Differentiation Between Transudative and Exudative Pleural Effusions by Diffusion Weighted Magnetic Resonance Imaging

Keskin, Zeynep; Yesildag, Mihrican; Alkan, Ender; Kayhan, Ayşegül; Tolu, İsmet; Keskin, Suat

doi:10.5812/iranjradiol.78775

Cited by 5 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CEUS has shown promising results in distinguishing between benign and malignant pleural lesions based on their vascularity patterns [40]. On the other hand, DW-MRI has demonstrated potential in detecting and characterizing MPE, particularly when CT findings are inconclusive [41]. Furthermore, integrating imaging findings with other diagnostic modalities, such as thoracoscopy, pleural fluid analysis, and molecular biomarkers may further enhance the diagnostic accuracy and management of MPE [42].…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Shehata,

Almalki,

Basha

et al. 2024

Diagnostics

View full text Add to dashboard Cite

Malignant pleural effusion (MPE) is a manifestation of advanced cancer that requires a prompt and accurate diagnosis. Ultrasonography (US) and computed tomography (CT) are valuable imaging techniques for evaluating pleural effusions; however, their relative predictive ability for a malignant origin remains debatable. This prospective study aimed to compare chest US with CT findings as predictors of malignancy in patients with undiagnosed exudative pleural effusion. Fifty-four adults with undiagnosed exudative pleural effusions underwent comprehensive clinical evaluation including chest US, CT, and histopathologic biopsy. Blinded radiologists evaluated the US and CT images for features suggestive of malignancy, based on predefined criteria. Diagnostic performance measures were calculated using histopathology as a reference standard. Of the 54 patients, 33 (61.1%) had MPEs confirmed on biopsy. No significant differences between US and CT were found in detecting parietal pleural abnormalities, lung lesions, chest wall invasion, or liver metastasis. US outperformed CT in identifying diaphragmatic pleural thickening ≥10 mm (33.3% vs. 6.1%, p < 0.001) and nodularity (45.5% vs. 3%, p < 0.001), whereas CT was superior for mediastinal thickening (48.5% vs. 15.2%, p = 0.002). For diagnosing MPE, diaphragmatic nodularity detected by US had 45.5% sensitivity and 100% specificity, whereas CT mediastinal thickening had 48.5% sensitivity and 90.5% specificity. Both US and CT demonstrate reasonable diagnostic performance for detecting MPE, with particular imaging findings favoring a malignant origin. US may be advantageous for evaluating diaphragmatic pleural involvement, whereas CT is more sensitive to mediastinal abnormalities.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Shehata,

Almalki,

Basha

et al. 2024

Diagnostics

View full text Add to dashboard Cite

show abstract

“…The ADC map obtained by DWI has emerged as a new method for characterization of pleural fluid at the molecular level [27]. There are 3 studies in the English language medical literature regarding the use of DWI in pleural fluid analysis [27][28][29]. In these studies, the ADC values were found to be lower in the exudative fluids than in the transudative fluids.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, only the ADC values of the fluids were taken into consideration, while a quantitative and qualitative analysis of the DWI was not performed. The ADC threshold value, specificity, sensitivity, NPV, PPV, and diagnostic accuracy ratio were 3/38 × 10 -3 mm 2 /s, 85%, 90.6%, 85%, 90.6%, and 88.5% for the first study; 3.6 × 10 -3 mm 2 /s, 63%, 71%, 68%, 66%, and 67% for the second study; and 3.51 × 10 -3 mm 2 /s, 90.4%, %78, 86.5%, 83.9%, and 84.9% for the third study [ 26 , 28 , 29 ]. In the present study, the ADC threshold value was measured as 2.95 × 10 -3 mm 2 /s, and the threshold value was significantly lower than in the other studies.…”

Section: Discussionmentioning

confidence: 99%

Can diffusion-weighted imaging be used in the examination of peritoneal fluids?

