Diagnostic Value of Diffusion Weighted Magnetic Resonance Imaging in Evaluation of Metastatic Neck Lymph Nodes in Head and Neck Cancer: A Sample of Iranian Patient

Abstract

Objective: To evaluate the diagnostic value of DWI in assessment of metastatic neck lymph node in a sample of Iranian patients with Head and Neck cancer. Methods: 25 patients with 80 neck lymph nodes were analyzed using 1.5 T MRI. DWI was performed with b values of 0 and 1,000 s/mm 2. Short axis diameter and ADC values (min, max and mean) were calculated for metastatic and non-metastatic neck LNs and results were compared with histopathological findings. The optimal ADC thresholds were analyzed using receiver coefficient characteristic (ROC) curves for discriminating between metastatic and benign neck lymph nodes. Result: Histopathological findings revealed that there are 45% (n=36) metastatic and 55% (n=44) non-metastatic neck LNs respectively. There was no statistically significant difference in short axis diameter between the two groups (p = 0.346). However, The ADC values of metastatic neck LNs were significantly lower than those of non-metastatic neck LNs (p < 0.001); 0.90 ± 0.10 × 10-3 mm 2 /s vs 1.06 ± 0.12 × 10-3 mm 2 /s (ADC mean), 0.78 ± 0.08 × 10-3 mm 2 /s vs 0.92 ± 0.20× 10-3 mm 2 /s (ADC min) and 1.02 ± 0.12 × 10-3 mm 2 /s vs 1.24 ± 0.15 × 10-3 mm 2 /s (ADC max). The optimal mean ADC threshold value was equal to 0.996 × 10-3 mm 2 /s for differentiating malignant from benign lymph nodes with sensitivity, specificity and accuracy of 80.56 %, 77.27 % and 71.59 % respectively. Conclusion: MR diffusion imaging and ADC values as a non-invasive technique can assess metastatic neck LNs in head and neck cancer with higher sensitivity, specificity and accuracy.

Mode of action of carboplatin via activating p53/miR‐145 axis in head and neck cancers

“…Head and neck cancers account for 3% to 4% of worldwide malignancies and are the fifth most common type of cancers. 31 The most frequent type of head and neck cancers is HNSCC. 1 Each year, approximately 700,000 patients are diagnosed with HNSCC worldwide, and 350,000 deaths occur associated with this cancer type.…”

“…Head and neck cancers account for 3% to 4% of worldwide malignancies and are the fifth most common type of cancers 31 . The most frequent type of head and neck cancers is HNSCC 1 .…”

A review of diffusion-weighted magnetic resonance imaging in head and neck cancer patients for treatment evaluation and prediction of radiation-induced xerostomia

“…Head and neck cancer (HNC) of the mucosa is increasing worldwide, currently accounting for up to 4% of all malignancies [ 1 ]. More than 60% of presentations are locally advanced tumours, with most fatalities caused by uncontrolled locoregional disease [ 2 , 3 ].…”

“…Diffusion-Weighted Imaging (DWI) is a function of MRI being explored in HNC management. It is a non-invasive technique that measures the random motion of water molecules within different tissue compartments [ 1 , 9 , 33 , 34 ]. Molecular motion is determined by its size, environmental temperature and the cellularity of its surroundings, therefore DWI can provide quantitative information of the diffusivity of each structure based on differences in water mobility [ 1 , 9 ].…”

Lymph nodes in the head and neck cancer: would diffusion-weighted magnetic resonance imaging solve the diagnostic dilemma?

“…They are accounting for about 3 to 4% of the overall malignancies. So far, tumors in the head and neck are responsible for more than 700, 000 cases and more than 350,000 deaths annually [8,9]. About 95% of head and neck cancer begins in squamous cells and known as head and neck squamous cell carcinoma (HNSCC).…”