Effectiveness of Diffusion-Weighted Magnetic Resonance Imaging in Differentiating Mediastinal Lymphadenopathy

Objective: Several methods are used to diagnose mediastinal lymphadenopathy, which may result from many benign and malignant etiologies. Various radiodiagnostic imaging methods, bronchoscopy, mediastinoscopy, and thoracoscopy are used for diagnosis and management. This study attempted to enhance the diagnostic reliability of diffusion-weighted magnetic resonance imaging (MRI) for characterizing mediastinal lymph nodes and to identify conventional MRI sequences that could be beneficial. Methods: A retrospective investigation was conducted on 40 patients exhibiting mediastinal lymphadenopathy as shown on chest MRI, including 27 with malignant and 13 with benign origins. The patients underwent echoplanar diffusion-weighted MRI, and apparent diffusion coefficient (ADC) maps were generated. The ADC values for lymph nodes located in the mediastinal region were computed. Additionally, statistical analysis was carried out, and the ADC values were connected to the findings of the histopathological examinations. Results: The average assessment of the lymph nodes’ ADC value that were malignant was found to be considerably lower (P < .001) compared to the value for lymph nodes that were benign. With a cut-off point of 1.50 × 10−3 mm2/s, the ADC variable is now being utilized. In the process of differentiating benign lymph nodes from malignant nodes, we were able to acquire a sensitivity rate of 85% and a specificity rate of 77%. The sensitivity and specificity values of short axis diameter measurements in this differentiation are 61% and 85%, respectively. Conclusion: Apparent diffusion coefficient levels are essential in differentiating between benign and malignant mediastinal lymphadenopathies.