Diffusion-weighted imaging in differentiating benign versus malignant lymphadenopathy: A cross-sectional study

Abstract

Background: Lymphadenopathy requires differentiation into benign and malignant for appropriate management. The current study was done to find out if diffusion-weighted images and apparent diffusion coefficient (ADC) will be able to differentiate benign from malignant cervical lymphadenopathy. Methods: This cross-sectional study was done in the Department of Radiology at Sri Ramachandra Medical College from April 2016 to August 2018. A total of 54 patients with a history of lymphadenopathy were recruited. Histopathological examination (HPE) and magnetic resonance imaging were done for all patients after a complete history and physical examination. The ADC was correlated with HPE in differentiating benign and malignant lymphadenopathy. Results: Majority (46.30%) were in the age group of 51 years and above. Twenty-eight (51.85%) had benign, whereas 26 (48.15%) had malignant lesions. There was a statistically significant difference between the nature of the lesion in ADC value ([× 10–3 mm2/s] [P < 0.001]). The ADC had good predictive validity in predicting malignancy, as indicated by the area under the curve of 0.904 (95% confidence interval 0.821 to 0.987, P < 0.001). Conclusion: ADC values can be used as a complementary tool in assessing the malignant potential of lymph nodes in various conditions and hence play an essential role in the further course of management.

Keywords

• apparent diffusion coefficient
• diffusion-weighted image
• lymph nodes
• magnetic resonance imaging
• malignant lesions