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Original Article
Study of differentiation of benign and malignant lymph nodes based on ADC value of MRI diffusion weighted imaging
LI Zhuo  XUE Hua-dan  HE Yong-lan  LEI Jing  JIN Zheng-yu 

DOI:10.3969/j.issn.1674-8034.2011.05.006.


[Abstract] Objective: To compare clinical value of three different semi-automatic methods in differential diagnosis of benign and malignant rabbit popliteal fossa nodes based on the apparent diffusion coefficient (ADC) map of magnetic resonance (MR) diffusion weighted imaging.Materials and Methods: Twenty-one rabbits were randomly divided into inflammatory and metastatic groups. After popliteal fossa lymph node metastasis model was setted up, MR diffusion weighted imaging was performed. After the scan the lymph nodes were taken for the pathologic diagnosis. The mean ADC of each whole lymph node was compared in the inflammatory and metastatic groups. Three different methods were used for evaluation of lymph nodes based on the ADC map. Method 1: The ADC ratio of cortex vs. medulla (high/low) was calculated; Method 2: Curve of the mean ADC value vs. distance to the node's center, which was manually identified, was generated and slope of the curve was acquired. Method 3: Curve of the mean ADC value vs. distance to the node's morphological skeleton was generated and slope of the curve was acquired. Based on the pathological results, ROC was obtained and AUC was calculated in each procedure.Results: Forty-one lymph nodes were included in the experiment, 22 were metastatic and 19 were inflammatory. The mean ADC value of whole nodes in the two groups was 1.54×10-3 mm2/s vs. 1.42×10-3 mm2/s (P=0.234). The area under the curve (AUC) in the three procedures and the mean of whole node were 0.839 (cortex vs. medulla), 0.775 (to the center), 0.654 (to the skeleton), and 0.583 respectively. And the Youden index were 0.639, 0.517, 0.304, and 0.266.Conclusions: Of the 3 methods, Method 1 showed the best AUC and it might be the best semi-automatic ADC methods for the identification of lymph node malignancy.
[Keywords] Diffusion weighted imaging;Lymph node;Metastasis;Apparent diffusion coefficient;Magnetic resonance imaging

LI Zhuo Radology Department, Peking Union Medical College Hospital, Beijing 100730, China

XUE Hua-dan Radology Department, Peking Union Medical College Hospital, Beijing 100730, China

HE Yong-lan Radology Department, Peking Union Medical College Hospital, Beijing 100730, China

LEI Jing Radology Department, Peking Union Medical College Hospital, Beijing 100730, China

JIN Zheng-yu* Radology Department, Peking Union Medical College Hospital, Beijing 100730, China

*Correspondence to: Jin ZY, E-mail: jin_zhengyu@163.com

Conflicts of interest   None.

Received  2011-08-01
Accepted  2011-09-09
DOI: 10.3969/j.issn.1674-8034.2011.05.006
DOI:10.3969/j.issn.1674-8034.2011.05.006.

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