Diffusion-Weighted Magnetic Resonance Imaging in Characterization of Neck Lymph Nodes in Head and Neck Cancer
International Journal of Medical Imaging
Volume 8, Issue 1, March 2020, Pages: 6-15
Received: Dec. 15, 2019;
Accepted: Dec. 30, 2019;
Published: Jan. 7, 2020
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Usama Elsaied Ghieda, Radiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Ahmed Abdul-Raheem Badr, Radiology Department, National Cancer Institute, Cairo University, Cairo, Egypt
Aim: to prospectively determine if diffusion weighted magnetic resonance imaging can help in discrimination between benign and malignant lymph nodes in patients with head and neck cancer, using histological results as the standard of reference. Patients & Methods: 40 patients complaining of palpable cervical lymph nodes with unknown primary malignancy or having known head and neck cancer. MRI neck study was done for all patients, including pre and post contrast sequences and DWI. Histopathology was done for all patients. Statistical analysis of the differences in ADC values for benign and malignant nodes was performed, together with further analysis of the differences between the ADC values of metastatic lymph nodes and lymphoma. Results: 30 patients were histopathological proved malignant lymphadenopathy (20 metastatic from head and neck malignancy and 10 primary lymphomas) and 10 patients were histopathological proved benign lymphadenopathy (1 acute reactive lymphadenitis, 1 chronic granulomatous inflammation, 4 chronic non-specific inflammation & 4 reactive lymphoid hyperplasia). A statistically significant difference between ADC values of benign and malignant cervical nodes was reported with a threshold ADC value equal to 1.30 ×10-3 mm2/sec was identified. The ADC value for lymphoma was less than that for metastatic carcinoma, with high specificity and sensitivity values and a threshold ADC value equal to 0.9 ×10-3 mm2/sec was identified. Conclusion: MR diffusion imaging is helpful non-invasive method in differentiation between benign and malignant lymph nodes, and to the same extent differentiation between the variant types of malignant lymphadenopathy.
Usama Elsaied Ghieda,
Ahmed Abdul-Raheem Badr,
Diffusion-Weighted Magnetic Resonance Imaging in Characterization of Neck Lymph Nodes in Head and Neck Cancer, International Journal of Medical Imaging.
Vol. 8, No. 1,
2020, pp. 6-15.
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