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Lymphoma and inflammation in the orbit: Diagnostic performance with diffusion-weighted imaging and dynamic
Bo Sun1, Liyuan Song1, Xinyan Wang1
1Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Purpose:
To investigate the diagnostic performance of diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), and the combination of both in the differential diagnosis of lymphoma and inflammation in the orbit.
Materials And Methods:
This retrospective study was approved by the Institutional Review Board and the informed consent requirement was waived. A total of 53 patients underwent preoperative 3T MRI. Parameters of DWI and DCE MRI were evaluated in these 30 patients with orbital lymphoma and 23 patients with orbital inflammation. The diagnostic performance was evaluated using receiver operating characteristic curve analysis.
Results:
Apparent diffusion coefficient (ADC) values and parameters derived from DCE MRI of orbital lymphoma and orbital inflammation differed significantly (ADC, Tmax , contrast index [CI], enhancement ratio [ER], and washout ratio [WR]: P < 0.001, P = 0.008, P < 0.001, P < 0.001, and P = 0.005 for reviewer 1, respectively; P < 0.001, P = 0.004, P < 0.001, P < 0.001, and P < 0.001 for reviewer 2, respectively). Sensitivity, specificity, and accuracy values of DWI were 76.67%, 100%, and 86.79% for reviewer 1; 70%, 95.65%, and 81.13% for reviewer 2, respectively. The combination of both were 90%, 86.96%, and 88.68% for reviewer 1; 93.33%, 78.26%, and 86.79% for reviewer 2, respectively. The combination of both was significantly superior to DWI for differentiation of orbital lymphoma from orbital inflammation (P = 0.016 for reviewer 1; P = 0.001 for reviewer 2).
Conclusion:
The combination of DWI and DCE MRI can improve diagnostic performance in differentiating lymphoma from inflammation in the orbit compared with DWI alone.
Level Of Evidence:
3 J. MAGN. RESON. IMAGING 2017;45:1438-1445.
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