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Author: search.filters.author.Erbay, GurcanSubject: search.filters.subject.abdominal

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    Optimal b Value in Diffusion-Weighted Imaging for Differentiation of Abdominal Lesions
    (2014) Koc, Zafer; Erbay, Gurcan; https://orcid.org/0000-0003-0987-1980; https://orcid.org/0000-0002-1706-8680; 24115207; S-8384-2016; AAK-5370-2021
    Purpose: To explore the optimal b value in diffusion-weighted imaging (DWI) for differentiation of benign and malignant abdominal lesions. Materials and Methods: A total of 108 consecutive patients (age 60 +/- 12.5 years) with 127 pathologically confirmed diagnoses of abdominal lesions were included. Single-shot echoplanar imaging (SH-EPI) DWI (1.5T) with seven b values and eight apparent diffusion coefficient (ADC) maps were obtained. The lesions were analyzed visually on DWI and ADC maps for benignity/malignity using a 5-point scale and by measuring the ADC values and ADC lesion/normal parenchyma ADC ratio. ROC analysis was used to evaluate the diagnostic accuracy of ADC for differentiating between benign and malignant lesions. Pathology results were the reference standard. Results: Differentiation between malignant and benign lesions using visual scoring was successful at b values of 600 or higher (sensitivities, specificities, and accuracies were 100/93.8/92.5, 84.7/82.6/80.4, and 94.4/89.7/88.1, respectively, for b600, 800, and 1000). The mean ADC values of malignant lesions were significantly lower than those of benign lesions for all b-value combinations except b0 and 50 s/mm(2) (P = 0.032 for b0 and 50 s/mm(2), P = 0.000 for other b values). The best b-value combination was 0 and 600 s/mm(2) and multiple b2. The lesion/normal parenchymal ADC ratio for b600, b1000, and multiple b2 better distinguished between benign and malignant lesions. Conclusion: In DWI, the optimal b value is 600 s/mm(2); multiple b values of 600 s/mm(2) and higher are recommended to differentiate between benign and malignant abdominal lesions. The lesion ADC/normal parenchyma ADC ratio is more accurate than using lesion ADC only.
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    Internal Comparison Standard for Abdominal Diffusion-Weighted Imaging
    (2017) Koc, Zafer; Erbay, Gurcan; Karadeli, Elif; 0000-0002-1706-8680; 0000-0002-0352-8818; 0000-0003-0987-1980; 27956463; AAK-5370-2021; AAK-5399-2021; S-8384-2016
    Background: Standards for abdominal diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) measurements, and analysis are required for reproducibility. Purpose: To identify optimal internal comparison standards for DWI to normalize the measured ADC for increased accuracy of differentiating malignant and benign abdominal lesions. Material and Methods: We retrospectively studied 97 lesions (89 patients; age, 57 +/- 13 years) with histopathologically confirmed abdominal disease. Seven normal body parts/contents (normal parenchyma, spleen, kidney, gallbladder bile, paraspinal muscle, spinal cord, and cerebrospinal fluid [CSF]) were assessed as internal references for possible use as comparison standards. Three observers performed ADC measurements. Statistical analyses included interclass correlation coefficients (ICCs), Mann-Whitney and Kruskal-Wallis tests, and coefficient of variation (CV). ROC analyses were performed to assess diagnostic accuracy of lesion ADC and normalized ADC for differentiating lesions. Pathology results were the reference standard. Results: Mean and normalized ADCs were significantly lower for malignant lesions than for benign lesions (P< 0.001). ICC was excellent for all internal references. Gallbladder had the lowest CV. Receiver operating characteristic (ROC) analyses showed that normalized ADCs obtained using normal parenchyma were better than lesion ADCs for differentiating malignant and benign abdominal lesions (area under the curve [AUC], 0.808 and 0.756, respectively). The normalized ADCs obtained using CSF shows higher accuracy than lesion ADCs (0.80 and 0.76, respectively) for differentiating between malignant and benign abdominal lesions. Conclusion: The normal parenchyma from a lesion-detected organ can be used as an internal comparison standard for DWI. CSF can be used as a generalizable in plane reference standard.