title: Diffusivity of intraorbital lymphoma vs. IgG4-related DISEASE: 3D turbo field echo with diffusion-sensitised driven-equilibrium preparation technique.
abstract: OBJECTIVE
  3D turbo field echo with diffusion-sensitised driven-equilibrium preparation (DSDE-TFE) is a novel non-echo planar technique for diffusion-weighted (DW) imaging. The purpose of this study was to differentiate intraorbital lymphoma from immunoglobulin G4-related disease (IgG4-RD) using the apparent diffusion coefficient (ADC) derived from DSDE-TFE.
  
  
  METHODS
  Fifteen patients with lymphomas and 8 with IgG4-RDs underwent imaging. ADC and signal intensities compared with normal grey matter on T1-weighted images, fat-suppressed T2-weighted images and fat-suppressed postcontrast T1-weighted images were measured. Statistical analyses were performed using the Mann-Whitney U test and receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  Intraorbital lesions were clearly visualised on DSDE-TFE without obvious geometrical distortion. The ADC of lymphoma (1.25 ± 0.50 × 10(-3) mm(2)/s; mean ± standard deviation) was significantly lower than that of IgG4-RD (1.67 ± 0.84 × 10(-3) mm(2)/s; P < 0.05). Conventional sequences could not separate lymphoma from IgG4-RD (0.93 ± 0.18 vs. 0.94 ± 0.21 on T1-weighted images, 0.92 ± 0.17 vs. 0.95 ± 0.14 on T2-weighted images and 2.03 ± 0.35 vs. 2.30 ± 0.58 on postcontrast T1-weighted images, for lymphoma and IgG4-RD, respectively; P > 0.05). ROC analysis showed the best diagnostic performance with ADC.
  
  
  CONCLUSIONS
  The apparent diffusion coefficient derived from diffusion-sensitised driven-equilibrium preparation techniques may help to differentiate lymphoma from immunoglobulin G4-related disease.
  
  
  CONCLUSIONS
  • Distinguishing between orbital lymphoma and immunoglobulin G4-related disease can be difficult • Intraorbital lesions were clearly visualised on diffusion-sensitised driven-equilibrium preparation magnetic resonance techniques. • Variations in field homogeneity do not affect DSDE-TFE techniques all that much. • ADCs derived from DSDE-TFE may help differentiate lymphoma from IgG4-RD.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, hiwatasi@radiol.med.kyushu-u.ac.jp.
authors.forename: Akio
authors.initials: A
authors.lastname: Hiwatashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiura
authors.forename: Osamu
authors.initials: O
authors.lastname: Togao
authors.forename: Koji
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Fujita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Takaomi
authors.initials: T
authors.lastname: Koga
authors.forename: Makoto
authors.initials: M
authors.lastname: Obara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D008223:Lymphoma / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000473:pathology; D009918:Orbital Neoplasms / Q000175:diagnosis / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D007074:Immunoglobulin G