Usuda Katsuo, Ishikawa Masahito, Iwai Shun, Iijima Yoshihito, Motono Nozomu, Matoba Munetaka, Doai Mariko, Hirata Keiya, Uramoto Hidetaka
Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa 920-0293, Japan.
Department of Radiology, Kanazawa Medical University, Ishikawa 920-0293, Japan.
Cancers (Basel). 2021 Mar 28;13(7):1551. doi: 10.3390/cancers13071551.
The purpose of this study is to determine whether the combination assessment of DWI and T2-weighted imaging (T2WI) improves the diagnostic ability for differential diagnosis of lung cancer from benign pulmonary nodules and masses (BPNMs). The optimal cut-off value (OCV) for differential diagnosis was set at 1.470 × 10 mm/s for apparent diffusion coefficient (ADC), and at 2.45 for T2 contrast ratio (T2 CR). The ADC (1.24 ± 0.29 × 10 mm/s) of lung cancer was significantly lower than that (1.69 ± 0.58 × 10 mm/s) of BPNM. The T2 CR (2.01 ± 0.52) of lung cancer was significantly lower than that (2.74 ± 1.02) of BPNM. As using the OCV for ADC, the sensitivity was 83.9% (220/262), the specificity 63.4% (33/52), and the accuracy 80.6% (253/314). As using the OCV for T2 CR, the sensitivity was 89.7% (235/262), the specificity 61.5% (32/52), and the accuracy 85.0% (267/314). In 212 PNMs which were judged to be malignant by both DWI and T2WI, 203 PNMs (95.8%) were lung cancers. In 33 PNMs which were judged to be benign by both DWI and T2WI, 23 PNMs (69.7%) were BPNMs. The combined assessment of DWI and T2WI could judge PNMs more precisely and would be acceptable for differential diagnosis of PNMs.
本研究的目的是确定弥散加权成像(DWI)与T2加权成像(T2WI)的联合评估是否能提高肺癌与良性肺结节及肿块(BPNM)鉴别诊断的诊断能力。鉴别诊断的最佳截断值(OCV)设定为表观扩散系数(ADC)为1.470×10⁻³mm²/s,T2对比率(T2 CR)为2.45。肺癌的ADC(1.24±0.29×10⁻³mm²/s)显著低于BPNM的ADC(1.69±0.58×10⁻³mm²/s)。肺癌的T2 CR(2.01±0.52)显著低于BPNM的T2 CR(2.74±1.02)。以ADC的OCV进行判断时,敏感性为83.9%(220/262),特异性为63.4%(33/52),准确性为80.6%(253/314)。以T2 CR的OCV进行判断时,敏感性为89.7%(235/262),特异性为61.5%(32/52),准确性为85.0%(267/314)。在DWI和T2WI均判定为恶性的212个肺结节中,203个(95.8%)为肺癌。在DWI和T2WI均判定为良性的33个肺结节中,23个(69.7%)为BPNM。DWI与T2WI的联合评估能更准确地判断肺结节,可用于肺结节的鉴别诊断。