title: Differentiation of central lung cancer from atelectasis: comparison of diffusion-weighted MRI with PET/CT.
abstract: OBJECTIVE
  Prospectively assess the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiation of central lung cancer from atelectasis.
  
  
  METHODS
  38 consecutive lung cancer patients (26 males, 12 females; age range: 28-71 years; mean age: 49 years) who were referred for thoracic MR imaging examinations were enrolled. MR examinations were performed using a 1.5-T clinical scanner and scanning sequences of T1WI, T2WI, and DWI. Cancers and atelectasis were measured by mapping of the apparent diffusion coefficients (ADCs) obtained with a b-value of 500 s/mm(2).
  
  
  RESULTS
  PET/CT and DW-MR allowed differentiation of tumor and atelectasis in all 38 cases, but T2WI did not allow differentiation in 9 cases. Comparison of conventional T2WI and DW-MRI indicated a higher contrast noise ratio of the central lung carcinoma than the atelectasis by DW-MRI. ADC maps indicated significantly lower mean ADC in the central lung carcinoma than in the atelectasis (1.83±0.58 vs. 2.90±0.26 mm(2)/s, p<0.0001). ADC values of small cell lung carcinoma were significantly greater than those from squamous cell carcinoma and adenocarcinoma (p<0.0001 for both).
  
  
  CONCLUSIONS
  DW-MR imaging provides valuable information not obtained by conventional MR and may be useful for differentiation of central lung carcinoma from atelectasis. Future developments may allow DW-MR imaging to be used as an alternative to PET-CT in imaging of patients with lung cancer.
authors.affiliation: Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical College, Guangzhou, China.
authors.forename: Rui-Meng
authors.initials: RM
authors.lastname: Yang
authors.forename: Long
authors.initials: L
authors.lastname: Li
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Wei
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Guo
authors.forename: Yun-Hai
authors.initials: YH
authors.lastname: Huang
authors.forename: Li-Sha
authors.initials: LS
authors.lastname: Lai
authors.forename: A-Mei
authors.initials: AM
authors.lastname: Chen
authors.forename: Guo-Shun
authors.initials: GS
authors.lastname: Liu
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Xiong
authors.forename: Liang-Ping
authors.initials: LP
authors.lastname: Luo
authors.forename: Xin-Qing
authors.initials: XQ
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D001261:Pulmonary Atelectasis / Q000175:diagnosis*; D055752:Small Cell Lung Carcinoma; D014057:Tomography, X-Ray Computed