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Early adequate therapy is highly desirable and depends on a reliable classification of tumor type. The apparent diffusion coefficient is a noninvasive neuroimaging marker with the potential to differentiate between major histological subtypes. Here we determine the sensitivity and specificity of the apparent diffusion coefficient to distinguish between NSCLC and SCLC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled all NSCLC and SCLC patients diagnosed between 2008 and 2019 at the University Medical Center G\u00f6ttingen. Cranial MR scans were visually inspected for brain metastases and the ratio of the apparent diffusion coefficient (ADC) was calculated by dividing the ADC measured within the solid part of a metastasis by a reference ADC extracted from an equivalent region in unaffected tissue on the contralateral hemisphere.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 411 enrolled patients, we detected 129 patients (83 NSCLC, 46 SCLC) with sufficiently large brain metastases with histologically classified lung cancer and no hemorrhage. We analyzed 185 brain metastases, 84 of SCLC and 101 of NSCLC. SCLC brain metastases showed an ADC ratio of 0.68\u2009\u00b1\u20090.12 SD, and NSCLC brain metastases showed an ADC ratio of 1.47\u2009\u00b1\u20090.31 SD. Receiver operating curve statistics differentiated brain metastases of NSCLC from SCLC with an area under the curve of 0.99 and a 95% CI of 0.98 to 1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001. Youden's J cut-point is 0.97 at a sensitivity of 0.989 and a specificity of 0.988.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with lung cancer and brain metastases with solid tumor parts, ADC ratio enables an ad hoc differentiation of SCLC and NSCLC, easily achieved during routine neuroradiological examination. Non-invasive MR imaging enables an early-individualized management of brain metastases from lung cancer.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration<\/jats:italic>\n                      : The study was registered in the German Clinical Trials Register (DRKS00023016).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-021-00602-7","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T07:07:49Z","timestamp":1618470469000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Differentiation of brain metastases from small and non-small lung cancers using apparent diffusion coefficient (ADC) maps"],"prefix":"10.1186","volume":"21","clinical-trial-number":[{"clinical-trial-number":"drks00023016","registry":"10.18810\/drks"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2147-9797","authenticated-orcid":false,"given":"Sebastian Johannes","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eya","family":"Khadhraoui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Neef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Heiner","family":"Riedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marielle","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"602_CR1","doi-asserted-by":"publisher","first-page":"2865","DOI":"10.1200\/JCO.2004.12.149","volume":"22","author":"JS Barnholtz-Sloan","year":"2004","unstructured":"Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE. 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(\u201cEthikkommission der Universit\u00e4tsmedizin G\u00f6ttingen\u201d, G\u00f6ttingen, Germany, No. 08\/05\/20) and registered in the German Clinical Trials Register (DRKS00023016). The full study protocol is provided in the supplemental data, see\u00a0Additional file\n                      \n                      : STARD 2015 checklist. This retrospective study adhered to the 2013 Helsinki Declaration. The approach and preliminary results (abstract only) were presented at the Proceedings of the 55th Annual Conference of the German Society for Neuroradiology [\n                      \n                      ].","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"70"}}