Non-Gaussian diffusion imaging for malignant and benign pulmonary nodule differentiation: a preliminary study
Non-Gaussian diffusion imaging for malignant and benign pulmonary nodule differentiation: a preliminary study
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DOI：
10.1177/0284185116639763
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发表时间：
2017-01-01
期刊：
影响因子：
1.3
通讯作者：
Yang, Han Feng
中科院分区：
文献类型：
--
作者：
Das, Sushant Kumar;Yang, Dong Jun;Yang, Han Feng
背景 弥散加权成像 (DWI) 衍生的表观弥散系数 (ADC) 已证明肺结节分化结果不一致。弥散峰度成像 (DKI) 量化非高斯弥散，被认为比传统 DWI 更好地表征组织微观结构。 目的 评估 DKI 在人肺中的可行性，并比较其与标准 DWI 在区分恶性肿瘤和良性肺结节方面的诊断价值。 材料和方法 35 例肺组织 使用 3b 值 0、500 和 1000s/mm(2) 以及 b 值 0 和 800s/mm(2) 的常规 DWI 对 32 名连续患者的结节进行评估。两名观察者独立评估和比较了平均峰度 (MK) 和 ADC 值在区分恶性肿瘤和良性肺结节方面的诊断准确性。还对每个衍生指标的观察者内和观察者间重复性（组内相关系数 [ICC]）进行了评估。结果 MK 的诊断准确性和区分恶性肿瘤与良性肺结节的曲线下面积 (AUC) 并没有显着升高（观察 1a：85.70%，0.87；观察 1b：80.00%，0.80；观察 1b：80.00%，0.80； 观察。与 ADC 相比（观察值 1a：77.14%，0.81；观察值 1b：80.00%，0.85；观察值 2：77.14%，0.85）。每次读数对于恶性和良性病变的观察者内和观察者间一致性（ICC）都很重要。 结论 本研究的初步结果表明 DKI 在人肺中的可行性。然而，对于恶性和良性肺结节的分化，DKI 衍生的 MK 值相对于 ADC 没有显着的益处。
Background Diffusion-weighted imaging (DWI) derived apparent diffusion coefficient (ADC) has demonstrated inconsistent results in pulmonary nodule differentiation. Diffusion kurtosis imaging (DKI), which quantifies non-Gaussian diffusion, is believed to better characterize tissue micro-structure than conventional DWI.Purpose To assess the feasibility of DKI in human lungs and to compare its diagnostic value with standard DWI in differentiating malignancies from benign pulmonary nodules.Material and Methods Thirty-five pulmonary nodules in 32 consecutive patients were evaluated by DKI by using 3b-values of 0, 500, and 1000s/mm(2) and conventional DWI with b values of 0 and 800s/mm(2). Two observers independently evaluated and compared diagnostic accuracy of mean kurtosis (MK) and ADC values in differentiating malignancies from benign pulmonary nodules. The intra- and inter-observer repeatability (intra-class correlation coefficient [ICC]) were also assessed for each derived measures.Results The diagnostic accuracy, and the area under curve (AUC) in differentiating malignancies from benign pulmonary nodule, were not significantly higher for MK (Obs. 1a: 85.70%, 0.87; Obs. 1b: 80.00%, 0.80; and Obs. 2: 82.80%, 0.91) as compared to ADC (Obs. 1a: 77.14%, 0.81; Obs. 1b: 80.00%, 0.85; and Obs. 2: 77.14%, 0.85 respectively). The intra- and inter-observer agreement (ICC) for malignant and benign lesions was substantial for each reading.Conclusion The initial results of this study indicate the feasibility of DKI in human lungs. However, there was no significant benefit of DKI derived MK values over ADC for malignant and benign pulmonary nodule differentiation.