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Diffusion-weighted imaging in head and neck squamous cell carcinomas: a systematic review
Juliette P Driessen1, Paulina M W van Kempen, Geert J van der Heijden
1Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands.
Diffusion-weighted imaging (DWI) demonstrates high accuracy for detecting head and neck cancers, metastatic lymph nodes, and recurrences. While promising, further research is needed due to sparse literature and varying ADC thresholds.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Head and neck squamous cell carcinomas (HNSCCs) pose diagnostic challenges.
- Accurate staging and detection of recurrence are crucial for patient outcomes.
Purpose of the Study:
- To review the diagnostic accuracy of diffusion-weighted imaging (DWI).
- To assess DWI's utility in primary HNSCC detection, lymph node metastasis, and recurrence identification.
Main Methods:
- A systematic review of studies utilizing DWI was conducted.
- Inclusion criteria were applied to select relevant research.
Main Results:
- DWI showed higher apparent diffusion coefficient (ADC) values in benign lesions compared to malignant ones.
- Diagnostic accuracy for primary HNSCC ranged from 66% to 86%.
- Accuracy for metastatic lymph nodes was 85%-91% with NPV >91%; accuracy for recurrences was 78%-100% with NPV 77%-100%.
Conclusions:
- DWI exhibits consistent high accuracy and negative predictive value (NPV).
- The technique shows significant potential for lymph node staging and recurrence detection in HNSCC.
- Limited literature and variable ADC thresholds necessitate further investigation.
