Characterization of pediatric head and neck masses with diffusion-weighted MR imaging

Abstract

We aimed to assess the clinical usefulness of the ADCs calculated from diffusion-weighted echo-planar MR images in the characterization of pediatric head and neck masses. This study included 78 pediatric patients (46 boys and 32 girls aged 3 months-15 years, mean 6 years) with head and neck mass. Routine MR imaging and diffusion-weighted MR imaging were done on a 1.5-T MR unit using a single-shot echo-planar imaging (EPI) with a b factor of 0.500 and 1,000 s mm(-2). The ADC value was calculated. The mean ADC values of the malignant tumours, benign solid masses and cystic lesions were (0.93 +/- 0.18) x 10(-3), (1.57 +/- 0.26) x 10(-3) and (2.01 +/- 0.21 ) x 10(-3) mm(2) s(-1), respectively. The difference in ADC value between the malignant tumours and benign lesions was statistically significant (p < 0.001). When an apparent diffusion coefficient value of 1.25 x 10(-3) mm(2) s(-1) was used as a threshold value for differentiating malignant from benign head and neck mass, the best results were obtained with an accuracy of 92.8%, sensitivity of 94.4%, specificity of 91.2%, positive predictive value of 91% and negative predictive value of 94.2%. Diffusion-weighted MR imaging is a new promising imaging approach that can be used for characterization of pediatric head and neck mass.

Differentiation of benign and malignant lesions of the tongue by using diffusion-weighted MRI at 3.0 T

“…In a study by Wang et al, 11 the researchers found that the ADC values of solid benign masses were significantly higher than those of malignant tumours in the head and neck, and the ADC values of cystic lesions were significantly higher than those of solid benign masses. These results were also supported by Abdel Razek et al 14 To our knowledge, there is only one previous report on DWI in the diagnosis of the tongue tumours by Ai et al 16 Their results indicated that malignant tumours exhibited significantly lower ADC values (using b-values of 500 and 1000 s mm…”

“…[8][9][10] Some studies reported the application of DWI with calculation of ADC in the differentiation between benign and malignant head and neck masses. [11][12][13][14][15] However, most studies used 1.5-T field strength. To our knowledge, there is only one report on using ADC measurements for differentiating malignant from benign lesions of the tongue at 1.5-T MR. 16 However, it is reported that the quantitative ADC values obtained at 1.5 T may not be transferable to 3.0 T. 17 The purpose of our study was to investigate the diagnostic value of the ADCs calculated from DWI in distinguishing between benign and malignant lesions of the tongue at 3.0-T field strength imaging.…”

Palatal lesions: discriminative value of conventional MRI and diffusion weighted imaging

“…The results are in consistence with previous study reporting 1.5 times more female patients having benign neoplasms in the hard palate. 17 The predilection for sex in the present study might be attributed to disease composition. Both pleomorphic adenoma and benign lymphoepithelial lesion have relatively higher frequency in female patients.…”

“…The reason why malignant tumours have lower ADC values are not well understood but is probably related to a combination of higher cellularity, tissue disorganization and increased extracellular space tortuosity, all contributing to reduced motion of water. 8 Although with different b-values and different optimal ADC thresholds, most previous studies inevitably proved the ability of DWI in differentiating malignant from benign head and neck tumours, [15][16][17][18][19][20][21][22][23][24] except that diagnostic dilemma exists in cholesteatoma, salivary gland tumours and lymph nodes. 8,25 However, the comparison of diagnostic ability between DWI and conventional MRI was less performed.…”

Changes of cerebrospinal fluid in the upper neck area with age using diffusion weighted MR imaging

“…[5] Furthermore, some reports showed the application of DWI with calculation of apparent diffusion coefficient (ADC) in the differentiation between malignant and benign diseases in head and neck. [6][7][8][9][10] Studies regarding absolute ADC values in the normal human brain and the effect of aging on diffusion are scarce, and only a few reports involving small numbers of subjects have been published. [11] Moreover, age is an important factor for spinal cord injury and repair.…”