Value of diffusionweighted MR imaging in the diag

Authors: Konstantin Holzapfel Jochen Gaa Elaine C Schubert Matthias Eiber Joerg Kleeff Ernst J Rummeny Martin Loos

Publish Date: 2016/06/07

Volume: 41, Issue: 10, Pages: 1937-1941

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Abstract

In 24 patients with cholangiocarcinoma MR imaging of the upper abdomen was performed prior to surgery at 15 T using a respiratorytriggered singleshot echoplanar imaging SSEPI sequence b values 50 300 and 600 s/mm2 ADC apparent diffusion coefficient values and diameters of regional lymph nodes LN were determined Subsequently in all patients surgical exploration and/or resection of the primary tumor and regional LN dissection were performed Imaging results were correlated with results of histopathologic analysis ADC values and diameters of benign and malignant LN were compared using the Mann–Whitney U test In addition a ROC receiver operating characteristic curve analysis was performedThe mean ADC value ×10−3 mm2/s of metastatic LN 121 ± 015 was significantly lower than that of benign LN 162 ± 033 p  0001 while there was no significant difference in the mean diameter of malignant 168 ± 54 mm and benign LN 141 ± 40 mm p = 009 Using an ADC value of 125 × 10−3 mm2/s as threshold 914 of LN were correctly classified as benign or malignant with a sensitivity/specificity of 833/928 and a positive/negative predictive value of 667/967 The area under the ROC curve was 093All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards The study was approved by our institutional review board As images were analyzed retrospectively in this singlecenter study the requirement for informed consent was waived

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