Head and neck squamous cell carcinoma: Differentiation of histologic grade with standard- and high-b-value diffusion-weighted MRI.
ABSTRACT BACKGROUND: The correlation between the histologic grades and the apparent diffusion coefficient (ADC) in head and neck squamous cell carcinomas (HNSCCs) remains unclear. This study aimed to evaluate the potential of diffusion-weighted MRI (DW-MRI) at both standard and high b values to differentiate the histologic grades of HNSCC. METHODS: In all, 54 consecutive patients with HNSCCs (34 well-differentiated, 10 moderately differentiated, and 10 poorly differentiated) performed DW-MRIs at both b = 1000 and 2000 s/mm(2) prior to biopsy or surgery. The ADC values were compared among the different histologic grades. RESULTS: The ADC values of well-differentiated and poorly differentiated HNSCC were significantly different at both b values (p < .001 in both). However, significant difference between moderately differentiated and poorly differentiated HNSCC was revealed at only b = 2000 s/mm(2) (p = .014). CONCLUSIONS: DW-MRIs at standard and high b values are helpful for differentiating histologic grades in HNSCC with better differentiation at a high b-value. © 2012 Wiley Periodicals, Inc. Head Neck, 2012.
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ABSTRACT: Diffusion-weighted imaging (DWI) is an established functional imaging technique that interrogates the delicate balance of water movement at the cellular level. Technological advances enable this technique to be applied to whole-body MRI. Theory, b-value selection, common artifacts and target to background for optimized viewing will be reviewed for applications in the neck, chest, abdomen, and pelvis. Whole-body imaging with DWI allows novel applications of MRI to aid in evaluation of conditions such as multiple myeloma, lymphoma, and skeletal metastases, while the quantitative nature of this technique permits evaluation of response to therapy. Persisting signal at high b-values from restricted hypercellular tissue and viscous fluid also permits applications of DWI beyond oncologic imaging. DWI, when used in conjunction with routine imaging, can assist in detecting hemorrhagic degradation products, infection/abscess, and inflammation in colitis, while aiding with discrimination of free fluid and empyema, while limiting the need for intravenous contrast. DWI in conjunction with routine anatomic images provides a platform to improve lesion detection and characterization with findings rivaling other combined anatomic and functional imaging techniques, with the added benefit of no ionizing radiation. J. Magn. Reson. Imaging 2013;38:253-268. © 2013 Wiley Periodicals, Inc.Journal of Magnetic Resonance Imaging 08/2013; 38(2):253-68. · 2.57 Impact Factor