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Chudobiński C, Świderski B, Antoniuk I, Kurek J. Enhancements in Radiological Detection of Metastatic Lymph Nodes Utilizing AI-Assisted Ultrasound Imaging Data and the Lymph Node Reporting and Data System Scale. Cancers (Basel) 2024; 16:1564. [PMID: 38672646 PMCID: PMC11048706 DOI: 10.3390/cancers16081564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
The paper presents a novel approach for the automatic detection of neoplastic lesions in lymph nodes (LNs). It leverages the latest advances in machine learning (ML) with the LN Reporting and Data System (LN-RADS) scale. By integrating diverse datasets and network structures, the research investigates the effectiveness of ML algorithms in improving diagnostic accuracy and automation potential. Both Multinominal Logistic Regression (MLR)-integrated and fully connected neuron layers are included in the analysis. The methods were trained using three variants of combinations of histopathological data and LN-RADS scale labels to assess their utility. The findings demonstrate that the LN-RADS scale improves prediction accuracy. MLR integration is shown to achieve higher accuracy, while the fully connected neuron approach excels in AUC performance. All of the above suggests a possibility for significant improvement in the early detection and prognosis of cancer using AI techniques. The study underlines the importance of further exploration into combined datasets and network architectures, which could potentially lead to even greater improvements in the diagnostic process.
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Affiliation(s)
- Cezary Chudobiński
- Copernicus Regional Multi-Specialty Oncology and Trauma Centre, 93-513 Lódź, Poland;
| | - Bartosz Świderski
- Department of Artificial Intelligence, Institute of Information Technology, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (B.Ś.); (I.A.)
| | - Izabella Antoniuk
- Department of Artificial Intelligence, Institute of Information Technology, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (B.Ś.); (I.A.)
| | - Jarosław Kurek
- Department of Artificial Intelligence, Institute of Information Technology, Warsaw University of Life Sciences, 02-776 Warsaw, Poland; (B.Ś.); (I.A.)
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2
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Becker M, de Vito C, Dulguerov N, Zaidi H. PET/MR Imaging in Head and Neck Cancer. Magn Reson Imaging Clin N Am 2023; 31:539-564. [PMID: 37741640 DOI: 10.1016/j.mric.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) can either be examined with hybrid PET/MR imaging systems or sequentially, using PET/CT and MR imaging. Regardless of the acquisition technique, the superiority of MR imaging compared to CT lies in its potential to interrogate tumor and surrounding tissues with different sequences, including perfusion and diffusion. For this reason, PET/MR imaging is preferable for the detection and assessment of locoregional residual/recurrent HNSCC after therapy. In addition, MR imaging interpretation is facilitated when combined with PET. Nevertheless, distant metastases and distant second primary tumors are detected equally well with PET/MR imaging and PET/CT.
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Affiliation(s)
- Minerva Becker
- Diagnostic Department, Division of Radiology, Unit of Head and Neck and Maxillofacial Radiology, Geneva University Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland.
| | - Claudio de Vito
- Diagnostic Department, Division of Clinical Pathology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland
| | - Nicolas Dulguerov
- Department of Clinical Neurosciences, Clinic of Otorhinolaryngology, Head and Neck Surgery, Unit of Cervicofacial Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland
| | - Habib Zaidi
- Diagnostic Department, Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland; Geneva University Neurocenter, University of Geneva, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
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3
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Ramamoorthy E, Garg M, Singh P, Aggarwal AN, Gupta N. Role of Diffusion-Weighted Magnetic Resonance Imaging for Characterization of Mediastinal Lymphadenopathy. Diagnostics (Basel) 2023; 13:diagnostics13040706. [PMID: 36832194 PMCID: PMC9955495 DOI: 10.3390/diagnostics13040706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/21/2022] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND To assess the diagnostic performance of diffusion-weighted (DW) magnetic resonance imaging (MRI) in the characterization of mediastinal lymph nodes and compare them with morphological parameters. METHODS A total of 43 untreated patients with mediastinal lymphadenopathy underwent DW and T2 weighted MRI followed by pathological examination in the period from January 2015 to June 2016. The presence of diffusion restriction, apparent diffusion coefficient (ADC) value, short axis dimensions (SAD), and T2 heterogeneous signal intensity of the lymph nodes were evaluated using receiver operating characteristic curve (ROC) and forward step-wise multivariate logistic regression analysis. RESULTS The ADC of malignant lymphadenopathy was significantly lower (0.873 ± 0.109 × 10-3 mm2/s) than that of benign lymphadenopathy (1.663 ± 0.311 × 10-3 mm2/s) (p = 0.001). When an ADC of 1.0955 × 10-3 mm2/s was used as a threshold value for differentiating malignant from benign nodes, the best results were obtained with a sensitivity of 94%, a specificity of 96%, and an area under the curve (AUC) of 0.996. A model combining the other three MRI criteria showed less sensitivity (88.9%) and specificity (92%) compared to the ADC-only model. CONCLUSION The ADC was the strongest independent predictor of malignancy. The addition of other parameters failed to show any increase in sensitivity and specificity.
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Affiliation(s)
- Eniyavel Ramamoorthy
- Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Mandeep Garg
- Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
- Correspondence:
| | - Paramjeet Singh
- Department of Radio Diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ashutosh N. Aggarwal
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Nalini Gupta
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Sakamoto M, Kojima I, Iikubo M, Ito K, Aoki T, Mori S, Ogawa T, Katori Y, Murata T, Ito D, Kodama T. Perfusion defects in non-enlarged metastatic lymph nodes using vessel wall magnetic resonance imaging: Detection performance and diagnostic value. Clin Exp Metastasis 2022; 39:421-431. [PMID: 35119560 DOI: 10.1007/s10585-022-10147-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Abstract
A perfusion defect (PD) in non-enlarged lymph nodes (LNs) of oral squamous cell carcinoma (OSCC) is the most reliable radiological criterion for the diagnosis of metastasis. However, conventional contrast-enhanced (CE) T1 weighted images using turbo spin echo (TSE) sequence is limited in detecting PD in non-enlarged LNs due to flow artifacts from cervical blood vessels. Vessel wall (VW) MR imaging with blood vessel flow suppression and high spatial resolution may provide new insights into the detection of PD. However, there are no reports in the literature on the usefulness of VW MR imaging for the diagnosis of LN metastasis. It is demonstrated that PD of non-enlarged LNs in CE VR MR imaging of OSCC patients is useful for the diagnosis of metastatic LNs. VW MR imaging was significantly more sensitive in detecting PD of non-enlarged metastatic LNs than conventional TSE imaging on visual evaluation. Furthermore, it was found that the image contrast between PD and surrounding intranodal tissue in CE VW MR images was higher than that in conventional CE TSE images. In the correlation between imaging and histopathological findings of metastatic LNs, all LNs that exhibited PD on CE VW MR images were at an advanced histopathological metastatic stage. The pathology of PD was necrotic tissue with keratinization. The results indicated that PD in CE VW imaging is useful in diagnosing non-enlarged LNs at an advanced metastasis stage. The addition of VW MR imaging to conventional MR examination achieves higher diagnostic performance for non-enlarged metastatic LNs.
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Affiliation(s)
- Maya Sakamoto
- Laboratory of Biomedical Engineering for Cancer, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan. .,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan. .,Department of Dental Informatics and Radiology, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.
