Background: Lung malignancy is the most common cause of death in the developed countries. Male to female ratio is 3:1. Consumption of Tobacco upsurges the rate of evolving lung cancer by 30 folds. Other risk factors include repeated exposure to aspects like carcinogens, asbestos, pulmonary fibrosis and radiotherapy. Aim of Study: The aim of this study is to assess the role of advanced MRI in the differentiation between malignant and benign pulmonary lesions. Patients and Methods: This study was conducted on 32 patients with lung lesions found on CT admitted at Benha University Hospital, chest department during the period from October 2018 to April 2021. They all signed informed consent forms. All the patients were diagnosed by direct chest X-ray and underwent a CT scan. The morphological characteristics of the lesions were evaluated. Patients underwent MRI study followed by pathological assessment. Results: Of the 32 lesions, 22 were malignant and 10 were benign. This study demonstrated that the mean ADC value of benign lesions was 1.74 ±0.27 –3mm2/s and for malignant lesions it was 1.09 ±0.18 -3mm2/s, which was significantly lower than that of the benign lesions (p = 0.02). The mean ADC in the center was 1.29 ±0.37, while in the periphery, it was 1.48 ±0.52. ADC was significantly lower in the center (1.29 ±0.37) than the periphery (1.48 ±0.52) (P = .0.017). The mean ADC in the center and periphery were significantly lower in the malignant lesions (1.09 and 1.26, respectively) than those with benign lesions (1.74 and 1.97, respectively). P values were < 0.001 and 0.005, respectively. ROC analysis was done for the ADC center and periphery for predicting malignancy. It showed significant AUC for ADC center (AUC = 0.964, P < 0.001) and periphery (AUC = 0.859, P = 0.001). The best cutoff points were ≤ 1.29 × 10–3 mm2/s for ADC center and ≤1.54 × 10–3 mm2/s for ADC periphery, at which sensitivity and specificity were 95.5% and 90%, respectively, for ADC center and 86.4% and 80%, respectively, for ADC periphery. Conclusion: Diffusion-weighted MRI and ADC can significantly differentiate between benign and malignant pulmonary masses. |
