Diffusivity of intraorbital lymphoma vs. IgG4-related DISEASE: 3D turbo field echo with diffusion-sensitised driven-equilibrium preparation technique

AbstractObjectives3D turbo field echo with diffusion-sensitised driven-equilibrium preparation (DSDE-TFE) is a novel non-echo planar technique for diffusion-weighted (DW) imaging. The purpose of this study was to differentiate intraorbital lymphoma from immunoglobulin G4-related disease (IgG4-RD) using the apparent diffusion coefficient (ADC) derived from DSDE-TFE.MethodsFifteen patients with lymphomas and 8 with IgG4-RDs underwent imaging. ADC and signal intensities compared with normal grey matter on T1-weighted images, fat-suppressed T2-weighted images and fat-suppressed postcontrast T1-weighted images were measured. Statistical analyses were performed using the Mann–Whitney U test and receiver operating characteristic (ROC) analysis.ResultsIntraorbital lesions were clearly visualised on DSDE-TFE without obvious geometrical distortion. The ADC of lymphoma (1.25 ± 0.50 × 10−3 mm2/s; mean ± standard deviation) was significantly lower than that of IgG4-RD (1.67 ± 0.84 × 10−3 mm2/s; P < 0.05). Conventional sequences could not separate lymphoma from IgG4-RD (0.93 ± 0.18 vs. 0.94 ± 0.21 on T1-weighted images, 0.92 ± 0.17 vs. 0.95 ± 0.14 on T2-weighted images and 2.03 ± 0.35 vs. 2.30 ± 0.58 on postcontrast T1-weighted images, for lymphoma and IgG4-RD, respectively; P > 0.05). ROC analysis showed the best diagnostic performance with ADC.ConclusionThe apparent diffusion coefficient derived from diffusion-sensitised driven-equilibrium preparation techniques may help to differentiate lymphoma from immunoglobulin G4-related disease.Key Points• Distinguishing between orbital lymphoma and immunoglobulin G4-related disease can be difficult • Intraorbital lesions were clearly visualised on diffusion-sensitised driven-equilibrium preparation magnetic resonance techniques.• Variations in field homogeneity do not affect DSDE-TFE techniques all that much.• ADCs derived from DSDE-TFE may help differentiate lymphoma from IgG4-RD.

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