Diffusion-Weighted Magnetic Resonance Imaging as a Noninvasive Parameter for Differentiating Benign and Malignant...

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Distinguishing benign from malignant intraperitoneal collections (IPCs) is crucial but challenging based solely on peritoneal morphology.
• Current imaging methods may not always definitively identify malignancy in IPCs.

Purpose of the Study:

• To evaluate the apparent diffusion coefficient (ADC) of ascitic fluid as a non-invasive criterion for differentiating benign from malignant intraperitoneal effusions.
• To establish stand-alone differentiation criteria using ADC values.

Main Methods:

• Retrospective analysis of magnetic resonance examinations in 61 patients with known IPCs (37 benign, 24 malignant).
• ADC values were measured by two radiologists and averaged.
• Independent samples t-test and receiver operating characteristic (ROC) analysis were used to assess diagnostic ability.

Main Results:

• A statistically significant difference in ADC values was found between benign and malignant IPCs (p = 0.0034).
• Mean ADC values were higher in the benign group (3.543 × 10⁻³ mm²/s) compared to the malignant group (3.057 × 10⁻³ mm²/s).
• An optimal ADC cutoff of <3.241 × 10⁻³ mm²/s demonstrated 77.78% sensitivity and 80% specificity for diagnosing malignant ascites.

Conclusions:

• ADC is a noninvasive and reproducible imaging parameter that aids in assessing intraperitoneal collections.
• ADC successfully distinguishes between malignant and benign IPCs.
• Further research is needed to confirm if ADC value differences relate to fluid physical characteristics or histopathological origins.