| | - Ikuho Kojima
- Department of Dental Informatics and Radiology, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Head and Neck Cancer Center, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Masahiro Iikubo
- Department of Dental Informatics and Radiology, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Head and Neck Cancer Center, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Koichi Ito
- Department of Computer and Mathematical Sciences, Graduate School of Information Sciences, Tohoku University, Aramaki Aza, Aoba, Sendai, Miyagi, 980-8579, Japan
| | - Takafumi Aoki
- Department of Computer and Mathematical Sciences, Graduate School of Information Sciences, Tohoku University, Aramaki Aza, Aoba, Sendai, Miyagi, 980-8579, Japan
| | - Shiro Mori
- Laboratory of Biomedical Engineering for Cancer, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Department of Oral and Maxillofacial Surgery, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Takenori Ogawa
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yukio Katori
- Head and Neck Cancer Center, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan.,Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan
| | - Takaki Murata
- Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Daisuke Ito
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Tetsuya Kodama
- Laboratory of Biomedical Engineering for Cancer, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan
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5
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Papoutsaki MV, Sidhu HS, Dikaios N, Singh S, Atkinson D, Kanber B, Beale T, Morley S, Forster M, Carnell D, Mendes R, Punwani S. Utility of diffusion MRI characteristics of cervical lymph nodes as disease classifier between patients with head and neck squamous cell carcinoma and healthy volunteers. NMR IN BIOMEDICINE 2021; 34:e4587. [PMID: 34240782 DOI: 10.1002/nbm.4587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
Diffusion MRI characteristics assessed by apparent diffusion coefficient (ADC) histogram analysis in head and neck squamous cell carcinoma (HNSCC) have been reported as helpful in classifying tumours based on diffusion characteristics. There is little reported on HNSCC lymph nodes classification by diffusion characteristics. The aim of this study was to determine whether pretreatment nodal microstructural diffusion MRI characteristics can classify diseased nodes of patients with HNSCC from normal nodes of healthy volunteers. Seventy-nine patients with histologically confirmed HNSCC prior to chemoradiotherapy, and eight healthy volunteers, underwent diffusion-weighted (DW) MRI at a 1.5-T MR scanner. Two radiologists contoured lymph nodes on DW (b = 300 s/m2 ) images. ADC, distributed diffusion coefficient (DDC) and alpha (α) values were calculated by monoexponential and stretched exponential models. Histogram analysis metrics of drawn volume were compared between patients and volunteers using a Mann-Whitney test. The classification performance of each metric between the normal and diseased nodes was determined by receiver operating characteristic (ROC) analysis. Intraclass correlation coefficients determined interobserver reproducibility of each metric based on differently drawn ROIs by two radiologists. Sixty cancerous and 40 normal nodes were analysed. ADC histogram analysis revealed significant differences between patients and volunteers (p ≤0.0001 to 0.0046), presenting ADC distributions that were more skewed (1.49 for patients, 1.03 for volunteers; p = 0.0114) and 'peaked' (6.82 for patients, 4.20 for volunteers; p = 0.0021) in patients. Maximum ADC values exhibited the highest area under the curve ([AUC] 0.892). Significant differences were revealed between patients and volunteers for DDC and α value histogram metrics (p ≤0.0001 to 0.0044); the highest AUC were exhibited by maximum DDC (0.772) and the 25th percentile α value (0.761). Interobserver repeatability was excellent for mean ADC (ICC = 0.88) and the 25th percentile α value (ICC = 0.78), but poor for all other metrics. These results suggest that pretreatment microstructural diffusion MRI characteristics in lymph nodes, assessed by ADC and α value histogram analysis, can identify nodal disease.
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Affiliation(s)
| | | | - Nikolaos Dikaios
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford, UK
| | - Saurabh Singh
- Centre for Medical Imaging, University College London, London, UK
| | - David Atkinson
- Centre for Medical Imaging, University College London, London, UK
| | - Baris Kanber
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Timothy Beale
- Department of Radiology, University College London Hospital, London, UK
| | - Simon Morley
- Department of Radiology, University College London Hospital, London, UK
| | - Martin Forster
- Department of Oncology, University College London, Cancer Institute, London, UK
- Department of Oncology, University College London Hospital, London, UK
| | - Dawn Carnell
- Department of Oncology, University College London Hospital, London, UK
| | - Ruheena Mendes
- Department of Oncology, University College London Hospital, London, UK
| | - Shonit Punwani
- Centre for Medical Imaging, University College London, London, UK
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6
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De Cataldo C, Bruno F, Palumbo P, Di Sibio A, Arrigoni F, Clemente A, Bafile A, Gravina GL, Cappabianca S, Barile A, Splendiani A, Masciocchi C, Di Cesare E. Apparent diffusion coefficient magnetic resonance imaging (ADC-MRI) in the axillary breast cancer lymph node metastasis detection: a narrative review. Gland Surg 2021; 9:2225-2234. [PMID: 33447575 DOI: 10.21037/gs-20-546] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The presence of axillary lymph nodes metastases in breast cancer is the most significant prognostic factor, with a great impact on morbidity, disease-related survival and management of oncological therapies; for this reason, adequate imaging evaluation is strictly necessary. Physical examination is not enough sensitive to assess breast cancer nodal status; axillary ultrasonography (US) is commonly used to detect suspected or occult nodal metastasis, providing exclusively morphological evaluation, with low sensitivity and positive predictive value. Currently, sentinel lymph node biopsy (SLNB) and/or axillary dissection are the milestone for the diagnostic assessment of axillary lymph node metastases, although its related morbidity. The impact of magnetic resonance imaging (MRI) in the detection of nodal metastases has been widely investigated, as it continues to represent the most promising imaging modality in the breast cancer management. In particular, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values represent additional reliable non-contrast sequences, able to improve the diagnostic accuracy of breast cancer MRI evaluation. Several studies largely demonstrated the usefulness of implementing DWI/ADC MRI in the characterization of breast lesions. Herein, in the light of our clinical experience, we perform a review of the literature regarding the diagnostic performance and accuracy of ADC value as potential pre-operative tool to define metastatic involvement of nodal structures in breast cancer patients. For the purpose of this review, PubMed, Web of Science, and SCOPUS electronic databases were searched with different combinations of "axillary lymph node", "breast cancer", "MRI/ADC", "breast MRI" keywords. All original articles, reviews and metanalyses were included.
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Affiliation(s)
- Camilla De Cataldo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alfredo Clemente
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Giovanni Luca Gravina
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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7
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Zhou Y, Yu T, Rui X, Jin T, Huang Z, Huang Z. Effectiveness of diffusion-weighted imaging in predicting cervical lymph node metastasis in head and neck malignancies. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:122-129.e2. [DOI: 10.1016/j.oooo.2020.06.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/11/2020] [Accepted: 06/28/2020] [Indexed: 01/18/2023]
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8
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Paterson C, Hargreaves S, Rumley CN. Functional Imaging to Predict Treatment Response in Head and Neck Cancer: How Close are We to Biologically Adaptive Radiotherapy? Clin Oncol (R Coll Radiol) 2020; 32:861-873. [PMID: 33127234 DOI: 10.1016/j.clon.2020.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023]
Abstract
It is increasingly recognised that head and neck cancer represents a spectrum of disease with a differential response to standard treatments. Although prognostic factors are well established, they do not reliably predict response. The ability to predict response early during radiotherapy would allow adaptation of treatment: intensifying treatment for those not responding adequately or de-intensifying remaining therapy for those likely to achieve a complete response. Functional imaging offers such an opportunity. Changes in parameters obtained with functional magnetic resonance imaging or positron emission tomography-computed tomography during treatment have been found to be predictive of disease control in head and neck cancer. Although many questions remain unanswered regarding the optimal implementation of these techniques, current, maturing and future studies may provide the much-needed homogeneous cohorts with larger sample sizes and external validation of parameters. With a stepwise and collaborative approach, we may be able to develop imaging biomarkers that allow us to deliver personalised, biologically adaptive radiotherapy for head and neck cancer.
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Affiliation(s)
- C Paterson
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
| | | | - C N Rumley
- Department of Radiation Oncology, Townsville University Hospital, Douglas, Australia; South Western Clinical School, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
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9
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Freihat O, Pinter T, Kedves A, Sipos D, Cselik Z, Repa I, Kovács Á. Diffusion-Weighted Imaging (DWI) derived from PET/MRI for lymph node assessment in patients with Head and Neck Squamous Cell Carcinoma (HNSCC). Cancer Imaging 2020; 20:56. [PMID: 32771060 PMCID: PMC7414722 DOI: 10.1186/s40644-020-00334-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To determine the usefulness of Diffusion Weighted Imaging (DWI) derived from PET/MRI in discriminating normal from metastatic lymph nodes and the correlation between the metastatic lymph nodes with the grade and the localization of the primary tumor. METHODS Retrospective study of 90 lymph nodes from 90 subjects; 65 patients who had proven histopathological metastatic lymph nodes from (HNSCC) who had undergone 18F- PET/MRI for clinical staging and assessment and twenty-five lymph nodes were chosen from 25 healthy subjects. Apparent Diffusion Coefficient (ADC) map was generated from DWI with b values (0 and 800 s/mm2). ADC values of the metastatic lymph nodes were calculated and compared to the normal lymph nodes ADC values, ROC was used to determine the best cut-off values to differentiate between the two group. Metastatic lymph nodes ADC mean values were compared to primary tumor grade and localization. RESULTS ADCmean value of the metastatic lymph nodes in the overall sample (0.899 ± 0.98*10- 3 mm2/sec) was significantly lower than the normal lymph nodes' ADCmean value (1.267 ± 0.88*10- 3 mm2/sec); (P = 0.001). The area under the curve (AUC) was 98.3%, sensitivity and specificity were 92.3 and 98.6%, respectively, when using a threshold value of (1.138 ± 0.75*10- 3 mm2/sec) to differentiate between both groups. Significant difference was found between metastatic lymph nodes (short-axis diameter < 10 mm), ADCmean (0.898 ± 0.72*10- 3 mm2/sec), and the benign lymph nodes ADCmean, (P = 0.001). No significant difference was found between ADCmean of the metastatic lymph nodes < 10 mm and the metastatic lymph nodes > 10 mm, ADCmean (0.899 ± 0.89*10- 3 mm2/sec), (P = 0.967). No significant differences were found between metastatic lymph nodes ADCmean values and different primary tumor grades or different primary tumor localization, (P > 0.05). CONCLUSION DWI-ADC is an effective and efficient imaging technique in differentiating between normal and malignant lymph nodes, and might be helpful to discriminate sub-centimeters lymph nodes. TRIAL REGISTRATION The trial is registered in clinical trials under ID: NCT04360993 , registration date: 17/04/2020.
