The Diagnostic Value of Cervical Lymph Node Metastasis in Head and Neck Squamous Carcinoma by Using Diffusion-Weighted Magnetic Resonance Imaging and Computed Tomography Perfusion

Abstract

Purpose. The aim of this study was to compare diffusion-weighted magnetic resonance imaging (DWI) with computed tomography perfusion (CTP) for preoperative detection of metastases to lymph nodes (LNs) in head and neck squamous cell carcinoma (SCC). Methods. Between May 2010 and April 2012, 30 patients with head and neck SCC underwent preoperative DWI and CTP. Two radiologists measured apparent diffusion coefficient (ADC) values and CTP parameters independently. Surgery and histopathologic examinations were performed on all patients. Results. On DWI, 65 LNs were detected in 30 patients. The mean ADC value of metastatic nodes was lower than benign nodes and the difference was statistically significant (P < 0.05). On CTP images, the mean value in metastatic nodes of blood flow (BF) and blood volume (BV) was higher than that in benign nodes, and mean transit time (MTT) in metastatic nodes was lower than that in benign nodes. There were significant differences in BF and MTT values between metastatic and benign LNs (P < 0.05). There were significant differences between the AUCs of DWI and CTP (Z=4.612, P < 0.001). Conclusion. DWI with ADC value measurements may be more accurate than CTP for the preoperative diagnosis of cervical LN metastases.

The diagnostic accuracy of diffusion weighted magnetic resonance (MR) imaging for discrimination of malignant from benign cervical lymphadenopathy in head and neck tumours using histopathology as the reference standard

“…Diffusion restriction was seen in 35 out of 41 malignant lymph nodes with resultant low signal on ADC maps and 7 out of 41 cases showed absence of diffusion restriction which contributed for False negative cases. This finding corroborated with the findings of study done by Jin Zhong et al [20].…”

“…The best threshold value was 1.03 × 10-3 mm2/sec, obtaining a sensitivity of 100% and a specificity of 92.9%. Similar findings had been illustrated by Zhong et al (20). They found out that the mean ADC value of metastatic nodes was approximately 0.849 × 10-3 mm2/sec (range: 0.738 × 10-3 mm2/sec-0.960 × 10-3 mm2/sec), lower than the mean value of the benign nodes (1.443 × 10-3 mm2/sec, range: 1.037 × 10-3 mm2/sec-1.849 × 10-3 mm2/sec).…”

The diagnostic role of diffusion-weighted magnetic resonance imaging in hypopharyngeal carcinoma

“…CT may reveal the extent of infiltration of hypopharyngeal carcinoma, but it also has certain limitations, including over estimation of invasion of the vocal cords, underestimation of invasion of the upper esophagus, difficulty in displaying mild invasion of thyroid cartilage, and uncertainty with regard to the normal size of the cervical lymph nodes and whether they are subject to metastasis. Routine MRI has high resolution in soft tissue, enabling it to accurately determine the infiltration extent of tumors; however, it remains a challenge to diagnose small lesions or micrometastatic nodes ( 3 ). Positron emission tomography (PET) and PET/CT may supply functional information and differentiate malignant tumors from benign lesions; however, they are expensive with low availability and are limited by relatively low spatial resolution and risk of radiation exposure ( 3 ).…”

Diffusion-Weighted Mri and Proton Magnetic Resonance Spectroscopy in the Diagnosis and Evaluation of the Effectiveness of Chemoradiotherapy of Head and Neck Tumors (The Literature Review)

“…По некоторым данным, поскольку злокачественные процессы демонстрируют большее ограничение диффузии молекул воды, чем доброкачественные, средние значения ИКД вторично измененных лимфатических узлов значительно ниже, чем у доброкачественных. При этом диапазон пороговых значений ИКД колеблется от 0,94 до 1,02 х 10 -3 мм 2 /сек [31][32][33][34][35][36][37][38]. Таким образом, роль ДВ МРТ в стадировании рака головы и шеи важна и потенциально перспективна для выявления вторичного поражения небольших метастатических узлов, которые соответствуют нормальным критериям по анатомической МРТ или КТ-картине.…”