scholarly journals Diagnostic Value of Diffusion Weighted Magnetic Resonance Imaging in Evaluation of Metastatic Neck Lymph Nodes in Head and Neck Cancer: A Sample of Iranian Patient

2019 ◽  
Vol 20 (6) ◽  
pp. 1789-1795 ◽  
Author(s):  
Fatemeh Alamolhoda ◽  
Fariborz Faeghi ◽  
Mohsen Bakhshandeh ◽  
Aslan Ahmadi ◽  
Morteza Sanei Taheri ◽  
...  
2020 ◽  
Vol 61 (11) ◽  
pp. 1580-1586
Author(s):  
Arvin Arian ◽  
Ahmed Mohamedbaqer Easa ◽  
Mehran Arab-Ahmadi

Background Researchers have recently focused on assessing the accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) in predicting pelvic lymph node metastases in gynecological malignancies. Purpose To evaluate the diagnostic value of DW-MRI in discriminating between metastatic and non-metastatic pelvic lymph nodes in endometrial cancer patients. Material and Methods This retrospective database study was conducted with 33 women aged 30–84 years with pathologically proven endometrial cancer that had been assessed by DW-MRI before their first treatment initiation at our referral hospital from March 2016 to April 2019. The diffusion technique (b = 50, 400, and 1000 mm2/s) was used in the imaging, and continuous apparent diffusion coefficient (ADC) metrics (ADCmin, ADCmax, ADCmean, ADCSD, and rADC) were compared between the metastatic and non-metastatic lymph nodes. Results In total, 48 lymph nodes from 33 patients were assessed. All metastatic lymph nodes were restricted, while among the non-metastatic lymph nodes, only 19.3% were restricted. Considering pathological reports of metastatic and non-metastatic lymph nodes as the gold standard, DWI-related restricted and non-restricted features had a sensitivity of 80.6%, a specificity of 100%, and an accuracy of 87.5% to discriminate between a metastatic and non-metastatic pattern. ADC metrics of ADCmin, ADCmax, ADCmean, ADCSD, and rADC showed high values enabling differentiation between metastatic and non-metastatic lymph nodes. The best cut-off values were 0.7 × 10−3, 1.2 × 10−3, 1.01 × 10−3, 123, and 0.78, respectively. Conclusion DW-MRI is a useful quantitative tool for differentiating between metastatic and benign lymph nodes in endometrial cancer patients.


Author(s):  
Dalia K. Serour ◽  
Bahaa Eldin Mahmoud ◽  
Bassant Daragily ◽  
Shaima Fattouh Elkholy

Abstract Background Head and neck cancer has been labeled as the fifth most common cancer. Lymph node (LN) metastases were reported as the most important predatory factor for diagnosis and selection of suitable treatment. Diffusion-weighted (DW) magnetic resonance (MR) imaging is a very important tool that gives quantitative data in several compartments. This work aims to evaluate the diagnostic value of diffusion-weighted as a part of the magnetic resonance imaging in patients with head and neck cancer to allow differentiation of lymph nodes, cancer staging, assessment of recurrence, and evaluation of the effects of oncologic therapy. Results The size of pathologically proven benign LNs ranged from 1 to 3 cm (1.71 ± 0.724) and malignant LNs ranged from 1.1 to 5.6 cm (2.54 ± 0.92) (P = 0.0103). The ADC value for benign LNs ranged from 1.26 × 10−3 to 2.49 × 10−3 (mean 1.98 × 10−3 ± 0.32 × 10−3), and malignant LNs from 0.608 × 10−3 to 2.1 × 10−3 (mean 0.971 × 10−3 ± 0.305 × 10−3) (P < 0.001) with sensitivity and a specificity of 94% and 100% respectively. The ADC value for metastatic LNs ranged from 0.70 × 10−3 to 2.10 × 10−3 (1.08 × 10−3 ± 0.31 × 10−3) while lymphomatous nodes ranged 0.608 × 10−3 to 1.16 × 10−3 (0.78 × 10−3 ± 0.17 × 10−3). In this study, a significant statistical difference was also observed between the ADC value of the SCC and lymphomatous LN (P = 0.0034) with sensitivity and a specificity of 90% and 75% respectively. Conclusion Diffusion-weighted MR imaging is an effective assist in differentiating benign and malignant lymph nodes. It acts as an indicator for recovery or recurrence after chemotherapy and radiotherapy.


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