Role of Apparent Diffusion Coefficient in Characterisation of Neck Masses- A Cross-sectional Study (original) (raw)
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Diagnostic and interventional radiology (Ankara, Turkey), 2015
We aimed to evaluate the role of apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging for head and neck lesion characterization in daily routine, in comparison with histopathological results. Ninety consecutive patients who underwent magnetic resonance imaging (MRI) at a university hospital for diagnosis of neck lesions were included in this prospective study. Diffusion-weighted echo-planar MRI was performed on a 1.5 T unit with b factor of 0 and 1000 s/mm2 and ADC maps were generated. ADC values were measured for benign and malignant whole lesions seen in daily practice. The median ADC value of the malignant tumors and benign lesions were 0.72×10-3 mm2/s, (range, 0.39-1.51×10-3 mm2/s) and 1.17×10-3 mm2/s, (range, 0.52-2.38×10-3 mm2/s), respectively, with a significant difference between them (P < 0.001). A cutoff ADC value of 0.98×10-3 mm2/s was used to distinguish between benign and malignant lesions, yielding 85.3% sensitivity and 78.6% specif...
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.
International Journal of Medical Research and Review, 2017
Head and neck cancers accounts for maximum number of cancer cases in Indian hospital settings. Involvement of neck nodes is a very important prognostic factor of its outcome. Differentiation between benign and metastatic lymphadenopathy often presents a diagnostic challenge with conventional imaging techniques. Diffusion-weighted imaging (DWI) has emerged as a powerful non-invasive imaging technique that is capable of characterisation of these lesions as benign or malignant with the help of apparent diffusion coefficient (ADC) maps. Aim: The aim of this cross-sectional study was to determine the diagnostic accuracy of DWI to differentiate benign from malignant cervical lymph nodes in head and neck tumours, subsequently confirming the results using histopathology as the reference standard. Materials and Methods: The cross-sectional study was conducted on 60 patients of either age or sex with enlarged neck lymph nodes over a period of 2 years, subsequently these patients underwent DW MRI imaging followed by histopathology of either neck dissection specimen or core biopsy or US guided FNAC as a part of the study. Results: Out of 60 patients, 41(68.33 percent) cases came out as malignant and 19 (31.67 percent) cases came out as benign. The results obtained were 36 true positives, 4 false positives, 15 true negatives and 5 false negatives. The overall sensitivity of DWI for differentiating malignant from benign cervical lymphadenopathy was 87.80% with specificity of 78.95%. The positive predictive value and negative predictive value were 90.00% and 75.00% respectively. The best ADC threshold value for distinguishing benign and malignant nodes was 1.005 × 10-3 mm 2 /sec. Conclusion: DWI is an important tool to differentiate benign vs malignant lymphadenopathy and helps in guiding the clinician to treat these nodes accordingly.
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.
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.
Oral oncology, 2010
The feasibility of performing diffusion-weighted MRI (DWI) of primary undifferentiated nasopharyngeal carcinoma (NPC) has not been assessed and it is unknown whether the apparent diffusion coefficients (ADC) of primary NPC differs from that of lymphoma or squamous cell carcinoma (SCC) in the head and neck. One hundred patients with newly diagnosed NPC, head and neck lymphoma or SCC underwent echo-planar DWI. ADCs of primary tumours were compared by Kruskal-Wallis test and Mann-Whitney U tests with Bonferroni correction using p<0.05 and p<0.017 respectively to indicate statistical significance. The utility of ADC thresholds for discriminating tumour histology was evaluated by receiver operating characteristic analysis. DWI was successful in 45/65 with NPC, 5/7 with lymphoma and 26/28 with SCC. Mean ADC (+/-SD) of NPC, lymphoma and SCC were 0.98+/-0.161, 0.75+/-0.190, 1.14+/-0.196 (x10(-3)mm(2)/s) respectively which were significantly different (p<0.001-0.003). Optimized ADC ...
Exploration of targeted anti-tumor therapy, 2022
Aim: Head and neck squamous cell cancer (HNSCC) is the ninth most common tumor worldwide. Neck lymph node (LN) status is the major indicator of prognosis in all head and neck cancers, and the early detection of LN involvement is crucial in terms of therapy and prognosis. Diffusion-weighted imaging (DWI) is a non-invasive imaging technique used in magnetic resonance imaging (MRI) to characterize tissues based on the displacement motion of water molecules. This review aims to provide an overview of the current literature concerning quantitative diffusion imaging for LN staging in patients with HNSCC. Methods: This systematic review performed a literature search on the PubMed database (https://pubmed. ncbi.nlm.nih.gov/) for all relevant, peer-reviewed literature on the subject following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria, using the keywords: DWI, MRI, head and neck, staging, lymph node. Results: After excluding reviews, meta-analyses, case reports, and bibliometric studies, 18 relevant papers out of the 567 retrieved were selected for analysis. Conclusions: DWI improves the diagnosis, treatment planning, treatment response evaluation, and overall management of patients affected by HNSCC. More robust data to clarify the role of apparent diffusion coefficient (ADC) and DWI parameters are needed to develop models for prognosis and prediction in HNSCC cancer using MRI.