Diffusion-weighted-MRI versus PET-CT in assessment of chest wall lesions

Abstract

Abstract Background Chest wall lesions comprise benign and malignant etiologies. Numerous classification systems have been proposed based on etiology, origin site, tissue composition and whether the lesion is benign or malignant. Despite that conventional radiological studies are able to provide detailed information about the tumor morphology such as size, location, and extent tissue characteristics, yet, they cannot reliably differentiate benign from malignant neoplasms. This study aimed to detect the diagnostic value of diffusion weighted MRI and PET/CT in evaluating chest wall lesions, and in differentiating benign from malignant lesions. Results The chest wall lesions were divided into either benign or malignant; 34 cases (47.9%) were diagnosed as benign, while 37 cases (52.1%) were diagnosed as malignant. The mean ADC value of malignant lesions (0.8 ± 0.3 × 10–3 mm2/s) was significantly lower than that of benign lesions (1.3 ± 0.6 × 10–3 mm2/s). This yielded statistically significant results with cut off value of 1.25 × 10–3 mm2/s for confident diagnosis and differentiation of benign from malignant lesions, with sensitivity of 91.9%, specificity of 70.6%, positive predictive value of 77.27%, negative predictive value of 88.89% and accuracy of 81.7%. The mean SUV of malignant lesions (14.2 ± 6.1) was significantly higher than that of benign lesions (1.5 ± 1.3). This yielded statistically significant results with cut off value of 2.45 for confident diagnosis and differentiation of benign from malignant lesions, with sensitivity of 100%, specificity of 82.4%, positive predictive value of 86.05%, negative predictive value of 100%, and accuracy of 91.5%. Conclusions Both DWI-MRI and PET/CT can reliably differentiate benign from malignant lesions, yet, PET/CT showed higher sensitivity, specificity and accuracy.