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Open AccessArticle

Diffusion-Weighted Imaging Can Differentiate between Malignant and Benign Pleural Diseases

1
Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa 920-0293, Japan
2
Department of Radiology, Kanazawa Medical University, Ishikawa 920-0293, Japan
3
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan
4
Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, Ishikawa 920-0293, Japan
*
Author to whom correspondence should be addressed.
Cancers 2019, 11(6), 811; https://doi.org/10.3390/cancers11060811
Received: 1 May 2019 / Revised: 1 June 2019 / Accepted: 3 June 2019 / Published: 12 June 2019
(This article belongs to the Special Issue Role of Medical Imaging in Cancers)
It is not clear whether magnetic resonance imaging (MRI) is useful for the assessment of pleural diseases. The aim of this study is to determine whether diffusion-weighted magnetic resonance imaging (DWI) can differentiate malignant pleural mesothelioma (MPM) from pleural dissemination of lung cancer, empyema or pleural effusion. The DWI was calibrated with the b value of 0 and 800 s/mm2. There were 11 MPMs (8 epithelioid and 3 biphasic), 10 pleural disseminations of lung cancer, 10 empyemas, and 12 pleural effusions. The apparent diffusion coefficient (ADC) of the pleural diseases was 1.22 ± 0.25 × 10−3 mm2/s in the MPMs, 1.31 ± 0.49 × 10−3 mm2/s in the pleural disseminations, 2.01 ± 0.45 × 10−3 mm2/s in the empyemas and 3.76 ± 0.62 × 10−3 mm2/s in the pleural effusions. The ADC of the MPMs and the pleural disseminations were significantly lower than the ADC of the empyemas and the pleural effusions. Concerning the diffusion pattern of DWI, all 11 MPMs showed strong continuous diffusion, 9 of 10 pleural disseminations showed strong scattered diffusion and 1 pleural dissemination showed strong continuous diffusion, all 10 empyemas showed weak continuous diffusion, and all 12 pleural effusions showed no decreased diffusion. DWI can evaluate pleural diseases morphologically and qualitatively, and thus differentiate between malignant and benign pleural diseases. View Full-Text
Keywords: magnetic resonance imaging; diffusion-weighted imaging; malignant pleural mesothelioma; pleural dissemination; empyema; pleural effusion magnetic resonance imaging; diffusion-weighted imaging; malignant pleural mesothelioma; pleural dissemination; empyema; pleural effusion
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Usuda, K.; Iwai, S.; Funasaki, A.; Sekimura, A.; Motono, N.; Matoba, M.; Doai, M.; Yamada, S.; Ueda, Y.; Uramoto, H. Diffusion-Weighted Imaging Can Differentiate between Malignant and Benign Pleural Diseases. Cancers 2019, 11, 811.

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