Differentiating the lung lesions using Intravoxel incoherent motion diffusion-weighted imaging: a meta-analysis

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Diagnostic performance of IVIM-DWI for pulmonary tumors is debated.
• This meta-analysis provides robust evidence on IVIM-DWI's utility.

Purpose of the Study:

• To evaluate the diagnostic performance of IVIM-DWI in differentiating pulmonary tumors.
• To compare the efficacy of different IVIM-DWI parameters.

Main Methods:

• Systematic literature search across major databases (PubMed, Embase, Web of Science, Wangfang).
• Meta-analysis of 11 studies involving 481 malignant and 258 benign lung lesions.
• Calculation of standardized mean differences (SMD) and pooled sensitivity, specificity, and AUC for IVIM-DWI parameters (ADC, D, D*, f).

Main Results:

• Lung cancer showed significantly lower ADC, D, and f values compared to benign lesions.
• The tissue diffusivity (D) parameter exhibited the best diagnostic performance (AUC=0.90), followed by ADC (AUC=0.86).
• D value also yielded the highest post-test probability for diagnosing lung tumors.

Conclusions:

• IVIM-DWI parameters possess strong diagnostic capabilities for lung tumors, reflecting cellularity and perfusion.
• The D value offers superior diagnostic performance compared to the standard mono-exponential ADC for lung tumor differentiation.