Role of dynamic contrast enhanced and diffusion weighted MRI in the differentiation between post treatment changes and recurrent laryngeal cancers

Post-treatment benign changes versus recurrence in non-lymphoid head and neck malignancies: can diffusion-weighted magnetic resonance imaging end up the diagnostic challenge?

“…The mean ADC value of the lesions was significantly lower in the "locoregional recurrence/residual tumour" group (1.08 × 10 −3 mm 2 /s) compared to the "posttreatment benign changes" group (1.95 × 10 −3 mm 2 /s); P < 0.001. This finding is in consonance with the previously published data which consistently reported that higher ADC values would be expected with post-treatment benign changes while lower ADC values would be expected with recurrent/residual malignant lesions [6][7][8][9]15].…”

“…Fellow research groups had postulated different ADC cutoff values in order to differentiate recurrent/residual malignant lesions from post-treatment benign changes in the head and neck, with different accuracies. Desouky and colleagues [7] demonstrated 100% sensitivity and 74% specificity when using an ADC cutoff value of 0.96 × 10 −3 mm 2 /s for differentiating recurrent squamous cell carcinomas from post-treatment changes in the region of the larynx only. Other authors, however, proposed slightly higher ADC cutoff values.…”

“…Over the past few years, investigating the role of DWI in evaluating possible tumour recurrences following treatment of head and neck malignancies has been the focus of several studies, with promising results. However, faulty DWI interpretations still exist; variations in the ranges of ADC measurements have been demonstrated by several studies; and different ADC cutoff values, with different accuracies, have been postulated in order to differentiate recurrent/residual malignant lesions from post-treatment benign changes in the head and neck region [6][7][8][9][10][11]. Hence, research in this particular area is still ongoing in attempts to end up the incompletely resolved diagnostic dilemma of "post-treatment head and neck lesions".…”

MRI with DWI for the Detection of Posttreatment Head and Neck Squamous Cell Carcinoma: Why Morphologic MRI Criteria Matter

“…[5][6][7][8][9] The imaging features of rHNSCC on morphologic MRI sequences have been scarcely addressed in the literature, 1,5,7,10 and several studies have focused on demonstrating the utility of DWI for the detection of recurrence. [5][6][7][8][9][11][12][13] However, the diagnostic performance of clearly defined morphologic MRI criteria, the interobserver reproducibility, and the impact of each technique (morphologic MRI versus combined DWI with morphologic MRI) have not been assessed in these studies. Earlier studies were rather small, 6,7,13 and they were based on a mix of HNSCC and other histologic tumor types 7,11 or included both local and nodal recurrence.…”

“…Earlier studies were rather small, 6,7,13 and they were based on a mix of HNSCC and other histologic tumor types 7,11 or included both local and nodal recurrence. 6,12 The aim of this study was to evaluate the diagnostic performance of morphologic MRI with clearly defined criteria for the detection of rHNSCC/sHNSCC and to compare it with the diagnostic performance of DWI alone and of DWI combined with morphologic MRI. We likewise aimed to analyze the added value of each technique and their respective contributions to the overall diagnostic performance of DWIMRI.…”