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Affiliation(s)
- Omar Freihat
- Doctoral School of Health Sciences, University of Pécs, P.O. Box: 7621, Vorosmarty 4, Pecs, Hungary
| | - Tamas Pinter
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, Kaposvár, Hungary
- Medicopus Non-Profit Ltd., “Moritz Kaposi” Teaching Hospital, Kaposvár, Hungary
| | - András Kedves
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, Kaposvár, Hungary
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Dávid Sipos
- Doctoral School of Health Sciences, University of Pécs, P.O. Box: 7621, Vorosmarty 4, Pecs, Hungary
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, Kaposvár, Hungary
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Zsolt Cselik
- Doctoral School of Health Sciences, University of Pécs, P.O. Box: 7621, Vorosmarty 4, Pecs, Hungary
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, Kaposvár, Hungary
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- Oncoradiology, Csolnoky Ferenc County Hospital, Veszprém, Hungary
| | - Imre Repa
- Doctoral School of Health Sciences, University of Pécs, P.O. Box: 7621, Vorosmarty 4, Pecs, Hungary
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, Kaposvár, Hungary
- Medicopus Non-Profit Ltd., “Moritz Kaposi” Teaching Hospital, Kaposvár, Hungary
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Árpád Kovács
- Doctoral School of Health Sciences, University of Pécs, P.O. Box: 7621, Vorosmarty 4, Pecs, Hungary
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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10
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Intravoxel incoherent motion diffusion-weighted imaging for discrimination of benign and malignant retropharyngeal nodes. Neuroradiology 2020; 62:1667-1676. [PMID: 32676831 DOI: 10.1007/s00234-020-02494-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Anatomical imaging criteria for the diagnosis of malignant head and neck nodes may not always be reliable. This study aimed to evaluate the diagnostic value of conventional diffusion-weighted imaging (DWI) and intravoxel incoherent motion (IVIM) DWI in discriminating benign and malignant metastatic retropharyngeal nodes (RPNs). METHODS IVIM DWI using 14 b-values was performed on RPNs of 30 patients with newly diagnosed metastatic nasopharyngeal carcinoma (NPC) and 30 patients with elevated plasma Epstein-Barr virus (EBV)-DNA without NPC who were part of an EBV-based NPC screening program. Histogram measurements of the two groups were compared for pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion volume fraction (f) and apparent diffusion coefficient (ADC) using the Mann-Whitney U test. Area under the curves (AUCs) of significant measurements were calculated from receiver-operating characteristics analysis and compared using the DeLong test. RESULTS Compared with metastatic RPNs, benign RPNs had lower ADCmean (0.73 vs 0.82 × 10-3 mm2/s) and Dmean (0.60 vs 0.71 × 10-3 mm2/s) and a higher D*mean (35.21 vs 28.66 × 10-3 mm2/s) (all p < 0.05). There was no difference in the f measurements between the two groups (p = 0.204 to 0.301). Dmean achieved the highest AUC of 0.800, but this was not statistically better than the AUCs of the other parameters (p = 0.148 to 0.991). CONCLUSION Benign RPNs in patients with EBV-DNA showed greater restriction of diffusion compared with malignant metastatic RPNs from NPC. IVIM did not show a significant advantage over conventional DWI in discriminating benign and malignant nodes.
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11
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Shukla M, Forghani R, Agarwal M. Patient-Centric Head and Neck Cancer Radiation Therapy: Role of Advanced Imaging. Neuroimaging Clin N Am 2020; 30:341-357. [PMID: 32600635 DOI: 10.1016/j.nic.2020.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The traditional 'one-size-fits-all' approach to H&N cancer therapy is archaic. Advanced imaging can identify radioresistant areas by using biomarkers that detect tumor hypoxia, hypercellularity etc. Highly conformal radiotherapy can target resistant areas with precision. The critical information that can be gleaned about tumor biology from these advanced imaging modalities facilitates individualized radiotherapy. The tumor imaging world is pushing its boundaries. Molecular imaging can now detect protein expression and genotypic variations across tumors that can be exploited for tailoring treatment. The exploding field of radiomics and radiogenomics extracts quantitative, biologic and genetic information and further expands the scope of personalized therapy.
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Affiliation(s)
- Monica Shukla
- Department of Radiation Oncology, Froedtert and Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA
| | - Reza Forghani
- Augmented Intelligence & Precision Health Laboratory, Department of Radiology, Research Institute of McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada
| | - Mohit Agarwal
- Department of Radiology, Section of Neuroradiology, Froedtert and Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
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Norris CD, Quick SE, Parker JG, Koontz NA. Diffusion MR Imaging in the Head and Neck: Principles and Applications. Neuroimaging Clin N Am 2020; 30:261-282. [PMID: 32600630 DOI: 10.1016/j.nic.2020.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diffusion imaging is a functional MR imaging tool that creates tissue contrast representative of the random, microscopic translational motion of water molecules within human body tissues. Long considered a cornerstone MR imaging sequence for brain imaging, diffusion-weighted imaging (DWI) increasingly is used for head and neck imaging. This review reports the current state of diffusion techniques for head and neck imaging, including conventional DWI, DWI trace with apparent diffusion coefficient map, diffusion tensor imaging, intravoxel incoherent motion, and diffusion kurtosis imaging. This article describes background physics, reports supportive evidence and potential pitfalls, highlights technical advances, and details practical clinical applications.
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Affiliation(s)
- Carrie D Norris
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA. https://twitter.com/CarrieDNorrisMD
| | - Sandra E Quick
- Department of Radiology, Richard L. Roudebush VA Medical Center, 1481 West 10th Street, Indianapolis, IN 46202, USA
| | - Jason G Parker
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA
| | - Nicholas A Koontz
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA; Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
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Jović A, Fila J, Gršić K, Ivkić M, Ozretić D. Diffusion-weighted MRI: impact of the size of the ROI in detecting metastases in subcentimeter lymph nodes in head and neck squamous cell carcinoma. Neuroradiology 2020; 62:987-994. [PMID: 32418025 DOI: 10.1007/s00234-020-02449-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/28/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Our aim is to determine the impact of the size of ROI in detecting subcentimeter metastatic lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC). Secondary aim is to determine the impact of the histopathologic grade of the primary cancer on the ADC value of the metastatic nodes. METHODS The prospective study included 51 patients with histopathologically proven HNSCC at the primary site. Primary site includes oral cavity, oropharynx, larynx, and hypopharynx. ADC values of the lymph nodes were measured on ADC maps by placing two ROIs in the lymph nodes (0.2 cm2 in the center of the node and the whole node). Lymph nodes were dissected by levels, marked by the surgeon, and sent to the pathologist. RESULTS By applying a smaller ROI, ADC values have greater sensitivity, specificity, NPV, PPV, and AUC in detecting metastasis compared to the ADC value of the entire node (88.0%, 80.73%, 90.7%, 75.9%, 0.912% versus 80.0%, 77.98%, 85% ,71.4%, and 0.819%, respectively) p < 0.001. Statistically significant negative correlation was established between the tumor grade and the ADC of lymph node at ROI 0.2 cm2and ROI of the whole lymph node (rho = - 0.425; p = 0.002, and rho = - 0.298; p = 0.038, respectively). CONCLUSION ROI size affects the ADC value of the nodes. The higher histopathological grade of the primary tumor is inversely correlated with the ADC value of the lymph nodes.
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Affiliation(s)
- Andrijana Jović
- Department of Neuroradiology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia.
| | - Jana Fila
- Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Krešimir Gršić
- Department of Head and Neck Surgery and Otorhinolaryngology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Mirko Ivkić
- School of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000, Rijeka, Croatia
| | - David Ozretić
- Department of Neuroradiology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
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Texture Analysis of Multi-Shot Echo-planar Diffusion-Weighted Imaging in Head and Neck Squamous Cell Carcinoma: The Diagnostic Value for Nodal Metastasis. J Clin Med 2019; 8:jcm8111767. [PMID: 31652840 PMCID: PMC6912832 DOI: 10.3390/jcm8111767] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/13/2019] [Accepted: 10/22/2019] [Indexed: 12/28/2022] Open
Abstract
Accurate assessment of nodal metastasis in head and neck squamous cell carcinoma (SCC) is important, and diffusion-weighted imaging (DWI) has emerged as a potential technique in differentiating benign from malignant lymph nodes (LNs). This study aims to evaluate the diagnostic performance of texture analysis using apparent diffusion coefficient (ADC) data of multi-shot echo-planar imaging-based DWI (msEPI-DWI) in predicting metastatic LNs of head and neck SCC. 36 patients with pathologically proven head and neck SCC were included in this study. A total of 204 MRI-detected LNs, including 176 subcentimeter-sized LNs, were assigned to metastatic or benign groups. Texture features of LNs were compared using independent t-test. Hierarchical cluster analysis was performed to exclude redundant features. Multivariate logistic regression and receiver operating characteristic analysis were performed to assess the diagnostic performance. The discriminative texture features for predicting metastatic LNs were complexity, energy and roundness. Areas under the curves (AUCs) for diagnosing metastasis in all/subcentimeter-sized LNs were 0.829/0.767 using complexity, 0.699/0.685 using energy and 0.671/0.638 using roundness, respectively. The combination of three features resulted in higher AUC values of 0.836/0.781. In conclusion, texture analysis of ADC data using msEPI-DWI could be a useful tool for nodal staging in head and neck SCC.
