Role of Diffusion-Weighted Echo-Planar MR Imaging in Differentiation of Residual or Recurrent Head and Neck Tumors and Posttreatment Changes

Razek, Ahmed Abdel Khalek Abdel; Kandeel, Ahmed; Soliman, Nermin; El-Shenshawy, H. M.; Kamel, Youssef; Nada, Nadia; Denewar, A.

doi:10.3174/ajnr.a0491

Cited by 197 publications

(114 citation statements)

References 16 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…37 Increased cellularity of the tumor leads to a greater proportion of intracellular compared to extracellular water components, whereas decreased cellularity indicates a greater proportion of relatively easily diffusible extracellular water components. 38,39 Even though intracellular water components are not exactly the same as the slow diffusion components and extracellular water components are not the same as the fast diffusion components, the components are considered to correspond. 35,40 Regarding the better response to chemoradiation therapy of solid tumors with high cell density in the highly proliferating state than those with low cellularity (including areas with necrotic components that represent tumor hypoxia with low oxygen tensions that render the tumor more resistant to chemotherapy or radiation therapy), tumors with high intracellular water components that dominate signal intensity at high b-value DWI rather than extracellular water components can show better response to induction chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Squamous Cell Carcinoma of the Head and Neck: Comparison of Diffusion-weighted MRI at b-values of 1,000 and 2,000 s/mm<sup>2</sup> to Predict Response to Induction Chemotherapy

Ryoo

Kim

Choi

et al. 2015

MRMS

View full text Add to dashboard Cite

Purpose: Recent publications have reported contradictory results of pretreatment diffusion-weighted magnetic resonance imaging (DWI) for the prediction of chemoradiotherapeutic response in primary squamous cell carcinomas of the head and neck (HNSCC). Therefore, we evaluated the diagnostic performance of DWI obtained with both standard (b = 0 and 1,000 s/mm 2 ) and high (b = 0 and 2,000 s/mm 2 ) b-values for predicting response to induction chemotherapy in HNSCCs.Methods: For 25 patients with primary HNSCC who underwent DWI with both standard and high b-values prior to treatment, we calculated corresponding apparent diffusion coefficient (ADC) maps. Regions of interest containing the tumor were drawn on every section of ADC maps and summated to make volume-based data of the entire tumor. Histogram parameters (mean ADC, kurtosis, and skewness) were correlated with treatment response using unpaired Student t test. Univariate and multivariate analysis of the ADC parameters, patient age, sex, whole tumor volume, and T stage were also performed to predict tumor response to induction chemotherapy.Results: Response to induction chemotherapy was good in 13 of the 25 patients and poor in 12. The mean ADC values of good responders at standard b-value (ADC 1000 ), 1.23 « 0.34 (© 10 ¹3 mm 2 /s), and high b-value (ADC 2000 ), 0.62 « 0.14 (© 10 ¹3 mm 2 /s), were lower than those of poor responders (ADC 1000 , 1.32 « 0.28 [© 10 ¹3 mm 2 /s]; ADC 2000 , 0.76 « 0.15 [© 10 ¹3 mm 2 /s]), but significant difference was achieved only at the ADC 2000 map (P = 0.02). In addition, mean tumor volume prior to treatment of good responders was smaller than that of poor responders. However, at multiple logistic regression analysis, only the mean ADC 2000 value remained as a significant predictor of response to induction chemotherapy.Conclusion: DWI with high b-values (b = 0 and 2,000 s/mm 2 ) as an assessment of ADC values may help predict tumor response to neoadjuvant chemotherapy for primary HNSCCs.

show abstract

Section: Discussionmentioning

confidence: 99%

Squamous Cell Carcinoma of the Head and Neck: Comparison of Diffusion-weighted MRI at b-values of 1,000 and 2,000 s/mm<sup>2</sup> to Predict Response to Induction Chemotherapy

Ryoo

Kim

Choi

et al. 2015

MRMS

View full text Add to dashboard Cite

show abstract

“…Therefore, DWI provides in characterization of different tissues and lesions. Previous reports showed the utility of DWI in the region of the head and neck for different pathology [19][20][21][22][23][24][25][26]. In studies focused on nodal staging, the imaging results were based on series with only clinical positive necks in which large lymph nodes were selected for evaluation [27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma

et al. 2009

View full text Add to dashboard Cite

Introduction The aim was to determine the diagnostic accuracy and additional value of diffusion-weighted imaging for detection of malignant lymph nodes in head and neck squamous cell carcinoma.Methods Two hundred nineteen lymph nodes, predominantly smaller than 10 mm (95.4%), in 16 consecutive patients were evaluated at 1.5 T. Lymph nodes were evaluated for maximum short axial diameter, morphological criteria, and apparent diffusion coefficient (ADC) values (b=0 and b=1,000 s/mm 2 ). Sensitivity, specificity, positive and negative predictive values as well as diagnostic odds ratios (DORs) and areas under the curves (AUCs) of ROC curves were calculated for the various magnetic resonance imaging (MRI) criteria individually and in combination. Histological examination of lymph nodes in the neck dissection specimen was the gold standard to determine malignant involvement. Results The optimal ADC threshold was 1.0×10 −3 mm 2 /s. Using this cutoff point, sensitivity and specificity were 92.3% and 83.9%, respectively. When used in combination with size and morphological criteria, ADC value <1.0× 10 −3 mm 2 /s was the strongest predictor of presence of metastasis (DOR=97.6). A model which added ADC values to the other MRI criteria performed significantly better than a model without ADC values: AUC=0.98 versus AUC=0.91 (p=0.036). Conclusion In this study, with predominantly small lymph nodes, the ADC criterion is the strongest independent predictor of presence of metastasis. The use of ADC values in combination with the other MRI criteria significantly improves the discrimination between malignant and benign lymph nodes.

