Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul-Aug;54(4):225-231.
doi: 10.1590/0100-3984.2020.0084.

Diffusion-weighted magnetic resonance imaging for differentiating between benign and malignant thoracic lymph nodes: a meta-analysis

Francisco de Souza Santos  1 , Nupur Verma  2 , Guilherme Watte  1 , Edson Marchiori  3 , Tan-Lucien H Mohammed  2 , Tássia Machado Medeiros  1 , Bruno Hochhegger  1
Affiliations

Diffusion-weighted magnetic resonance imaging for differentiating between benign and malignant thoracic lymph nodes: a meta-analysis

Francisco de Souza Santos et al. Radiol Bras. 2021 Jul-Aug.

Abstract
in English, Portuguese

Objective: To establish the diagnostic performance of diffusion-weighted magnetic resonance imaging (DWI) in discriminating malignant from non-malignant thoracic lymph nodes.

Materials and methods: This was a meta-analysis involving systematic searches of the MEDLINE, EMBASE, and Web of Science databases up through April 2020. Studies reporting thoracic DWI and lymph node evaluation were included. The pooled sensitivity, specificity, diagnostic odds ratio, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) were calculated.

Results: We evaluated six studies, involving a collective total of 356 mediastinal lymph nodes in 214 patients. Thoracic DWI had a pooled sensitivity and specificity of 92% (95% confidence interval [95% CI]: 71-98%) and 93% (95% CI: 79-98%), respectively. The positive and negative likelihood ratios were 13.2 (95% CI: 4.0-43.8) and 0.09 (95% CI: 0.02-0.36), respectively. The diagnostic odds ratio was 149 (95% CI: 18-1,243), and the AUC was 0.97 (95% CI: 0.95-0.98).

Conclusion: DWI is a reproducible technique and has demonstrated high accuracy for differentiating between malignant and benign states in thoracic lymph nodes.

Objetivo: Uma meta-análise foi realizada para estabelecer o desempenho diagnóstico da ressonância magnética com imagem ponderada em difusão (DWI) na discriminação de linfonodos torácicos malignos de benignos.

Materiais e métodos: MEDLINE, EMBASE e Web of Science foram sistematicamente pesquisados até abril de 2020. Foram incluídos estudos que relatavam o uso de DWI na avaliação de linfonodos torácicos. Sensibilidade, especificidade, razão de chances de diagnóstico, valores preditivos positivos e negativos e área sob a curva (AUC) foram calculados.

Resultados: Foram encontrados 356 linfonodos mediastinais de 214 pacientes nos seis estudos incluídos. DWI produziu sensibilidade e especificidade combinadas de 92% (intervalo de confiança 95% [IC 95%]: 71-98%) e 93% (IC 95%: 79-98%), respectivamente. A razão de verossimilhança positiva foi de 13,2 (IC 95%: 4,0-43,8), a razão de verossimilhança negativa foi de 0,09 (IC 95%: 0,02-0,36); A razão de chances de diagnóstico foi de 149 (IC 95%: 18-1.243). A DWI teve uma AUC de 0,97 (IC 95%: 0,95-0,98).

Conclusão: DWI é uma técnica reprodutível que demonstrou alta acurácia na diferenciação de estados malignos e benignos nos linfonodos torácicos.

Keywords: Diffusion magnetic resonance imaging; Lymph nodes/diagnostic imaging; Lymphadenopathy; Magnetic resonance imaging; Meta-analysis; Thoracic neoplasms/diagnosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PRISMA flow chart detailing the search and article selection processes.
Figure 2
Figure 2
QUADAS-2 summary. The overall QUADAS-2 score for the articles selected suggests that they were of high quality.
Figure 3
Figure 3
Forest plots of the sensitivity and specificity of DWI for differentiating between malignant and benign thoracic lymph nodes. Heterogeneity was high, as evidenced by the I2 value, which was 82%, values over 75% being considered indicative of high heterogeneity.
Figure 4
Figure 4
Conditional probability plot of the ability of DWI to differentiate between malignant and benign mediastinal lymph nodes. LR, likelihood ratio.
Figure 5
Figure 5
Receiver operating characteristic curve for DWI. AUC suggest a high diagnostic performance. Numbers within circles represent the studies referenced.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mennini ML, Catalano C, Del Monte M, et al. Computed tomography and magnetic resonance imaging of the thoracic lymphatic system. Thorac Surg Clin. 2012;22:155–160. - PubMed
    1. Passlick B. Detection of disseminated lung cancer cells in lymph nodes by monoclonal antibodies: impact on staging and prognosis. Ann Ital Chir. 1999;70:839–840. - PubMed
    1. Gupta S, Seaberg K, Wallace MJ, et al. Imaging-guided percutaneous biopsy of mediastinal lesions: different approaches and anatomic considerations. Radiographics. 2005;25:763–786. - PubMed
    1. Goldberg SN, Raptopoulos V, Boiselle PM, et al. Mediastinal lymphadenopathy: diagnostic yield of transbronchial mediastinal lymph node biopsy with CT fluoroscopic guidance-initial experience. Radiology. 2000;216:764–767. - PubMed
    1. Torabi M, Aquino SL, Harisinghani MG. Current concepts in lymph node imaging. J Nucl Med. 2004;45:1509–1518. - PubMed

LinkOut - more resources