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Differentiation of lymphomatous, metastatic, and non-malignant lymphadenopathy in the neck with quantitative diffusion-weighted imaging: systematic review and meta-analysis. Neuroradiology 2019; 61:897-910. [DOI: 10.1007/s00234-019-02236-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/13/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022]
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Alamolhoda F, Faeghi F, Bakhshandeh M, Ahmadi A, Sanei Taheri M, Aabbasi S. 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. Asian Pac J Cancer Prev 2019; 20:1789-1795. [PMID: 31244301 PMCID: PMC7021623 DOI: 10.31557/apjcp.2019.20.6.1789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Indexed: 11/25/2022] Open
Abstract
Objective: To evaluate the diagnostic value of DWI in assessment of metastatic neck lymph node in a sample of Iranian patients with Head and Neck cancer. Methods: 25 patients with 80 neck lymph nodes were analyzed using 1.5 T MRI. DWI was performed with b values of 0 and 1,000 s/mm2. Short axis diameter and ADC values (min, max and mean) were calculated for metastatic and non-metastatic neck LNs and results were compared with histopathological findings. The optimal ADC thresholds were analyzed using receiver coefficient characteristic (ROC) curves for discriminating between metastatic and benign neck lymph nodes. Result: Histopathological findings revealed that there are 45% (n=36) metastatic and 55% (n=44) non-metastatic neck LNs respectively. There was no statistically significant difference in short axis diameter between the two groups (p = 0.346). However, The ADC values of metastatic neck LNs were significantly lower than those of non-metastatic neck LNs (p < 0.001); 0.90 ± 0.10 × 10-3 mm2/s vs 1.06 ± 0.12 × 10-3 mm2/s ( ADC mean ), 0.78 ± 0.08 × 10-3 mm2/s vs 0.92 ± 0.20× 10-3 mm2/s ( ADC min ) and 1.02 ± 0.12 × 10-3 mm2/s vs 1.24 ± 0.15 × 10-3 mm2/s (ADC max ). The optimal mean ADC threshold value was equal to 0.996 × 10-3 mm2/s for differentiating malignant from benign lymph nodes with sensitivity, specificity and accuracy of 80.56 %, 77.27 % and 71.59 % respectively. Conclusion: MR diffusion imaging and ADC values as a non-invasive technique can assess metastatic neck LNs in head and neck cancer with higher sensitivity, specificity and accuracy.
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Affiliation(s)
- Fatemeh Alamolhoda
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fariborz Faeghi
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohsen Bakhshandeh
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Aslan Ahmadi
- Ear Nose Throat (ENT) and Head and Neck Surgery Research Center, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Sanei Taheri
- Department of Radiology, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Aabbasi
- Department of Radiology, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Diffusion-weighted imaging and loco-regional N staging of patients with colorectal liver metastases. Eur J Surg Oncol 2019; 45:347-352. [DOI: 10.1016/j.ejso.2018.11.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 11/19/2018] [Accepted: 11/23/2018] [Indexed: 12/27/2022] Open
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Suh CH, Choi YJ, Baek JH, Lee JH. The Diagnostic Value of Diffusion-Weighted Imaging in Differentiating Metastatic Lymph Nodes of Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol 2018; 39:1889-1895. [PMID: 30213809 DOI: 10.3174/ajnr.a5813] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/07/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Accurate lymph node staging is crucial for proper treatment planning for metastasis in patients with head and neck squamous cell carcinoma. PURPOSE Our aim was to evaluate the diagnostic performance of DWI for differentiating metastatic cervical lymph nodes from benign cervical lymph nodes in patients with head and neck squamous cell carcinoma and to identify optimal cutoff values for ADC. DATA SOURCES A computerized literature search was performed to identify relevant original articles in Ovid MEDLINE and EMBASE. STUDY SELECTION Studies evaluating the diagnostic performance of DWI for differentiating metastatic cervical lymph nodes from benign cervical lymph nodes were selected. DATA ANALYSIS Diagnostic meta-analysis was conducted with a bivariate random-effects model, and a hierarchical summary receiver operating characteristic curve was obtained. Meta-regression was also performed. DATA SYNTHESIS Nine studies with 337 patients were included. In all studies, ADC values derived from metastatic lymph nodes were significantly lower than ADC values derived from benign lymph nodes. The median ADC cutoff value was 0.965 × 10-3 mm2/s. The pooled sensitivity and specificity for the diagnostic performance of DWI in differentiating metastatic lymph nodes from benign lymph nodes were 90% (95% CI, 84%-94%) and 88% (95% CI, 80%-93%), respectively. In the meta-regression, sensitivity was significantly higher in the studies using a 3-mm slice thickness (93% [95% CI, 88%-98%]) than in studies using a slice thickness of >3 mm (86% [95% CI, 77%-95%], P < .01). LIMITATIONS A small number of studies were included in our meta-analysis. CONCLUSIONS DWI demonstrated high diagnostic performance for differentiating metastatic lymph nodes from benign lymph nodes in patients with head and neck squamous cell carcinoma, and the median ADC cutoff value was 0.965 × 10-3 mm2/s. A 3-mm DWI slice thickness can provide a slight improvement in sensitivity.
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Affiliation(s)
- C H Suh
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Y J Choi
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - J H Baek
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Lee
- From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Wolosker AMB. Contribution of dynamic contrast enhancement and diffusion-weighted magnetic resonance imaging to the diagnosis of malignant cervical lymph nodes. Radiol Bras 2018; 51:IX. [PMID: 29991850 PMCID: PMC6034722 DOI: 10.1590/0100-3984.2018.51.3e3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Angela M Borri Wolosker
- MD, PhD, Attending Physician in the Head and Neck Sector of the Department of Diagnostic Imaging at the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), Senior Physician for Grupo Fleury, São Paulo, SP, Brazil. E-mail:
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Kelly HR, Curtin HD. Chapter 2 Squamous Cell Carcinoma of the Head and Neck—Imaging Evaluation of Regional Lymph Nodes and Implications for Management. Semin Ultrasound CT MR 2017; 38:466-478. [DOI: 10.1053/j.sult.2017.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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21
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State of the art MRI in head and neck cancer. Clin Radiol 2017; 73:45-59. [PMID: 28655406 DOI: 10.1016/j.crad.2017.05.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/26/2017] [Indexed: 12/17/2022]
Abstract
Head and neck cancer affects more than 11,000 new patients per year in the UK1 and imaging has an important role in the diagnosis, treatment planning, and assessment, and post-treatment surveillance of these patients. The anatomical detail produced by magnetic resonance imaging (MRI) is ideally suited to staging and follow-up of primary tumours and cervical nodal metastases in the head and neck; however, anatomical images have limitations in cancer imaging and so increasingly functional-based MRI techniques, which provide molecular, metabolic, and physiological information, are being incorporated into MRI protocols. This article reviews the state of the art of these functional MRI techniques with emphasis on those that are most relevant to the current management of patients with head and neck cancer.
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Agnello F, Cupido F, Sparacia G, Midiri F, Miroddi M, Grassedonio E, Galia M. Computerised tomography and magnetic resonance imaging of laryngeal squamous cell carcinoma: A practical approach. Neuroradiol J 2017; 30:197-204. [PMID: 28627987 PMCID: PMC5480796 DOI: 10.1177/1971400916689373] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Squamous cell carcinoma is the most common head and neck cancer. This review describes the state-of-the-art computerised tomography and magnetic resonance imaging protocols of the neck and the normal larynx anatomy, and provides a practical approach for the diagnosis and staging of laryngeal squamous cell carcinoma.
