Utility of MRI Diffusion Techniques in the Evaluation of Tumors of the Head and Neck

Abstract

The use of diffusion-weighted imaging in the head and neck is an increasingly used technique that requires adaptation of the acquisition parameters. Parallel imaging and emerging techniques such as IVIM are playing a new role. The main indications for performing DWI are tissue characterization, nodal staging and therapy monitoring. Lower apparent diffusion coefficients have been reported in this region for malignant lesions such as SCC, lymphoma and metastatic lymph node, as opposed to higher ADC in benign lesions and lymph nodes. Follow-up and early response to treatment are reflected in an ADC increase in both primary tumor and nodal metastasis.

The Role of Intravoxel Incoherent Motion MRI in Predicting Early Treatment Response to Chemoradiation for Metastatic Lymph Nodes in Nasopharyngeal Carcinoma

“…The findings regarding ADC and D may have been the result of the decreased cellularity and less variation in the amount of stromal tissue in malignant tumors, which would increase water diffusivity [31].…”

Diffusion kurtosis imaging for differentiating between the benign and malignant sinonasal lesions

“…Both imaging tools are useful for disease staging and surgical planning . However, morphological information provided by CT and MRI is not always enough for the evaluation of biological properties of sinonasal lesions . Functional imaging, such as the diffusion weighted imaging (DWI), have been widely used in the differentiation between malignant and benign lesions in the head and neck .…”

Modelling tumour volume variations in head and neck cancer: contribution of magnetic resonance imaging for patients undergoing induction chemotherapy

“…In fact, it is possible to characterise tissue cellularity by evaluating the motion of water molecules on MR diffusion-weighted imaging (DWI) and to provide information regarding tumour perfusion and permeability with MR perfusion-weighted imaging (PWI) or perfusion-CT (PCT) studies. DWI is described to be a predictor of response to therapy and a good tool to differentiate between recurrent tumours from post-radiation changes 3 33 - 34 . PWI may play a role in detecting residual disease and predict patient outcomes 35 36 .…”