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Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging
J Wang1, S Takashima, F Takayama
1Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Purpose:
To evaluate whether apparent diffusion coefficients (ADCs) calculated from diffusion-weighted echo-planar magnetic resonance (MR) images can be used to characterize head and neck lesions.
Materials And Methods:
Diffusion-weighted echo-planar MR imaging was performed with a 1.5-T MR unit in 97 head and neck lesions in 97 patients. Images were obtained with a diffusion-weighted factor, factor b, of 0, 500, and 1,000 sec/mm(2), and an ADC map was constructed. The ADCs of lesions, cerebrospinal fluid, and spinal cord were calculated.
Results:
Acceptable images for ADC measurement were obtained in 81 (84%) patients. The mean ADC of malignant lymphomas, (0.66 +/- 0.17[SD]) x 10(-3) mm(2)/sec (n = 13), was significantly smaller (P <.001) than that of carcinomas. The mean ADC of carcinomas, (1.13 +/- 0.43) x 10(-3) mm(2)/sec (n = 36), was significantly smaller (P =.002) than that of benign solid tumors. The mean ADC of benign solid tumors, (1.56 +/- 0.51) x 10(-3) mm(2)/sec (n = 22), was significantly smaller (P =.035) than that of benign cystic lesions, (2.05 +/- 0.62) x 10(-3) mm(2)/sec (n = 10). No significant differences were seen in the mean ADC of cerebrospinal fluid and of spinal cord among four groups of lesions. When an ADC smaller than 1.22 x 10(-3) mm(2)/sec was used for predicting malignancy, the highest accuracy of 86%, with 84% sensitivity and 91% specificity, was obtained.
Conclusion:
Measurement of ADCs may be used to characterize head and neck lesions.
Insights
Apparent diffusion coefficients (ADCs) from MRI can differentiate head and neck lesions. Lower ADCs in malignant lymphomas and carcinomas suggest their utility in lesion characterization.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Head and neck lesions require accurate characterization for effective diagnosis and treatment planning.
- Diffusion-weighted magnetic resonance (MR) imaging offers insights into tissue microstructure.
Purpose of the Study:
- To determine if apparent diffusion coefficients (ADCs) derived from diffusion-weighted echo-planar MR images can effectively characterize head and neck lesions.
- To assess the diagnostic performance of ADCs in distinguishing between different types of head and neck pathologies.
Main Methods:
- Diffusion-weighted echo-planar MR imaging was performed on 97 head and neck lesions in 97 patients using a 1.5-T MR unit.
- Apparent diffusion coefficients (ADCs) were calculated from images acquired with diffusion-weighting factors (b-values) of 0, 500, and 1,000 sec/mm(2).
- ADCs were measured for lesions, cerebrospinal fluid, and spinal cord to establish reference values.
Main Results:
- Diagnostic quality images for ADC measurement were obtained in 84% of patients.
- Significantly lower mean ADCs were observed for malignant lymphomas (0.66 x 10(-3) mm(2)/sec) and carcinomas (1.13 x 10(-3) mm(2)/sec) compared to benign solid tumors (1.56 x 10(-3) mm(2)/sec) and benign cystic lesions (2.05 x 10(-3) mm(2)/sec).
- Using an ADC threshold of 1.22 x 10(-3) mm(2)/sec to predict malignancy yielded an accuracy of 86%, with 84% sensitivity and 91% specificity.
Conclusions:
- Measurement of apparent diffusion coefficients (ADCs) is a valuable tool for characterizing head and neck lesions.
- ADC values can help differentiate between malignant and benign pathologies in the head and neck region.
- Diffusion-weighted MR imaging provides quantitative information that aids in the diagnostic workup of head and neck abnormalities.
