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Fig. 2 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 2

From: Suspicious lung lesions for malignancy: the lesion-to-spinal cord signal intensity ratio in T2WI and DWI–MRI versus PET/CT; a prospective pathologic correlated study with accuracy and ROC analyses

Fig. 2

A 50-year-old male patient complained of chronic cough and chest pain. A Axial chest CT cut (lung window) showed left upper lobar apical–posterior large sub-pleural homogeneous solid lung nodule showing two pleura tags and surrounded by parenchymal ground-glass reaction/halo; this is on a background of bilateral upper lobar para-septal emphysema. B Axial chest PET-CT image showing high 18F-FDG uptake. C Axial T2WI shows the high signal intensity of the nodule. After placing two ROIs within the nodule and the spinal cord, the lesion-to-spinal cord signal intensity ratio was calculated = 0.9. D Same axial T2WI showing iso-intense signal of the surrounding lung parenchyma. After placing two ROIs within the parenchyma around the lesion and the spinal cord, the lesion-to-spinal cord signal intensity ratio was calculated = 1.2. E Axial DWI showing bright signal of restricted diffusion and lesion-to-spinal cord signal intensity ratio was calculated = 1.9. F ADC mapping images showing low signal intensity with minimum ADC = 0.5 × 10−3 mm2/s and mean ADC = 0.8 × 10−3 mm2/s. Referring to the estimated cutoff values, T2WI L-to-SC SI ratio, DWI L-to-SC SI ratio, minimum ADC, and mean ADC suggested a malignant process. Pathologically proven non-small cell lung cancer (NSCLC)

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