Diffusion-weighted imaging in the head and neck region: usefulness of apparent diffusion coefficient values for characterization of lesions (original) (raw)
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The Egyptian Journal of Radiology and Nuclear Medicine, 2013
The aim of this study was to determine the role of diffusion-weighted MR imaging (DWI) and the apparent diffusion coefficient (ADC) in characterization of head and neck lesions. Patients and methods: MR imaging including diffusion-weighted sequences was performed on 43 patients presented with head and neck lesions. Images were obtained with a diffusion-weighted factor (b factor) of 100, 500, and 1000 s/mm 2. ADC maps were reconstructed, and the ADC value of the lesions was calculated. Results: The mean ADC value of malignant tumors was (1.02 ± 0.22) • 10 À3 mm 2 /s (n = 31). The mean ADC value of benign tumors was (1.62 ± 0.27) • 10 À3 mm 2 /s (n = 12). The mean ADC of lymphomas was significantly lower than that of carcinomas. The difference in the ADC value between the malignant tumors and benign lesions was statistically significant (p < 0.001). Selection of (1.2) • 10 À3 mm 2 /s as a threshold value of ADC for differentiating benign from malignant tumors yielded the best result, with an accuracy of 94%, sensitivity of 95%, specificity of 92%, positive predictive value of 92% and negative predictive value of 94%. Conclusion: DWI and the ADC measurement are promising, non-invasive imaging approach that can be used for characterization of head and neck lesions. It can help differentiate malignant tumors from benign lesions.
Journal of Cancer Prevention & Current Research, 2016
We evaluated the value contribution of diffusion-weighted MR images in the differentiation of benign and malign neck masses. We retrospectively evaluated the findings of 102 patients with neck masses. Mean ADC (apparent diffusion coefficient) values of malignant lesions were 1,27±0,57mm 2 /s, 95% confidence interval was (1,18 mm 2 /s-1,49 mm 2 /s). Mean ADC values of benign lesions were 1,61±0,67mm 2 /s, 95% confidence interval was (1,42 mm 2 /s-1,84 mm 2 /s). When we compare these ADC values, mean ADC values of malignant lesions were smaller than those of benign lesions. Result was statistically significant (p<0,01). We concluded that, diffusion-weighted MR imaging may be used to help in characterization of head and neck lesions.
Role of Apparent Diffusion Coefficient in Characterisation of Neck Masses- A Cross-sectional Study
INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY, 2021
Introduction: Neck masses are frequently encountered in clinical practice and differential diagnoses of a patient presenting with a neck mass is wide. Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) is an imaging technique based on molecular diffusion. It is a very helpful complementary technique in distinguishing neoplastic from non neoplastic tissue and has numerous applications in the evaluation of head and neck masses especially in head and neck lymphadenopathy. Aim: To evaluate the accuracy of Apparent Diffusion Coefficient (ADC) in differentiating benign and malignant neck masses. Materials and Methods: A single-centre cross-sectional study comprising of 50 patients of all age groups with clinical suspicion of neck swelling was conducted in Department of Radiodiagnosis at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India from March 2018 to February 2020. All patients included were subjected to general physical and detailed local examin...
American Journal of Neuroradiology, 2007
BACKGROUND AND PURPOSE: The purpose of this work was to evaluate whether diffusion-weighted MR imaging can be used in differentiating residual or recurrent head and neck tumors from postoperative or postradiation changes. MATERIALS AND METHODS: This study included 32 patients clinically suspected for recurrent head and neck tumor after surgery (n ϭ 3), radiation therapy (n ϭ 13), or both (n ϭ 16). Diffusion-weighted MR imaging was done by using a single-shot spin-echo echo-planar sequence. The apparent diffusion coefficient (ADC) value of the suspected lesion was calculated and correlated with pathologic results. RESULTS: Adequate diffusion-weighted MR images and ADC maps were obtained in 30 patients (93.8%). The mean ADC value of residual or recurrent lesions (1.17 Ϯ 0.33 ϫ 10 Ϫ3 mm 2 /s) was less than that of posttherapeutic changes (2.07 Ϯ 0.25 ϫ 10 Ϫ3 mm 2 /s), and the difference was statistically significant (P Ͻ .001). When an ADC value of 1.30 ϫ 10 Ϫ3 mm 2 /s was used as a threshold value for differentiation, the best results were obtained with an accuracy of 87%, sensitivity of 84%, specificity of 90%, positive predictive value of 94%, and negative predictive value of 76%. CONCLUSIONS: Diffusion-weighted MR imaging with ADC measurement has promising results for differentiating residual or recurrent head and neck tumors from postoperative or postradiation changes.