Keskin¹

2023

Pol J Radiol

Self Cite

View full text Add to dashboard Cite

Purpose:The aetiology of free fluid detected in the abdomen can be investigated with magnetic resonance imaging (MRI).The aim of this study is to investigate the effectiveness of diffusion-weighted images (DWI) and apparent diffusion coefficient (ADC) values in the evaluation of abdominopelvic fluids. Material and methods:Patients with abdominopelvic fluid detected on MRI of the lower abdomen were included in this retrospective, single-centre study. Paracentesis and fluid analysis was performed in these patients. The average ADC values in fluids were measured by a radiologist. A cut-off value was determined, and the specificity, sensitivity, negative predictive value (NPV), and positive predictive values (PPV) were calculated. Intra-observer agreement was investigated. Results:The study comprised 41 (33 female) patients, and their mean age was 48 ± 4.02 years. The ADC values in infective fluids were significantly higher than in non-infective fluids (p < 0.001). The cut-off value used was 2.95 × 10 -3 mm²/s. According to this threshold value, sensitivity in distinguishing non-infective from infective fluids was 88%, specificity was 93.8%, PPV was 95.7%, and NPV was 83.3%. Intra-observer agreement was strong in ADC values (κ = 0.699) (p < 0.001). Conclusions:We concluded that the ADC value is a non-invasive, reliable, reproducible imaging parameter that can be useful in the evaluation and characterization of abdominal fluids.

show abstract

“…The ADC values represent a quantitative measurement of the degree of such motion in tissue, and are also used as a marker of cellularity [15]. Aside from being a noninvasive, reliable, and reproducible imaging parameter, the ADC measurements have been proven to be useful in the evaluation and characterization of different types of effusion [15,17]. To our knowledge, research involving these methods has been limited to the pleural fluid to date, and successfully proved that differences in liquid content have an important influence on ADC values [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Diffusion-Weighted Magnetic Resonance Imaging as a Noninvasive Parameter for Differentiating Benign and Malignant Intraperitoneal Collections

et al. 2020

View full text Add to dashboard Cite

Background and Objective: The imaging differentiation of benign from malignant intraperitoneal collections (IPCs) relies on the tumoral morphological modifications of the peritoneum, which are not always advocating for malignancy. We aimed to assess ascitic fluid with the apparent diffusion coefficient (ADC) to determine non-invasive, stand-alone, differentiation criteria for benign and malignant intraperitoneal effusions. Materials and Methods: Sixty-one patients with known IPCs who underwent magnetic resonance examinations for reasons such as tumor staging, undetermined abdominal mass and disease follow up were retrospectively included in this study. All subjects had a final diagnosis of the fluid based on pathological examinations, which were divided into benign (n = 37) and malignant (n = 24) IPCs groups. ADC values were measured separately by two radiologists, and the average values were used for comparing the two groups by consuming the independent samples t-test. The receiver operating characteristic analysis was performed to test the ADC values’ diagnostic ability to distinguish malignant from benign collections. Results: The differentiation between benign and malignant IPCs based on ADC values was statistically significant (p = 0.0034). The mean ADC values were higher for the benign (3.543 × 10−3 mm2/s) than for the malignant group (3.057 × 10−3 mm2/s). The optimum ADC cutoff point for the diagnosis of malignant ascites was <3.241 × 10−3 mm2/s, with a sensitivity of 77.78% and a specificity of 80%. Conclusions: ADC represents a noninvasive and reproducible imaging parameter that may help to assess intraperitoneal collections. Although successful in distinguishing malignant from benign IPCs, further research must be conducted in order to certify if the difference in ADC values is a consequence of the physical characteristics of the ascitic fluids or their appurtenance to a certain histopathological group.

show abstract

Differentiation Between Transudative and Exudative Pleural Effusions by Diffusion Weighted Magnetic Resonance Imaging

Cited by 5 publications

References 16 publications

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Can diffusion-weighted imaging be used in the examination of peritoneal fluids?

Diffusion-Weighted Magnetic Resonance Imaging as a Noninvasive Parameter for Differentiating Benign and Malignant Intraperitoneal Collections

Contact Info

Product

Resources

About