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Fig. 4 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 4

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. 4

A 30-year-old male patient complained of chest pain, dyspnea, and hemoptysis. A Axial chest CT cut (mediastinal window) showed right middle lobar consolidation collapse with interrupted air bronchogram and suspected iso-dense central obstructing lesion. B Axial chest PET-CT image showing high 18F-FDG uptake at the right peri-hilar lesion. C, D Axial T2WI showing the heterogeneous high signal intensity of central obstructing lesion with distal atelectasis. After placing two ROIs within the largest lesion and the spinal cord, the lesion-to-spinal cord signal intensity ratio was calculated = 1.1. E Axial DWI showing bright signal of restricted diffusion and lesion-to-spinal cord signal intensity ratio was calculated = 0.5. F ADC mapping images showing low signal intensity with minimum ADC (0.9 × 10−3 mm2/s) and mean ADC (1.1 × 10−3 mm2/s). Referring to the estimated cutoff values, the T2WI L-to-SC SI ratio, minimum ADC, and mean ADC suggested a malignant process; however, the DWI L-to-SC SI ratio was mismatched. Pathologically proven carcinoid neoplasm

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