Diffusion-weighted imaging in head and neck cancers
Future Oncology, 2009
This article reviews the utility of diffusion-weighted imaging (DWI) in the diagnosis, prognosis and monitoring of treatment response in tumors arising in the head and neck region. The apparent diffusion coefficient (ADC) value, determined from DWI, can help in cancer staging and detection of subcentimeter nodal metastasis. The ADC value also discriminates carcinomas from lymphomas, benign lesions from malignant tumors and tumor necrosis from abscesses. Low pretreatment ADC values typically predict a favorable response to chemoradiation therapy. These promising reports indicate the potential of DWI as a potential biomarker for diagnosis and monitoring of treatment response in head and neck cancers. In view of the overlapping ADC values between different salivary gland tumors, care should be taken when interpreting these results and other imaging parameters should be considered for a better diagnosis. Susceptibility and motion-induced artifacts may sometimes degrade DWI image quality; however, novel techniques are being developed to overcome these drawbacks.
Egyptian Journal of Radiology and Nuclear Medicine, 2020
Background: The aim of this prospective cohort study is to substantiate the added value of diffusion-weighted magnetic resonance imaging (DW-MRI) over conventional MRI assessment in the differentiation between locoregional recurrence/residual tumour and post-treatment benign changes in patients with non-lymphoid head and neck malignancies. Thirty adult patients, each with a suspicious lesion on post-treatment imaging scans at the primary site of a previously treated non-lymphoid head and neck malignancy, were evaluated by MRI and diffusion-weighted imaging (DWI). The apparent diffusion coefficient (ADC) values of the lesions were calculated. Results: Diffusion-weighted MRI yielded an accuracy of 90%, a sensitivity of 88.9%, a specificity of 91.7%, a positive predictive value of 94.1% and a negative predictive value of 84.6%. The mean ADC value of the lesions was lower in the "locoregional recurrence/residual tumour" group (1.08 × 10 −3 mm 2 /s) compared to the "post-treatment benign changes" group (1.95 × 10 −3 mm 2 /s); P < 0.001. An ADC cutoff value of 1.43 × 10 −3 mm 2 /s achieved the same accuracy as the visual assessment by DW-MRI. Conclusion: Incorporating the DWI sequence into the post-treatment imaging assessment protocol brings a substantial added value to conventional MRI assessment in patients with non-lymphoid head and neck malignancies. This valuable merit of DW-MRI can help avoid or, at least, largely minimize unnecessary or unfeasible tissue sampling. An ADC cutoff value of 1.43 × 10 −3 mm 2 /s can also be utilized to aid in the assessment process.
Neuroradiology, 2010
In the head and neck, squamous cell carcinoma is one of the most common tumour types. Currently, the primary imaging modalities for initial locoregional staging are computed tomography and-to a lesser extentmagnetic resonance imaging, whilst [ 18 F]fluorodeoxyglucose (FDG) positron emission tomography has additional value in the detection of subcentimetric metastatic lymph nodes and of tumour recurrence after chemoradiotherapy (CRT). However, dependency on the morphological and size-related criteria of anatomical imaging and the limited spatial resolution and FDG avidity of inflammation in metabolic imaging may reduce diagnostic accuracy in the head and neck. Diffusion-weighted magnetic resonance imaging (DWI) is a noninvasive imaging technique that measures the differences in water mobility in different tissue microstructures. Water mobility is likely influenced by cell size, density, and cellular membrane integrity and is quantified by means of the apparent diffusion coefficient. As such, the technique is able to differentiate tumoural tissue from normal tissue, inflammatory tissue and necrosis. In this article, we examine the use of DWI in head and neck cancer, focussing on technique optimization and image interpretation. Afterwards, the value of DWI will be outlined for clinical questions regarding nodal staging, lesion characterization, differentiation of post-CRT tumour recurrence from necrosis and inflammation, and predictive imaging towards treatment outcome. The possible consequences of adding DWI towards therapeutic management are outlined.
