Malignant pleural disease: diagnosis by using diffusion-weighted and dynamic contrast-enhanced MR imaging--initial...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Malignant pleural disease (MPD) diagnosis can be challenging.
• Accurate differentiation between benign and malignant pleural lesions is crucial for patient management.

Purpose of the Study:

• To evaluate diffusion-weighted (DW) imaging for distinguishing benign pleural lesions from malignant pleural disease (MPD).
• To assess if combining DW imaging with dynamic contrast-enhanced (DCE) MRI enhances diagnostic performance.

Main Methods:

• Thirty-one patients with suspicious pleural abnormalities underwent whole-body PET/CT and thoracic MRI.
• Apparent diffusion coefficient (ADC) from DW imaging was used for initial evaluation.
• DCE MRI data were incorporated for equivocal DW imaging findings.
• Histopathologic analysis served as the reference standard.

Main Results:

• DW imaging achieved 71.4% sensitivity, 100% specificity, and 87.1% accuracy in differentiating benign from malignant pleural lesions.
• Combining DW imaging with DCE MRI improved results to 92.8% sensitivity, 94.1% specificity, and 93.5% accuracy.
• PET/CT showed 100% sensitivity but only 35.3% specificity for MPD.

Conclusions:

• DW imaging is a valuable tool for differentiating MPD from benign lesions with high accuracy.
• Supplementing DW imaging with DCE MRI further enhances diagnostic sensitivity for MPD.