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Affiliation(s)
| | - Francesco Cupido
- Department of Surgical and Oncological Sciences, University of Palermo, Italy
| | | | | | | | | | - Massimo Galia
- Department of Radiology, University of Palermo, Italy
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Differentiation of Benign and Malignant Head and Neck Lesions With Diffusion Tensor Imaging and DWI. AJR Am J Roentgenol 2017; 208:1110-1115. [DOI: 10.2214/ajr.16.16486] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Taha Ali TF, El Hariri MA. Combined diffusion-weighted MRI and MR spectroscopy: Feasibility to improve the MRI capability in differentiation between benign and malignant neck lymphadenopathy. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2016.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dickerson E, Srinivasan A. Advanced Imaging Techniques of the Skull Base. Radiol Clin North Am 2017; 55:189-200. [DOI: 10.1016/j.rcl.2016.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Pekçevik Y, Çukurova İ, Arslan İB. Apparent diffusion coefficient for discriminating metastatic lymph nodes in patients with squamous cell carcinoma of the head and neck. Diagn Interv Radiol 2016. [PMID: 26200481 DOI: 10.5152/dir.2015.14468] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate the apparent diffusion coefficient (ADC) values of metastatic lymph nodes in patients with squamous cell carcinoma (SCC) of the head and neck. METHODS Patients with metastatic lymph nodes underwent 1.5 Tesla diffusion-weighted magnetic resonance imaging (MRI). The ADC values of the histologically proven metastases were evaluated retrospectively and mean ADC values were compared using one-way analysis of variance test. Receiver operating characteristic analysis was performed to identify ADC threshold values. RESULTS We included 33 patients (27 males, 6 females; mean age, 60.7 years) with 53 metastatic lymph nodes in the study. Mean ADC values for nodal metastases of nasopharyngeal carcinoma (NPC) (n=7), oropharyngeal (n=12), laryngeal (n=27), and hypopharyngeal (n=7) carcinoma were (0.810±0.158)×10-3 mm2/s, (0.985±0.099)×10-3 mm2/s, (1.037±0.150)×10-3 mm2/s, and (0.948±0.081)×10-3 mm2/s, respectively. The mean ADC values of nodal metastases of NPC were significantly lower than ADC values of laryngeal carcinoma (LSCC) (P = 0.002). An ADC value less than 0.890×10-3 mm2/s was found to facilitate differentiation of NPC from LSCC with a sensitivity of 71% and specificity of 85% (area under the curve, 0.852). CONCLUSION The mean ADC values showed significant differences between nodal metastases of NPC and LSCC. Considering SCCs as a single group may affect the accuracy of ADC-based differentiation. Location of the primary tumor should be taken into account and cutoff values should be determined separately for each anatomical location.
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Affiliation(s)
- Yeliz Pekçevik
- Department of Radiology, Tepecik Training and Research Hospital, İzmir, Turkey.
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Sohn B, Koh YW, Kang WJ, Lee JH, Shin NY, Kim J. Is there an additive value of 18 F-FDG PET-CT to CT/MRI for detecting nodal metastasis in oropharyngeal squamous cell carcinoma patients with palpably negative neck? Acta Radiol 2016; 57:1352-1359. [PMID: 26013025 DOI: 10.1177/0284185115587544] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Cervical node metastasis is one of the most significant prognostic factors in patients with oropharyngeal squamous cell carcinoma (SCC). There is little information regarding the comparison of histopathologic analysis following neck dissection with imaging results in oropharyngeal SCC. Purpose To investigate the clinical utility of PET-CT compared with computed tomography (CT) or magnetic resonance imaging (MRI) for detecting nodal metastasis in oropharyngeal SCC patients with palpably negative neck and to investigate whether pretreatment imaging modalities support the rationale for elective neck treatment. Material and Methods A total of 49 oropharyngeal SCC patients with palpably negative neck (42 men, 7 women; average age, 59.1 years) underwent primary tumor resection and neck dissection as a primary treatment. All patients were preoperatively evaluated with PET-CT and CT/MRI, and the diagnostic accuracy of each imaging modality was assessed by comparison with histopathologic results of the surgical specimen. Results Twenty-five (51.0%) of our 49 patients had neck metastases. On a level-by-level analysis, the sensitivity of PET-CT, CT/MRI, and a combination of PET-CT and CT/MRI was 54.6%, 54.6%, and 60.6%, respectively, at all neck levels. The area under the ROC showed that the diagnostic performance of the combined interpretation was not significantly different from that of CT/MRI alone (0.780 vs. 0.750, respectively; P = 0.158) and PET-CT alone (0.780 vs. 0.765, respectively; P = 0.501). Conclusion Addition of PET-CT to CT/MRI did not provide better diagnostic accuracy for detecting nodal metastasis in preoperative evaluation of oropharyngeal SCC patients with palpably negative neck, suggesting that current imaging studies might not replace elective neck dissection.
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Affiliation(s)
- Beomseok Sohn
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won Jun Kang
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Hoon Lee
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Na-Young Shin
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinna Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yuan J, Lo G, King AD. Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers. Quant Imaging Med Surg 2016; 6:430-448. [PMID: 27709079 DOI: 10.21037/qims.2016.06.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Radiation therapy (RT), in particular intensity-modulated radiation therapy (IMRT), is becoming a more important nonsurgical treatment strategy in head and neck cancer (HNC). The further development of IMRT imposes more critical requirements on clinical imaging, and these requirements cannot be fully fulfilled by the existing radiotherapeutic imaging workhorse of X-ray based imaging methods. Magnetic resonance imaging (MRI) has increasingly gained more interests from radiation oncology community and holds great potential for RT applications, mainly due to its non-ionizing radiation nature and superior soft tissue image contrast. Beyond anatomical imaging, MRI provides a variety of functional imaging techniques to investigate the functionality and metabolism of living tissue. The major purpose of this paper is to give a concise and timely review of some advanced functional MRI techniques that may potentially benefit conformal, tailored and adaptive RT in the HNC. The basic principle of each functional MRI technique is briefly introduced and their use in RT of HNC is described. Limitation and future development of these functional MRI techniques for HNC radiotherapeutic applications are discussed. More rigorous studies are warranted to translate the hypotheses into credible evidences in order to establish the role of functional MRI in the clinical practice of head and neck radiation oncology.
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Affiliation(s)
- Jing Yuan
- Department of Medical Physics and Research, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Gladys Lo
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Ann D King
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Wendl CM, Müller S, Eiglsperger J, Fellner C, Jung EM, Meier JK. Diffusion-weighted imaging in oral squamous cell carcinoma using 3 Tesla MRI: is there a chance for preoperative discrimination between benign and malignant lymph nodes in daily clinical routine? Acta Radiol 2016; 57:939-46. [PMID: 26454065 DOI: 10.1177/0284185115609365] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 09/01/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Preoperative staging of cervical lymph nodes is important to determine the extent of neck dissection in patients with oral squamous cell carcinoma (OSCC). PURPOSE To evaluate whether a preoperative discrimination of benign and malignant cervical lymph nodes with diffusion-weighted imaging (DWI) (3T) is feasible for clinical application. MATERIAL AND METHODS Forty-five patients with histological proven OSCC underwent preoperative 3T-MRI. DWI (b = 0, 500, and 1000 s/mm(2)) was added to the standard magnetic resonance imaging (MRI) protocol. Mean apparent diffusion coefficients (ADCmean) were measured for lymph nodes with 3 mm or more in short axis by two independent readers. Finally, these results were matched with histology. RESULTS Mean ADC was significantly higher for malignant than for benign nodes (1.143 ± 0.188 * 10(-3) mm(2)/s vs. 0.987 ± 0.215 * 10(-3) mm(2)/s). Using an ADC value of 0.994 * 10(-3) mm(2)/s as threshold results in a sensitivity of 80%, specificity of 65%, positive predictive value of 31%, and negative predictive value of 93%. CONCLUSION Due to a limited sensitivity and specificity DWI alone is not suitable to reliably discriminate benign from malignant cervical lymph nodes in daily clinical routine. Hence, the preoperative determination of the extent of neck dissection on the basis of ADC measurements is not meaningful.
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Affiliation(s)
- Christina M Wendl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Steffen Müller
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | | | - Claudia Fellner
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Ernst M Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Johannes K Meier
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
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The Role of Intravoxel Incoherent Motion MRI in Predicting Early Treatment Response to Chemoradiation for Metastatic Lymph Nodes in Nasopharyngeal Carcinoma. Adv Ther 2016; 33:1158-68. [PMID: 27294489 DOI: 10.1007/s12325-016-0352-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Pilot studies have suggested potential clinical applications for intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in head and neck cancers. This study aimed to characterize metastatic lymph nodes using IVIM MRI, and to evaluate the role of IVIM MRI in the prediction of the early treatment response of lymph node metastasis from nasopharyngeal carcinoma (NPC). METHODS A total of 122 patients with metastatic lymph nodes from NPC underwent two MRI examinations, pre-treatment and post-treatment (at 4 weeks and at ≥2 years from the end of chemoradiotherapy). Treatment response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1. Differences in the initial IVIM parameters [pure molecular diffusion (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f)] between nodes with a partial response (PR) and a complete response (CR) were analyzed in 102 patients after the exclusion of 20. RESULTS The initial D*, D, and apparent diffusion coefficient (ADC) did not reveal a significant difference between nodes showing a PR or a CR. The mean initial f value was significantly higher in patients with a PR relative to patients with a CR (p = 0.003), and its sensitivity and specificity in predicting treatment response to chemoradiotherapy were 86.7% and 100%, respectively. CONCLUSIONS The present study indicated that the initial f value may be more accurate than the initial D*, D, and ADC in the early prediction of treatment response to chemoradiotherapy for metastatic lymph nodes in patients with NPC.
