The Role of Diffusion Weighted MRI in the Evaluation of Pediatric Soft Tissue Masses
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- Category: Vol. 85, June 2017
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The Role of Diffusion Weighted MRI in the Evaluation of Pediatric Soft Tissue Masses, ESSAM A. AL-SHEIKH, IMAN M. ZAKI, LOBNA M. SHALABY, YAHIA L. MAHMOUD and MARWA A. ABOU EL-HASSAN
Abstract
Background: Soft tissue masses usually represent a diag-nostic dilemma, since there is a large and heterogeneous group of lesions than can manifest as such in children, including both neoplastic and non neoplastic lesions.
Purpose: To evaluate the signal characteristics of MRI diffusion weighted sequences of soft tissue masses in pediatric patients and their corresponding ADC measurements and their ability to differentiate between benign and malignant lesions and follow-up response to therapy.
Material and Methods: Between July 2012 and March 2014 fifty children with soft tissue tumors were assessed by conventional sequences and diffusion weighted (DWI) MR images. DWI was carried out by single shot SE-EPI sequence using b-value of 0, 500 and 1000. ADC was automatically generated on the operating console. The DWI and ADC were compared with the histopathological results of the tumor post biopsy/excision.
Results: The ADC value of benign tumors ranged from 1.1 X 10–3mm2/s to 2.2 X 10–3mm2/s with mean ADC ± SD 1.47 X 1 0–3mm2/s ±0.29 while the ADC value of malignant tumors ranged from 0.4 X 10–3mm2/s to 1.1 X 10–3mm2/s with mean ADC ± SD is 0.8 X 10–3mm2/s ±0.21. There was a significant difference in the ADC values of benign and malignant masses (p-value <0.001). However, overlap still exists. ROC analysis produced a cutoff value £0.9 X 10–3 mm2/s has 100% specificity and 88.24% sensitivity and a cut off value £1.1 X 10–3mm2/s has 84.62% specificity and 100% sensitivity. The mean ADC value of tumors that had received treatment was 1.6 X 1 0–3mm2/s which proved to be signifi-cantly different from that of de novo malignant tumors.
Conclusions: DWI and ADC can assist in the initial evaluation of soft tissue masses in conjunction with conven-tional sequences and follow-up response to therapy.