Does Diffusion Magnetic Resonance Imaging (DWI) has Role in Irradiated Laryngeal Carcinoma?

DWI involves acquisition of signal of movement of water proton in cellular spaces of body (Brownian motion). It includes qualitative method either restricted or facilitated and quantitive method which is apparent diffusion coefficient value(ADC) which is related to proportion of extracellular and intracellular components of the tissue., ADC is calculated with use of at least two b value more accurate using more DWI with different b value,ADC levels is low in increased tissue cellularity, as malignancy., ADC levels is high in non-tumoral tissue alterations such as direct endoscopy oedema, radiotherapy necrosis are expected to have minimal cellularity. ADC is most accurate in the detection of malignancy versus tissue edema or radionecrosis the aim of study to assess value of ADC as regarding measuring sensitivity and specificity and accuracy to differentiate tumor recurrence from radionecrosis. This study includes 36 patients who were suspected patients of tumor recurrence after radiotherapy; it is a prospective randomized comparative clinical trial. The patients were assessed using direct laryngoscopic examination under general anaesthesia and biopsy, and diffusion weighted image on the neck (b0 and b1000), ADC map and ADC value measured al lesion and normal tissues and compared with pathology results. ADC value (mean 0.93 ± 0.30 X 10^-3 mm²/s) in patients had recurrent carcinoma was significantly lower (P < .0001) than the mean ADC of normal tissue in the same patients (1.26 ± 0.134) while mean ADC of tumour recurrence (P < .0001) was lower than mean ADC value of radio necrosis (1.63 ± 0.21 × 10^-3 mm²/s). MRI ADC value is a sensitive and non-invasive method in detection of a recurrent laryngeal lesion from radionecrosis.