show abstract

“…Many studies have shown the advantages of DW-MRI or PET/CT for distinguishing recurrent tumors from post-treatment changes in head and neck cancers (1,2,4,9). However, few studies have investigated the diagnostic performence of DW-MRI and PET-CT in the same patients with head and neck cancers (8,11).…”

Section: Resultsmentioning

confidence: 99%

“…The areas of gross necrosis and possible areas of edema should be excluded from the ROI, and multiple ROIs with a mean value should be used to prevent sampling error even if the lesion shows significant signal intensity homogeneity or heterogeneity. However, volume averaging and areas of micronecrosis cannot be avoided during ADC measurements (4).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Diffusion-Weighted MRI and FDG PET/CT for Detecting the Local Recurrence of Head and Neck Squamous Cell Carcinoma

Öz¹,

Şerifoğlu²,

Salihoğlu³

et al. 2016

Istanbul Med J

View full text Add to dashboard Cite

IntroductionFor patients with head and neck squamous cell carcinoma (HNSCC), multidisciplinary treatment involving surgery, radiotherapy, and/or chemotherapy improves survival and quality of life (1, 2). Despite aggressive combined management, locoregional recurrence is observed in approximately 40% of patients (3). Physical examination after treatment can be compromised by post-treatment changes, as surgical intervention can change the normal anatomy and radiotherapy can cause edema, inflammation, fibrosis, and necrosis (4). Particularly in the early stages of treatment, posttreatment follow-up imaging is also a challenge. Differentiation of post-treatment changes from a recurrence of HNSCC is generally not possible on computed tomography (CT) or magnetic resonance imaging (MRI); recurrent tumors and post-treatment changes may show similar appearances on routine MRI. After contrast administration, mass-like enhancement of post-treatment changes may mimic recurrence (1). Conversely, some recurrent tumors do not show enhancements, and thus, they cannot be distinguished from post-treatment changes (5).Diffusion-weighted MRI (DW-MRI) is sensitive to the randomized (Brownian) motion of water molecules. This imaging technique uses two opposite gradients of similar strength along a particular diffusion direction. The first gradient stimulates dephasing, and the second gradient will completely rephase all stationary molecules. Consequently, the movement of protons in living tissues results in incomplete rephrasing and is then converted into a decrease in the signal intensity on the resulting image (6, 7). The apparent diffusion coefficient ( Bulgular: Nüks saptanan hastalarda ADC ortalama değerleri saptanmayan hastalarla karşılaştırıldığında istatistiksel olarak anlamlı derecede düşük bulunmuştur (0,773'e karşı 1,588 x10-3/mm 2 sırasıyla, p<0,001). Nüks saptanan hastalarda SUV max değerleri saptanmaya hastalara göre istatistiksel olarak anlamlı derecede yüksek bulundu (15,642' karşı 4,508 sırasıyla; p<0,001). Nüks saptanan hastalarda ADC ortalama ve SUV max değerleri arasında anlamlı bir korelasyon izlenmedi (p=0,278, r=0,341). Nüks saptanmayan hastalarda ADC ortalama ve SUV max değerleri arasında negatif korelasyon saptandı (p=0,019, r=-0,691).Sonuç: PET/BT ve DAG-MRG baş-boyun SCC hastalarında tedavi sonrası nüksü saptamada etkin yöntemlerdir. Baş-Boyun SCC hastaları tedavi sonrası DAG-MRG ile takip edilebilir ve nüks şüphesi olan hastalarda PET-BT takip protokolüne eklenebilir.Anahtar Kelimeler: Baş ve boyun kanseri; difüzyon ağırlıklı görüntüleme, görünür difüzyon katsayısı, pozitron emisyon tomografisi/bilgisayarlı tomografi, standardize tutulum değeri Objective: To compare the efficacy between diffusion-weighted magnetic resonance imaging (DW-MRI) and positron emission tomography/computed tomography (PET/CT) in detecting the local recurrence of head and neck squamous cell carcinoma (HNSCC) following treatment in the same patient group. Methods: Twenty-three patients who had biopsy-proven HNSCC were enrolled. All ...

show abstract

Role of Diffusion-Weighted Echo-Planar MR Imaging in Differentiation of Residual or Recurrent Head and Neck Tumors and Posttreatment Changes

Cited by 197 publications

References 16 publications

Squamous Cell Carcinoma of the Head and Neck: Comparison of Diffusion-weighted MRI at b-values of 1,000 and 2,000 s/mm<sup>2</sup> to Predict Response to Induction Chemotherapy

Squamous Cell Carcinoma of the Head and Neck: Comparison of Diffusion-weighted MRI at b-values of 1,000 and 2,000 s/mm<sup>2</sup> to Predict Response to Induction Chemotherapy

Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma

Diagnostic Performance of Diffusion-Weighted MRI and FDG PET/CT for Detecting the Local Recurrence of Head and Neck Squamous Cell Carcinoma

Contact Info

Product

Resources

About