Head and Neck Lesions: Characterization with Diffusion-weighted Echo-planar MR Imaging

Wang, Jichen; Takashima, S; Takayama, Fumiyoshi; Kawakami, Satoshi; Saito, Akitoshi; Matsushita, Takehiko; Momose, Masanobu; Ishiyama, Tetsuya

doi:10.1148/radiol.2202010063

Cited by 502 publications

(459 citation statements)

References 23 publications

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“…The b value of 500 s/mm 2 was used in our study to acquire DW-MR images with sufficient diffusion weighting and image quality. The b values used by other investigators (24,25,27,45) were in the range of 128*1000 s/mm 2 . From a clinical perspective, this pilot study suggests that DW-MRI could have clinical relevance in providing additional risk stratification information for small thyroid cancers that appear to be confined to the thyroid based on standard preoperative ultrasound and clinical evaluations.…”

Section: Discussionmentioning

confidence: 99%

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

Moreira

Hatzoglou

et al. 2015

Thyroid

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Background: Initial management recommendations of papillary thyroid carcinoma (PTC) are very dependent on preoperative studies designed to evaluate the presence of PTC with aggressive features. The purpose of this study was to evaluate whether diffusion-weighted magnetic resonance imaging (DW-MRI) before surgery can be used as a tool to stratify tumor aggressiveness in patients with PTC. Methods: In this prospective study, 28 patients with PTC underwent DW-MRI studies on a three Tesla MR scanner prior to thyroidectomy. Due to image quality, 21 patients were finally suitable for further analysis. Apparent diffusion coefficients (ADCs) of normal thyroid tissues and PTCs for 21 patients were calculated. Tumor aggressiveness was defined by surgical histopathology. The Mann-Whitney U test was used to compare the difference in ADCs among groups of normal thyroid tissues and PTCs with and without features of tumor aggressiveness. Receiver operating characteristic (ROC) analysis was performed to assess the discriminative specificity, sensitivity, and accuracy of and determine the cutoff value for the ADC in stratifying PTCs with tumor aggressiveness. Results: There was no significant difference in ADC values between normal thyroid tissues and PTCs. However, ADC values of PTCs with extrathyroidal extension (ETE; 1.53 -0.25 · 10 -3 mm 2 /s) were significantly lower than corresponding values from PTCs without ETE (2.37 -0.67 · 10 -3 mm 2 /s; p < 0.005). ADC values identified 3 papillary carcinoma patients with extrathyroidal extension that would have otherwise been candidates for observation based on ultrasound evaluations. The cutoff value of ADC to discriminate PTCs with and without ETE was determined at 1.85 · 10 -3 mm 2 /s with a sensitivity of 85%, specificity of 85%, and ROC curve area of 0.85. Conclusion: ADC value derived from DW-MRI before surgery has the potential to stratify ETE in patients with PTCs.

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Section: Discussionmentioning

confidence: 99%

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

Moreira

Hatzoglou

et al. 2015

Thyroid

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“…Some studies reported the ability of DWI to discriminate between different histological lymph node cancers in the neck [28][29][30]. Others showed that ADC determination on DWI-MRI may have added value in discriminating malignant from benign lymph nodes in the neck [19,20,27]. All studies were performed in patients with palpable cervical lymphadenopathy (clinical positive necks), and further evaluation by MRI was limited to selected enlarged lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

“…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

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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.

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“…Regarding primary tumors, it has been clearly demonstrated that malignant lymphoma has the lowest ADC values followed by carcinoma, benign tumor, and cystic lesions, and that ADC values significantly differ between well-differentiated and poorly differentiated lesions [46,47]. ADC significantly correlates with cellularity, stromal component, and nuclear-cytoplasmic ratio; and the positive correlation of ADC and stromal component may partly reflect the poor prognostic value of high pre-treatment ADC [48].…”

Section: Diffusion-weighted Imaging (Epi-dwi Non-epi-dwi Resolve)mentioning

confidence: 99%

“…The advantages of suppressing the signal from fat is to suppress artifacts due to high fat signals, to improve T2 contrast between fatty and non-fatty tissue, to enable detection of enhancing tumors hidden in fatty tissue, and the proof of adipose tissue, such as in lipoma, or cholesterol granuloma. Reading T1w and T2w basic sequences and T2w fat sat images is important because the very high STIR/TIRM ▶ Table 1 (Continuation) MRI sequences main pathologies/field of application diagnostic clues paraganglioma high peak enhancement, SER, and short TME on DCE [37] schwannoma low peak enhancement and SER with a longer TME on DCE [37] diffusionweighted imaging primary tumors low ADC values (lymphoma, followed by carcinoma, benign tumor and cystic lesions) [47] lymph node staging low ADC values [49] residual cancer after chemoradiation therapy lower increase in the percentage change of the mean ADC or decrease in ADC during treatment [51,52] cholesteatoma high signal on DWI [60] Granulation tissue, fibrous tissue, cholesterol granuloma or serous fluid…”

Section: Introductionmentioning

confidence: 99%

MRI Sequences in Head & Neck Radiology – State of the Art

Widmann¹,

Henninger²,

Kremser³

et al. 2017

Fortschr Röntgenstr

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ZUSAMMENFASSUNGHintergrund Magnetic resonance imaging (MRI) ist ein essentielles bildgebendes Verfahren für die Beurteilung von Kopf-Hals Erkrankungen. Die diagnostische Aussagekraft der MRI ist jedoch stark von der entsprechenden Auswahl und Interpretation der Protokolle und Sequenzen abhängig. Das Ziel dieses Beitrags ist es, State-of-the-art-Sequenzen für die klinische Routine der Kopf-Hals-MRI zusammenzufassen und die Evidenz zu beschreiben, für welche medizinische Fragestellungen diese Sequenzen nützlich sind.Methode Literaturübersicht von State-of-the-art-Sequences in der Kopf-Hals-MRI.

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Head and Neck Lesions: Characterization with Diffusion-weighted Echo-planar MR Imaging

Abstract: Measurement of ADCs may be used to characterize head and neck lesions.

Cited by 502 publications

References 23 publications

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

Using Diffusion-Weighted MRI to Predict Aggressive Histological Features in Papillary Thyroid Carcinoma: A Novel Tool for Pre-Operative Risk Stratification in Thyroid Cancer

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

MRI Sequences in Head & Neck Radiology – State of the Art

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