide
• Is Part Of: European journal of radiology. Volume 85:Issue 4(2016)
• Page Start: 864
• Page End: 873
• Publication Date: 2016-04
• Subjects: Diffusion-weighted imaging -- Apparent diffusion coefficient -- Gallbladder carcinoma -- Gallbladder; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.02.003
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To retrospectively evaluate the utility of apparent diffusion coefficient (ADC) and lesion to spinal cord ratio (LSR) in diffusion-weighted magnetic resonance (MR) imaging (DWI) as compared with morphological assessment alone, for differentiating malignant from benign gallbladder disorders. Methods: This study was approved by the ethics committee, and written informed consent was waived. Ninety-one patients (13 malignancy and 78 benignancy) were reviewed. ADC was calculated using two DW images with different motion-probing gradient strengths ( b = 0, 1000 s/mm 2 ). LSR was measured by dividing the signal intensity of a thickened gallbladder wall by the maximum signal intensity of the lumbar enlargement of the spinal cord. In addition, the morphology of the gallbladders was assessed with conventional MR imaging. Results: In receiver operating characteristic curve analysis, the areas under the curves for ADC and LSR were 0.861 and 0.906, respectively. Three morphological findings were considered: a massive formation, a disrupted mucosal line, and the absence of a two-layered pattern. When a combination of two or more of these morphological findings was positive for malignancy, the sensitivity, specificity, and accuracy were 76.9%, 84.0%, and 83.0%, respectively. When a combination of three or more of the above morphological findings together with ADC of less than 1.2 × 10 −3 mm 2 /s or LSR of more than 0.48 were positive for malignancy, these values were 73.0%, 96.2%, and 92.9%, respectively. There were significant differences in specificity and accuracy. Conclusion: Use of ADC and LSR in DWI can improve diagnostic performance for differentiating malignant from benign gallbladder disorders.