ADC for Differentiation between Posttreatment Changes and Recurrence in Head and Neck Cancer: A Systematic Review and Meta-analysis

Abstract

BACKGROUND: Previous studies reported that the ADC values of recurrent head and neck cancer lesions are lower than those of posttreatment changes, however, the utility of ADC to differentiate them has not been definitively summarized and established. PURPOSE:Our aim was to evaluate the diagnostic benefit of ADC calculated from diffusion-weighted imaging in differentiating recurrent lesions from posttreatment changes in head and neck cancer.DATA SOURCES: MEDLINE, Scopus, and EMBASE data bases were searched for studies.STUDY SELECTION: The review identified 6 prospective studies with a total of 365 patients (402 lesions) who were eligible for the meta-analysis.DATA ANALYSIS: Forest plots were used to assess the mean difference in ADC values. Heterogeneity among the studies was evaluated using the Cochrane Q test and the I 2 statistic. DATA SYNTHESIS: Among included studies, the overall mean of ADC values of recurrent lesions was 1.03 Â 10 À3 mm 2 /s and that of the posttreatment changes was 1.51 Â 10 À3 mm 2 /s. The ADC value of recurrence was significantly less than that of posttreatment changes in head and neck cancer (pooled mean difference: À0.45; 95% CI, À0.59-0.32, P , .0001) with heterogeneity among studies. The threshold of ADC values between recurrent lesions and posttreatment changes was suggested to be 1.10 Â 10 À3 mm 2 /s. LIMITATIONS:Given the heterogeneity of the data of the study, the conclusions should be interpreted with caution. CONCLUSIONS:The ADC values in recurrent head and neck cancers are lower than those of posttreatment changes, and the threshold of ADC values between them was suggested.

Normalized Parameters of Dynamic Contrast-Enhanced Perfusion MRI and DWI-ADC for Differentiation between Posttreatment Changes and Recurrence in Head and Neck Cancer

“…Previous studies have shown that ADC values in recurrent head and neck cancer lesions are lower than those after benign posttreatment changes, [18][19][20] consistent with the results in the present study. The use of normalized ADCs in the present study and the aforementioned normalized DCE-MR imaging parameters is expected to be reproducible in other institutions by minimizing the effects of several factors that may affect the ADC values such as differences in MR imaging scanners, magnetic field strength, and patient variability.…”

“…DWI parameters, especially ADC, were lower in the recurrence of head and neck cancers than in benign changes after treatment. [18][19][20] To date, there have been no studies that have investigated the differentiation between head and neck cancer recurrences and posttreatment changes using normalized DWI-ADC that also consider intervendor and interinstitutional reproducibility as in the previously described normalized DCE-MR imaging parameters.…”

MRI features of sinonasal tract angiofibroma/juvenile nasopharyngeal angiofibroma: Case series and systematic review

“…The ADC values of sinonasal benign tumors, including STA, have been reported to be higher than those of sinonasal malignant tumors, 59 and in a previous systematic review, the mean maximum ADC of malignant lesions of the head and neck region was reported to be 1.35-1.20 × 10 −3 mm 2 /second. 60,61 The lowest mean ADC value for STA in the present study was 1.5 (10 −3 mm 2 /second); therefore, a relatively high ADC value of at least 1.5 × 10 −3 mm 2 /second or higher in clinically suspected STA may indicate a high probability of STA.…”

Apparent diffusion coefficient for differentiation between extra-nodal lymphoma and squamous cell carcinoma in the head and neck: a systematic review and meta-analysis

“…Head and neck malignant tumors have been shown to have lower ADC values than benign lesions (7,8). Although both head and neck cancers and lymphomas are highly cellular tumors, previous studies have shown that lymphomas tend to have particularly low ADC values (9)(10)(11)(12)(13)(14)(15)(16).…”