Malignant versus benign mediastinal lesions: quantitative assessment with diffusion weighted MR imaging

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Mediastinal lesions pose diagnostic challenges.
• Accurate differentiation between benign and malignant masses is crucial for patient management.
• Conventional MRI sequences have limitations in distinguishing lesion types.

Purpose of the Study:

• To assess the efficacy of diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating malignant from benign mediastinal lesions.
• To determine the diagnostic performance of apparent diffusion coefficient (ADC) values.

Main Methods:

• Fifty-three mediastinal lesions underwent conventional T1- and T2-weighted MRI.
• Diffusion-weighted images were acquired with b-values of 0 and 1000 s/mm².
• Apparent diffusion coefficient (ADC) values were calculated and analyzed using the Student-t test.

Main Results:

• Malignant mediastinal lesions exhibited significantly lower mean ADC values compared to benign masses (p < 0.001).
• An ADC cut-off value of ≤ 1.39 × 10⁻³ mm²/s achieved 95% sensitivity and 87% specificity for malignancy detection.
• DW-MRI demonstrated strong performance in distinguishing between malignant and benign mediastinal pathologies.

Conclusions:

• Diffusion-weighted imaging is a valuable tool for differentiating benign from malignant mediastinal masses.
• ADC values derived from DW-MRI provide quantitative information for improved diagnostic accuracy.
• DW-MRI can aid clinicians in treatment planning for patients with mediastinal lesions.