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The Current Status of PSMA PET-CT for Evaluating Biochemical PSA Relapse in Prostate Cancer. CURRENT RADIOLOGY REPORTS 2016. [DOI: 10.1007/s40134-016-0162-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lee MC, Chuang KS, Chen MK, Liu CK, Lee KW, Tsai HY, Lin HH. Fuzzy C-means clustering of magnetic resonance imaging on apparent diffusion coefficient maps for predicting nodal metastasis in head and neck cancer. Br J Radiol 2016; 89:20150059. [PMID: 27168028 DOI: 10.1259/bjr.20150059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The present study evaluated and analyzed apparent diffusion coefficients (ADCs) from partitions through a fuzzy C-means (FCM) technique for distinguishing nodal metastasis in head and neck cancer. METHODS MRI studies of 169 lymph node lesions, dissected from 22 patients with a histopathologically confirmed lymph node status, were analyzed using in-house software developed using MATLAB(®) (The MathWorks(®) Inc., Natick, MA). A radiologist manually contoured the lesions, and ADCs for each lesion were divided into two (low and high) and three (low, intermediate and high) partitions by using the FCM clustering algorithm. RESULTS The results showed that the low-value ADC clusters were more sensitive (95.7%) in distinguishing malignant from benign lesions than the whole-lesion mean ADC values (78.3%), while retaining a high specificity (approximately 90%). Moreover, receiver-operating characteristic curves demonstrated that the low-value ADC clusters used as a predictor of malignancy for lymph nodes could achieve a higher area under the curve (0.949 and 0.944 for two and three partitions, respectively). CONCLUSION The segmentation by ADC values of lesions through the FCM technique enables the efficient characterization of the lymph node pathology and can help distinguish malignant from benign lymph nodes. ADVANCES IN KNOWLEDGE Tumour heterogeneity may degrade the prediction of metastatic lymph nodes that involves using mean region-of-interest ADC values. The clustering of ADC values in lesions by using FCM can improve the diagnostic accuracy of nodal metastasis and reduce interreader variance.
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Affiliation(s)
- Ming-Che Lee
- 1 Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.,2 Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan.,3 Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Keh-Shih Chuang
- 1 Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Mu-Kuan Chen
- 4 Superintendent's Office, Changhua Christian Hospital, Changhua, Taiwan
| | - Chi-Kuang Liu
- 2 Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan
| | - Kwo-Whei Lee
- 2 Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan
| | - Hui-Yu Tsai
- 5 Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,6 Medical Physics Research Center, Institute for Radiological Research, Chang Gung University/Chang Gung Memorial Hospital, Taoyuan, Taiwan.,7 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Hon Lin
- 1 Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.,6 Medical Physics Research Center, Institute for Radiological Research, Chang Gung University/Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Souren C, Kloss-Brandstätter A, Stadler A, Kross K, Yamauchi K, Ketelsen D, Kessler P, Lethaus B. Ultrasound-guided fine-needle aspiration cytology as a diagnostic tool in comparison to ultrasound and MRI for staging in oral- and oropharyngeal squamous cell tumors. J Craniomaxillofac Surg 2016; 44:197-201. [DOI: 10.1016/j.jcms.2015.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/08/2015] [Accepted: 11/06/2015] [Indexed: 10/22/2022] Open
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Yuan Y, Tang W, Jiang M, Tao X. Palatal lesions: discriminative value of conventional MRI and diffusion weighted imaging. Br J Radiol 2016; 89:20150911. [PMID: 26764280 DOI: 10.1259/bjr.20150911] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To evaluate and compare the ability of conventional MRI, diffusion-weighted imaging (DWI) and a combination of both MRI techniques to differentiate malignant and benign palatal lesions. METHODS A retrospective review of MRI findings was performed in patients with pathologically confirmed palatal lesions between January 2012 and December 2014. Each lesion was evaluated with conventional MRI characteristics, including enhancement, inner texture, margin, adjacent soft-tissue involvement and cervical lymph node, and/or apparent diffusion coefficient (ADC) value. Statistical analyses were performed to assess the differential performance of each parameter separately and together. RESULTS A total of 42 patients (24 males, 18 females; age: 54.9 ± 16.4 years) were investigated. The optimal cut-off ADC value to distinguish malignant from benign lesions was 1.02 × 10(-3) mm(2) s(-1), with a sensitivity of 87.5% and a specificity of 75.0%. Conventional MRI showed a sensitivity of 87.1% and a specificity of 63.6%. Combination of conventional MRI and ADC scores increased sensitivity to 100% and specificity to 75.0%. The AUCs did not differ significantly between conventional MRI alone, DWI alone and integration of both. CONCLUSION Additional DWI does not substantially improve differential ability of conventional MRI. However, combining ADC values with conventional MRI improves both sensitivity and specificity, which is of worth to be further validated in prospective studies with larger sample sizes. ADVANCES IN KNOWLEDGE Combination of conventional MRI and ADC scores could increase the ability to differentiate malignant from benign palatal lesions, with a sensitivity of 100% and specificity of 75.0%, although without statistical significance.
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Affiliation(s)
- Ying Yuan
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Weiqing Tang
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Mengda Jiang
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
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Schilling C, Stoeckli SJ, Haerle SK, Broglie MA, Huber GF, Sorensen JA, Bakholdt V, Krogdahl A, von Buchwald C, Bilde A, Sebbesen LR, Odell E, Gurney B, O'Doherty M, de Bree R, Bloemena E, Flach GB, Villarreal PM, Fresno Forcelledo MF, Junquera Gutiérrez LM, Amézaga JA, Barbier L, Santamaría-Zuazua J, Moreira A, Jacome M, Vigili MG, Rahimi S, Tartaglione G, Lawson G, Nollevaux MC, Grandi C, Donner D, Bragantini E, Dequanter D, Lothaire P, Poli T, Silini EM, Sesenna E, Dolivet G, Mastronicola R, Leroux A, Sassoon I, Sloan P, McGurk M. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer 2015; 51:2777-84. [PMID: 26597442 DOI: 10.1016/j.ejca.2015.08.023] [Citation(s) in RCA: 220] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/22/2015] [Accepted: 08/23/2015] [Indexed: 01/18/2023]
Abstract
PURPOSE Optimum management of the N0 neck is unresolved in oral cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis. The object of this study was to establish whether the technique was both reliable in staging the N0 neck and a safe oncological procedure in patients with early-stage oral squamous cell carcinoma. METHODS An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB was undertaken with an average of 3.2 nodes removed per patient. Patients were excluded if the sentinel node (SN) could not be identified. A positive SN led to a neck dissection within 3 weeks. Analysis was performed at 3-year follow-up. RESULTS An SN was found in 99.5% of cases. Positive SNs were found in 23% (94 in 415). A false-negative result occurred in 14% (15 in 109) of patients, of whom eight were subsequently rescued by salvage therapy. Recurrence after a positive SNB and subsequent neck dissection occurred in 22 patients, of which 16 (73%) were in the neck and just six patients were rescued. Only minor complications (3%) were reported following SNB. Disease-specific survival was 94%. The sensitivity of SNB was 86% and the negative predictive value 95%. CONCLUSION These data show that SNB is a reliable and safe oncological technique for staging the clinically N0 neck in patients with T1 and T2 oral cancer. EORTC Protocol 24021: Sentinel Node Biopsy in the Management of Oral and Oropharyngeal Squamous Cell Carcinoma.
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Affiliation(s)
- Clare Schilling
- Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK
| | - Sandro J Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St Gallen, Switzerland
| | - Stephan K Haerle
- Department of Head and Neck Surgery, University of Basel, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St Gallen, Switzerland
| | - Gerhard F Huber
- Department of Otolaryngology University Hospital Zurich, Switzerland
| | - Jens Ahm Sorensen
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark
| | - Vivi Bakholdt
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark
| | | | - Christian von Buchwald
- Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Anders Bilde
- Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Lars R Sebbesen
- Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Edward Odell
- Head and Neck/Oral Pathology, King's College London, Guys and St Thomas NHS Trust, London, UK
| | - Benjamin Gurney
- Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK
| | - Michael O'Doherty
- Department of Nuclear Medicine, Guys and St Thomas NHS Trust, London, UK
| | - Remco de Bree
- Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisabeth Bloemena
- Department of Pathology, VU University Medical Centre and Academic Centre of Dentistry Amsterdam, The Netherlands
| | - Geke B Flach
- Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Pedro M Villarreal
- Department of Maxillofacial Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Julio Alvarez Amézaga
- Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain
| | - Luis Barbier
- Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain
| | - Joseba Santamaría-Zuazua
- Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain
| | - Augusto Moreira
- Department of Head and Neck Surgery, Instituto Portugues de Oncologia do Porto, Portugal
| | - Manuel Jacome
- Department of Head and Neck Surgery, Instituto Portugues de Oncologia do Porto, Portugal
| | | | - Siavash Rahimi
- Department of Histopathology, San Carlo Hospital Rome, Italy
| | | | - Georges Lawson
- Department of Head and Neck Surgery, CHU Dinant Godinne, Université Catholique de Louvain, Belgium
| | - Marie-Cecile Nollevaux
- Department of Head and Neck Surgery, CHU Dinant Godinne, Université Catholique de Louvain, Belgium
| | - Cesare Grandi
- Department of Otolaryngology, Ospedale S. Chiara, Trento, Italy
| | - Davide Donner
- Department of Nuclear Medicine, Ospedale S. Chiara, Trento, Italy
| | - Emma Bragantini
- Department of Surgical Pathology, Ospedale S. Chiara, Trento, Italy
| | - Didier Dequanter
- Department of Maxillofacial Surgery CHU de Charleroi Belgium, Belgium
| | - Philippe Lothaire
- Department of Maxillofacial Surgery CHU de Charleroi Belgium, Belgium
| | - Tito Poli
- Department of Maxillofacial Surgery, Azienda Ospedaliera, Universitaria of Parma, Italy
| | - Enrico M Silini
- Department of Pathology Azienda Ospedaliera Universitaria of Parma, Italy
| | - Erinco Sesenna
- Department of Maxillofacial Surgery, Azienda Ospedaliera, Universitaria of Parma, Italy
| | - Giles Dolivet
- Department of Head and Neck Surgery Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | - Romina Mastronicola
- Department of Head and Neck Surgery Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | - Agnes Leroux
- Department of Pathology Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | | | - Philip Sloan
- Department of Cellular Pathology, Newcastle University Hospital, UK
| | - Mark McGurk
- Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK.
