Head and neck squamous cell carcinoma: Differentiation of histologic grade with standard- and high-b-value diffusion-weighted MRI

Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Head & Neck (Impact Factor: 2.64). 05/2013; 35(5). DOI: 10.1002/hed.23008
Source: PubMed


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.
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/mm2 prior to biopsy or surgery. The ADC values were compared among the different histologic grades.
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/mm2 (p = .014).
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, 2013

1 Follower
22 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and purpose: High b-value DWI has been expected to have an additional diagnostic role and demonstrated some promising results in head and neck cancer. The aim of this study was to evaluate the diagnostic performance of DWI at a high b-value (b=2000 s/mm(2)) compared with a standard b-value (b=1000 s/mm(2)) and the ratio of ADC values of high and standard b-values for their ability to differentiate between recurrent tumor and posttreatment changes after the treatment of head and neck squamous cell carcinoma. Materials and methods: A total of 33 patients diagnosed with head and neck squamous cell carcinoma were enrolled in the present study; all had contrast-enhancing lesions on follow-up MR imaging. All patients underwent single-shot echo-planar DWI at b=1000 s/mm(2) and b=2000 s/mm(2), and corresponding ADC maps were generated (ADC1000 and ADC2000, respectively). The mean ADC1000, ADC2000, and ADCratio (ADCratio = ADC2000/ADC1000 × 100) values were evaluated within a manually placed ROI with contrast-enhanced T1-weighted images as references. For the statistical analysis, we performed a Student t test and multivariate logistic regression. Results: The mean ADC1000 in recurrent tumor was significantly lower than that in posttreatment changes (P < .001), whereas the mean ADC2000 resulted in no significant difference (P = .365). The mean ADCratio was significantly higher in recurrent tumor than that in posttreatment changes (73.5 ± 7.2% vs 56.9 ± 8.8%, respectively; P < .001). Multivariate logistic regression analysis revealed that the ADCratio was the only independently differentiating variable (P = .024). The sensitivity, specificity, and accuracy of ADCratio were 95.0%, 69.2%, and 84.8%, respectively, by use of the optimal cutoff value of 62.6%. Conclusions: We suggest that the ADCratio calculated from the ADC1000 and ADC2000 is a promising value for the differentiation of recurrent tumor and posttreatment changes in head and neck squamous cell carcinoma.
    American Journal of Neuroradiology 06/2013; 34(12). DOI:10.3174/ajnr.A3603 · 3.59 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    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. DOI:10.1002/jmri.24285 · 3.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Standard magnetic resonance imaging (MRI) and computed tomography continue to be the imaging modalities of choice in staging and reviewing patients with head and neck cancer. Diffusion-weighted MRI (DW-MRI) is an advanced imaging modality that records the molecular diffusion of protons and thus provides an opportunity to further assess tissue character. Interest in DW-MRI of the head and neck continues to grow, especially its application to the assessment and treatment of head and neck cancer. We highlight the potential role of DW-MRI in the delineation, characterization, and lymph node staging of head and neck tumours. Furthermore, we discuss the ability of DW-MRI to provide a real opportunity to differentiate post-treatment tumour recurrence from chemoradiotherapy-induced local tissue changes. The future impact of these findings upon the clinical practice of the head and neck surgeon is discussed.
    International Journal of Oral and Maxillofacial Surgery 10/2014; 44(1). DOI:10.1016/j.ijom.2014.09.008 · 1.57 Impact Factor
Show more