International Journal of Medical Imaging, 2020
Aim: to prospectively determine if diffusion weighted magnetic resonance imaging can help in discrimination between benign and malignant lymph nodes in patients with head and neck cancer, using histological results as the standard of reference. Patients & Methods: 40 patients complaining of palpable cervical lymph nodes with unknown primary malignancy or having known head and neck cancer. MRI neck study was done for all patients, including pre and post contrast sequences and DWI. Histopathology was done for all patients. Statistical analysis of the differences in ADC values for benign and malignant nodes was performed, together with further analysis of the differences between the ADC values of metastatic lymph nodes and lymphoma. Results: 30 patients were histopathological proved malignant lymphadenopathy (20 metastatic from head and neck malignancy and 10 primary lymphomas) and 10 patients were histopathological proved benign lymphadenopathy (1 acute reactive lymphadenitis, 1 chronic granulomatous inflammation, 4 chronic non-specific inflammation & 4 reactive lymphoid hyperplasia). A statistically significant difference between ADC values of benign and malignant cervical nodes was reported with a threshold ADC value equal to 1.30 ×10-3 mm2/sec was identified. The ADC value for lymphoma was less than that for metastatic carcinoma, with high specificity and sensitivity values and a threshold ADC value equal to 0.9 ×10-3 mm2/sec was identified. Conclusion: MR diffusion imaging is helpful non-invasive method in differentiation between benign and malignant lymph nodes, and to the same extent differentiation between the variant types of malignant lymphadenopathy.
Role of Diffusion Weighted MRI of Cervical Lymph Nodes in Head and Neck Malignancies
Introduction: Cervical lymph node metastasis is one of the important prognostic factor in staging and management of head and neck malignancy. The definitive diagnostic method for lymph node analysis is histopathology which is invasive. However, Diffusion weighted MRI has emerged as good alternative for the characterization of cervical lymph nodes in head and neck malignancy. A differential diagnosis of benign and malignant lesions of the head and neck is critical as it enables clinicians to implement appropriate management strategies for malignant lesions. Aims and objectives: To assess the diagnostic utility of diffusion weighted MRI sequence and ADC values for the characterization of cervical lymph nodes in head and neck malignancies. Material and Methods: Fifty patients with clinically suspected or newly diagnosed head and neck malignancies were subjected to MRI neck or MRI face and neck. The study assessed cervical lymph nodes in patients with head and neck malignancies by characterizing them into benign and malignant using DWI MRI and ADC value calculation with histopathology/cytology reference study. The findings were compared and analysed statistically. Results: Majority of patients studied were in the age group of less than 60 years. The study included head and neck malignancies like buccal mucosa, tongue cancer, hypopharyngeal and laryngeal cancers, alveolus cancer, thyroid cancer etc. Most of patients in our study presented with complaint of dysphagia and non healing ulcer in mouth with/without trismus with pain or bleeding from ulcer. About 84% patients had past history of chronic smoking out of which 62% were chronic alcoholic. A total of 311 cervical lymph nodes seen in these malignancies were assessed on DWI and ADC values. Out of 311 cervical lymph nodes, 103 nodes showed metastasis (33.1%) and the rest 208 cervical lymph nodes were negative for metastasis (66.9 %). Majority of metastatic cervical lymph nodes observed in head and neck malignancies in our study were squamous cell carcinoma. The mean ADC value of 0.594 x 10 −3 mm²/s ± 0.197 was observed in metastatic lymph nodes and value of 1.04 x 10 −3 mm²/s ± 0.710 in non-metastatic lymph nodes with p value less than 0.001 which was statistically significant. DWI and quantitative analysis of ADC values revealed that mean ADC value of metastatic nodes was significantly lower than that of the non-metastatic nodes. Conclusion: DWI sequence of MRI has been the advantage for detecting micro structural changes in the tissue. Hence, Diffusion-weighted MR imaging is an effective assist in differentiating benign and malignant cervical lymph nodes in patients of head and neck malignancies. It has been considered as a cancer biomarker. It is non invasive technique and does not have any radiation exposure.