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The indication area of a diagnostic test. Part I—discounting gain and loss in diagnostic certainty. J Clin Epidemiol 2015; 68:1120-8. [DOI: 10.1016/j.jclinepi.2015.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 05/02/2015] [Accepted: 05/11/2015] [Indexed: 11/20/2022]
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Taha MS, El Fiky LM, Taha TM, Sabra RM, Youssef TA, Nada IM. Utility of apparent diffusion coefficient in characterization of different sinonasal pathologies. Am J Rhinol Allergy 2015; 28:181-6. [PMID: 25198015 DOI: 10.2500/ajra.2014.28.4098] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sinonasal lesions are a heterogeneous group of lesions that span from a tumor to tumor-like nature. Characterization of such cases preoperatively can improve the surgical control and the overall outcome of these patients. OBJECTIVE In this prospective study, we aimed at evaluation of the role of apparent diffusion coefficient (ADC) in the differentiation between benign and malignant sinonasal lesions. SUBJECTS AND METHODS All patients scheduled to have sinonasal surgical intervention at Ain Shams University Hospitals, Cairo, Egypt, were enrolled. Diffusion-weighted (DW) magnetic resonance imaging (MRI) with calculation of ADC were done for all cases. Radiologic findings were then compared with histologic findings, and the sensitivity, specificity, negative and positive predictive values (PPVs) of the conventional MRI, DW-MRI, and ADC value in differentiation of benign from malignant sinonasal lesions were then calculated. RESULTS There were 59 patients with median age of 43 years old. There were 20 cases of inflammatory lesions, 16 cases of benign tumors, and 23 cases of malignant lesions. The ADC values of all cases ranged from 0.4 × 10(-3) to 2 × 10(-3) (median = 1.5 × 10(-3)). The median ADC value for the malignant lesions was 0.6 × 10(-3), whereas that for the inflammatory conditions was 1.6 × 10(-3) and that for the benign tumors was 1.5 × 10(-3) with a highly significant difference (p < .001). Analysis of the conventional MRI and DW-MRI to differentiate between malignant and benign lesions showed that the sensitivity, specificity, PPV, and negative predictive value (NPV) were 100%, 97%, 96%, and 100% and 91%, 97%, 95%, and 95%, respectively. CONCLUSION DW-MRI did not add significantly to the information gained from conventional MRI. It should be considered complimentary only to standard MRI in uncertain cases when malignancy is still a concern.
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Affiliation(s)
- Mohamed S Taha
- Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Sun J, Li B, Li CJ, Li Y, Su F, Gao QH, Wu FL, Yu T, Wu L, Li LJ. Computed tomography versus magnetic resonance imaging for diagnosing cervical lymph node metastasis of head and neck cancer: a systematic review and meta-analysis. Onco Targets Ther 2015; 8:1291-313. [PMID: 26089682 PMCID: PMC4467645 DOI: 10.2147/ott.s73924] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN) and specificity (SPE) data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73–0.87]) than MRI (0.72 [95% CI 0.70–0.74]) when node was considered as unit of analysis (P<0.05); MRI had a higher SPE (0.81 [95% CI 0.80–0.82]) than CT (0.72 [95% CI 0.69–0.74]) when neck level was considered as unit of analysis (P<0.05) and MRI had a higher area under concentration-time curve than CT when the patient was considered as unit of analysis (P<0.05). With regards to diagnostic criteria, for MRI, the results showed that the minimal axial diameter of 10 mm could be considered as the best size criterion, compared to 12 mm for CT. Overall, MRI conferred significantly higher SPE while CT demonstrated higher SEN. The diagnostic criteria for MRI and CT on size of metastatic lymph nodes were suggested as 10 and 12 mm, respectively.
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Affiliation(s)
- J Sun
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - B Li
- West China School of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - C J Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - Y Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
| | - F Su
- Department of stomatology, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China
| | - Q H Gao
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - F L Wu
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - T Yu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China
| | - L Wu
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - L J Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, People's Republic of China
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Suarez-Gironzini V, Khoo V. Imaging Advances for Target Volume Definition in Radiotherapy. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0092-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dirix P, Haustermans K, Vandecaveye V. The value of magnetic resonance imaging for radiotherapy planning. Semin Radiat Oncol 2015; 24:151-9. [PMID: 24931085 DOI: 10.1016/j.semradonc.2014.02.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The success of highly conformal radiotherapy techniques in the sparing of normal tissues or in dose escalation, or both, relies heavily on excellent imaging. Because of its superior soft tissue contrast, magnetic resonance imaging is increasingly being used in radiotherapy treatment planning. This review discusses the current clinical evidence to support the pivotal role of magnetic resonance imaging in radiation oncology.
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Affiliation(s)
- Piet Dirix
- Department of Radiation Oncology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Leuven, Belgium; Department of Radiology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Leuven, Belgium.
| | - Karin Haustermans
- Department of Radiation Oncology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - Vincent Vandecaveye
- Department of Radiology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Leuven, Belgium; Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
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Differential diagnosis between metastatic and non-metastatic lymph nodes using DW-MRI: a meta-analysis of diagnostic accuracy studies. J Cancer Res Clin Oncol 2014; 141:1119-30. [PMID: 25515409 DOI: 10.1007/s00432-014-1895-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 12/02/2014] [Indexed: 12/20/2022]
Abstract
PURPOSES The purpose of our meta-analysis was to assess the overall diagnostic value of diffusion-weighted magnetic resonance imaging (DW-MRI) in detecting node metastases and investigate whether the apparent diffusion coefficient (ADC) value could be used to discriminate between metastatic and non-metastatic lymph nodes in patients with primary tumors. MATERIALS AND METHODS The meta-analysis included a total of 1,748 metastatic and 6,547 non-metastatic lymph nodes from 39 studies, including 8 different tumor types with lymph node metastases. RESULTS The pooled sensitivity and specificity of DW-MRI were 0.82 (95 % CI 0.76-0.87) and 0.92 (95 % CI 0.88-0.94), respectively. The positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the area under the curve were 9.8 (95 % CI 6.9-14.0), 0.20 (95 % CI 0.15-0.26) and 0.93 (95 % CI 0.91-0.95), respectively. The probability of 42 % can be viewed as the cutoff pretest probability for DW-MRI to diagnosis lymph node metastases; when the more chance of metastatic increased from 42 % that the pretest probability was estimated, it was more suitable to emphasize on "ruling in," on the contrary, and when the more chance of metastatic decreased from 42 %, it was more suitable to emphasize on "ruling out." Furthermore, the mean ADC value of metastatic lymph nodes was significantly lower than that of non-metastatic (P = 0.001). CONCLUSIONS DW-MRI is useful for differentiation between metastatic and non-metastatic lymph nodes. However, DW-MRI has a moderate diagnostic value for physician's decision making when PLR and NLR took into consideration, while a superior ability for nodal metastases confirmation, but an inferior ability for ruling out. In the future, large-scale, high-quality trials are necessary to evaluate, respectively, their clinical value in different tumor types with nodal metastases.
