Abstract
Background
Solid malignant tumors are more highly cellular than benign lesions and hence have a restricted diffusion of water molecules.
Objective
To evaluate whether diffusion-weighted MR imaging (DWI) can differentiate between benign and malignant pediatric abdominal tumors.
Materials and methods
We retrospectively analyzed DWI scans of 68 consecutive children with 39 benign and 34 malignant abdominal masses. To calculate the apparent diffusion coefficient (ADC) maps and ADC values, we used 1.5-T sequences at TR/TE/b-value of 5,250–7,500/54–64/b = 0, 500 and 3-T sequences at 3,500–4,000/66–73/b = 0, 500, 800. ADC values were compared between benign and malignant and between data derived at 1.5 tesla (T) and at 3 tesla magnetic field strength, using the Mann-Whitney-Wilcoxon test, ANOVA and a receiver operating curve (ROC) analysis.
Results
There was no significant difference in ADC values obtained at 1.5 T and 3 T (P = 0.962). Mean ADC values (× 10−3 mm2/s) were 1.07 for solid malignant tumors, 1.6 for solid benign tumors, 2.9 for necrotic portions of malignant tumors and 3.1 for cystic benign lesions. The differences between malignant and benign solid tumors were statistically significant (P = 0.000025). ROC analysis revealed an optimal cut-off ADC value for differentiating malignant and benign solid tumors as 1.29 with excellent inter-observer reliability (alpha score 0.88).
Conclusion
DWI scans and ADC values can contribute to distinguishing between benign and malignant pediatric abdominal tumors.
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Abbreviations
- DWI:
-
Diffusion-weighted MR imaging
- ADC:
-
Apparent diffusion coefficient
- ANOVA:
-
Analysis of variance
- ROC:
-
Receiver operating curve
- FSE:
-
Fast spin-echo
- LAVA:
-
Liver acquisition with volume acquisition
- FOV:
-
Field of view
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Acknowledgments
This work was supported by a grant from the Society for Pediatric Radiology Research and Education Foundation and by the Thrasher Research Fund. We would like to acknowledge Jennifer Vancil, who helped us with the editing of the images and figures for this manuscript.
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Gawande, R.S., Gonzalez, G., Messing, S. et al. Role of diffusion-weighted imaging in differentiating benign and malignant pediatric abdominal tumors. Pediatr Radiol 43, 836–845 (2013). https://doi.org/10.1007/s00247-013-2626-0
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DOI: https://doi.org/10.1007/s00247-013-2626-0