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Diagnostic performance of diffusion-weighted magnetic resonance imaging in pulmonary malignant lesions: a
Ning Chang1, Xiao-Hui Wang2, Long-Biao Cui3
1Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Background:
Overuse or misuse of positron emission tomography/computed tomography (PET/CT) should be avoided for its ionizing-radiation. Diffusion-weighted magnetic resonance imaging (DW-MRI), characterized by no radiation, may be regarded as an alternative in differentiating pulmonary nodules. We aim to estimate the diagnostic accuracy of DW-MRI in diagnosing of pulmonary lesions.
Methods:
Relevant studies were searched through PubMed and Embase with no language restriction from inception to March 8, 2019. We selected studies reporting sensitivity and specificity of DW-MRI for differentiating pulmonary nodules. A summary estimates of sensitivity, specificity and area under curve (AUC) of receiver operating characteristic (ROC) of DW-MRI were analyzed with a random effects model.
Results:
We included data from 37 studies, which altogether included 2,311 pulmonary lesions. The pooled sensitivity and specificity were 0.86 (95% CI, 0.82-0.89) and 0.79 (95% CI, 0.72-0.85), and AUC was 0.90 (95% CI, 0.87-0.92). Subsequent subgroup analysis showed the higher sensitivity of DW-MRI in pulmonary lesion >2 cm in comparison to lesions ≤2 cm, however, higher specificity was observed in smaller lesions.
Conclusions:
Radiation-free DW-MRI showed a favorable balance between sensitivity and specificity in diagnosing pulmonary malignancies especially in lesion size ≤2 cm. Existing evidence indicated that DW-MRI may be considered as an independent substitute in diagnosis of lung lesions, which might help to prevent long-term side-effects from radiographic diagnosing and evaluating procedures.
Insights
Diffusion-weighted MRI (DW-MRI) offers a radiation-free alternative for diagnosing lung lesions. This technique shows favorable sensitivity and specificity, potentially replacing traditional imaging methods.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Positron emission tomography/computed tomography (PET/CT) involves ionizing radiation, necessitating alternatives for diagnosing pulmonary nodules.
- Diffusion-weighted magnetic resonance imaging (DW-MRI) is a radiation-free imaging technique with potential for differentiating pulmonary lesions.
Purpose of the Study:
- To evaluate the diagnostic accuracy of DW-MRI in identifying pulmonary lesions.
- To compare the efficacy of DW-MRI against traditional imaging modalities.
Main Methods:
- A systematic literature search was conducted on PubMed and Embase up to March 8, 2019.
- Studies reporting sensitivity and specificity of DW-MRI for pulmonary nodule differentiation were selected.
- Meta-analysis using a random effects model was performed to pool diagnostic accuracy metrics, including area under the curve (AUC).
Main Results:
- Data from 37 studies encompassing 2,311 pulmonary lesions were analyzed.
- Pooled sensitivity was 0.86 (95% CI, 0.82-0.89) and pooled specificity was 0.79 (95% CI, 0.72-0.85).
- The area under the receiver operating characteristic curve (AUC) was 0.90 (95% CI, 0.87-0.92), indicating good diagnostic performance. Subgroup analysis revealed higher sensitivity for lesions >2 cm and higher specificity for lesions ≤2 cm.
Conclusions:
- Radiation-free DW-MRI demonstrates a balanced sensitivity and specificity for diagnosing pulmonary malignancies, particularly for smaller lesions (≤2 cm).
- DW-MRI can be considered a viable alternative to radiographic procedures for diagnosing lung lesions.
- Utilizing DW-MRI may help mitigate long-term side effects associated with traditional diagnostic imaging.
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