Assessment of mediastinal tumors with diffusion-weighted single-shot echo-planar MRI.
OBJECTIVE
To assess the role of diffusion-weighted single-shot echo-planar magnetic resonance imaging (MRI) in patients with mediastinal tumors.


METHODS
Prospective study was conducted on 45 consecutive patients (29 male, 16 female, age 22-66 years, mean 41 years) with mediastinal tumor. They underwent diffusion-weighted single-shot echo-planar MRI of the mediastinum with a b-factor of 0, 300, and 600 sec/mm(2). The apparent diffusion coefficient (ADC) value of the mediastinal tumor was correlated with the histopathological findings.


RESULTS
The mean ADC value of malignant mediastinal tumors was 1.09 +/- 0.25 x 10(-3) mm(2)/sec, and of benign tumors was 2.38 +/- 0.56 x 10(-3) mm(2)/sec. There was a significant difference in the mean ADC value between malignant and benign tumors (P = 0.001) and within different grades of malignancy (0.001). When an ADC value of 1.56 x 10(-3) mm(2)/sec was used as a threshold value for differentiating malignant from benign tumor, the best results were obtained with an accuracy of 95%, sensitivity of 96%, specificity of 94%, positive predictive value of 94%, negative predictive value of 96%, and area under the curve of 0.938.


CONCLUSIONS
The ADC value is a noninvasive parameter that can be used for differentiation of malignant from benign mediastinal tumors and grading of mediastinal malignancy.
Razek
Ahmed Abdel
AA
Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt. arazek@mans.eun.eg
Elmorsy
Ahmed
A
Elshafey
Mohsen
M
Elhadedy
Tamer
T
Hamza
Osama
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology*; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D055815:Young Adult