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ElSaid NAE, Nada OMM, Habib YS, Semeisem AR, Khalifa NM. Diagnostic accuracy of diffusion weighted MRI in cervical lymphadenopathy cases correlated with pathology results. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Lim HK, Lee JH, Baek HJ, Kim N, Lee H, Park JW, Kim SY, Cho KJ, Baek JH. Is diffusion-weighted MRI useful for differentiation of small non-necrotic cervical lymph nodes in patients with head and neck malignancies? Korean J Radiol 2014; 15:810-6. [PMID: 25469094 PMCID: PMC4248638 DOI: 10.3348/kjr.2014.15.6.810] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 07/21/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the usefulness of measuring the apparent diffusion coefficient (ADC) in diffusion-weighted magnetic resonance imaging to distinguish benign from small, non-necrotic metastatic cervical lymph nodes in patients with head and neck cancers. MATERIALS AND METHODS Twenty-six consecutive patients with head and neck cancer underwent diffusion-weighted imaging (b value, 0 and 800 s/mm(2)) preoperatively between January 2009 and December 2010. Two readers independently measured the ADC values of each cervical lymph node with a minimum-axial diameter of ≥ 5 mm but < 11 mm using manually drawn regions of interest. Necrotic lymph nodes were excluded. Mean ADC values were compared between benign and metastatic lymph nodes after correlating the pathology. RESULTS A total of 116 lymph nodes (91 benign and 25 metastatic) from 25 patients were included. Metastatic lymph nodes (mean ± standard deviation [SD], 7.4 ± 1.6 mm) were larger than benign lymph nodes (mean ± SD, 6.6 ± 1.4 mm) (p = 0.018). Mean ADC values for reader 1 were 1.17 ± 0.31 × 10(-3) mm(2)/s for benign and 1.25 ± 0.76 × 10(-3) mm(2)/s for metastatic lymph nodes. Mean ADC values for reader 2 were 1.21 ± 0.46 × 10(-3) mm(2)/s for benign and 1.14 ± 0.34 × 10(-3) mm(2)/s for metastatic lymph nodes. Mean ADC values between benign and metastatic lymph nodes were not significantly different (p = 0.594 for reader 1, 0.463 for reader 2). CONCLUSION Measuring mean ADC does not allow differentiating benign from metastatic cervical lymph nodes in patients with head and neck cancer and non-necrotic, small lymph nodes.
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Affiliation(s)
- Hyun Kyung Lim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. ; Department of Radiology, Soonchunhyang University Hospital, Seoul 140-743, Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Hye Jin Baek
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Namkug Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Hayoung Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Jee Won Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Kyung Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
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44
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Payne KFB, Haq J, Brown J, Connor S. The role of diffusion-weighted magnetic resonance imaging in the diagnosis, lymph node staging and assessment of treatment response of head and neck cancer. Int J Oral Maxillofac Surg 2014; 44:1-7. [PMID: 25442741 DOI: 10.1016/j.ijom.2014.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 06/30/2014] [Accepted: 09/10/2014] [Indexed: 11/25/2022]
Abstract
Standard magnetic resonance imaging (MRI) and computed tomography continue to be the imaging modalities of choice in staging and reviewing patients with head and neck cancer. Diffusion-weighted MRI (DW-MRI) is an advanced imaging modality that records the molecular diffusion of protons and thus provides an opportunity to further assess tissue character. Interest in DW-MRI of the head and neck continues to grow, especially its application to the assessment and treatment of head and neck cancer. We highlight the potential role of DW-MRI in the delineation, characterization, and lymph node staging of head and neck tumours. Furthermore, we discuss the ability of DW-MRI to provide a real opportunity to differentiate post-treatment tumour recurrence from chemoradiotherapy-induced local tissue changes. The future impact of these findings upon the clinical practice of the head and neck surgeon is discussed.
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Affiliation(s)
- K F B Payne
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London, UK.
| | - J Haq
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London, UK
| | - J Brown
- Department of Dental Radiology, Guy's Hospital, London, UK
| | - S Connor
- Department of Radiology, King's College Hospital, London, UK
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45
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de Bree R, Takes RP, Castelijns JA, Medina JE, Stoeckli SJ, Mancuso AA, Hunt JL, Rodrigo JP, Triantafyllou A, Teymoortash A, Civantos FJ, Rinaldo A, Pitman KT, Hamoir M, Robbins KT, Silver CE, Hoekstra OS, Ferlito A. Advances in diagnostic modalities to detect occult lymph node metastases in head and neck squamous cell carcinoma. Head Neck 2014; 37:1829-39. [PMID: 24954811 DOI: 10.1002/hed.23814] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/02/2014] [Accepted: 06/18/2014] [Indexed: 12/19/2022] Open
Abstract
Regional metastasis is a prominent feature of head and neck squamous cell carcinoma (HNSCC) and is an important prognostic factor. The currently available imaging techniques for assessment of the neck have limitations in accuracy; thus, elective neck dissection has remained the usual choice of management of the clinically N0 neck (cN0) for tumors with significant (≥20%) incidence of occult regional metastasis. As a consequence, the majority of patients without regional metastasis will undergo unnecessary treatment. The purpose of this review was to discuss new developments in techniques that potentially improve the accuracy of the assessment of the neck in patients with HNSCC. Although imaging has improved in the last decades, a limitation common to all imaging techniques is a lack of sensitivity for small tumor deposits. Therefore, complementary to improvements in imaging techniques, developments in more invasive diagnostic procedures, such as sentinel node biopsy (SNB) will add to the accuracy of diagnostic algorithms for the staging of the neck.
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Affiliation(s)
- Remco de Bree
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jonas A Castelijns
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jesus E Medina
- Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Sandro J Stoeckli
- Department of Otorhinolaryngology-Head and Neck Surgery, Kantonsspital, St. Gallen, Switzerland
| | - Anthony A Mancuso
- Department of Radiology, University of Florida College of Medicine, Gainesville, Florida
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | - Afshin Teymoortash
- Department of Otolaryngology-Head and Neck Surgery, University of Marburg, Marburg, Germany
| | - Francisco J Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | | | - Karen T Pitman
- Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, Arizona
| | - Marc Hamoir
- Department of Head and Neck Surgery, Head and Neck Oncology Program, St. Luc University Hospital and Cancer Center, Brussels, Belgium
| | - K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Carl E Silver
- Departments of Surgery and Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Alfio Ferlito
- University of Udine School of Medicine, Udine, Italy
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46
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Azeem Ismail AA, Hasan DI, Abd-Alshakor H. Diagnostic accuracy of apparent diffusion coefficient value in differentiating metastatic form benign axillary lymph nodes in cancer breast. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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47
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Arya S, Rane P, Deshmukh A. Oral cavity squamous cell carcinoma: Role of pretreatment imaging and its influence on management. Clin Radiol 2014; 69:916-30. [DOI: 10.1016/j.crad.2014.04.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 03/31/2014] [Accepted: 04/15/2014] [Indexed: 11/28/2022]
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48
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Kim EJ, Kim SH, Kang BJ, Choi BG, Song BJ, Choi JJ. Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI. Magn Reson Imaging 2014; 32:1230-6. [PMID: 25072504 DOI: 10.1016/j.mri.2014.07.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 07/21/2014] [Indexed: 02/06/2023]
Abstract
PURPOSES To evaluate the diagnostic value of diffusion-weighted MRI (DWI) and combination of conventional MRI and DWI to predict metastatic axillary lymph nodes in breast cancer. MATERIALS AND METHODS Two hundred fifty-two breast cancer patients with 253 axillae were included. The morphological parameters on axial T2-weighted images without fat saturation and apparent diffusion coefficient (ADC) values were retrospectively analyzed. An independent t-test/chi-square test and receiver operating characteristics (ROC) curve analysis were used. RESULTS On conventional MRI, short and long axis length, maximal cortical thickness, relative T2 value, loss of fatty hilum (p<0.001 for each), and eccentric cortical thickening (p<0.003) were statistically significantly different between the metastatic and nonmetastatic groups. The short axis to long axis ratio was not a statistically significant parameter. The ADC value was significantly different between the 2 groups, with an AUC that was higher than that of conventional MR parameters (AUC, 0.815; threshold, ≤0.986×10-3 mm(2)/sec; sensitivity, 75.8%; specificity, 83.9%). Using the adopted thresholds for each parameter, a total number of findings suggesting malignancy of 4 or higher was determined as the threshold, with high specificity (90.1%). CONCLUSION Using conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity.
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Affiliation(s)
- Eun Jeong Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Byung Gil Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Byung Joo Song
- General Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
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49
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Hassan O, Taha MS, Farag W. Diffusion-weighted MRI versus PET/CT in evaluation of clinically N0 neck in patients with HNSCC. Systematic review and meta-analysis study. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.ejenta.2014.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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50
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The role of 3 Tesla diffusion-weighted imaging in the differential diagnosis of benign versus malignant cervical lymph nodes in patients with head and neck squamous cell carcinoma. BIOMED RESEARCH INTERNATIONAL 2014; 2014:532095. [PMID: 25003115 PMCID: PMC4070473 DOI: 10.1155/2014/532095] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/18/2014] [Accepted: 05/18/2014] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The aim of this study was to validate the role of diffusion-weighted imaging (DWI) at 3 Tesla in the differential diagnosis between benign and malignant laterocervical lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS Before undergoing surgery, 80 patients, with biopsy proven HNSCC, underwent a magnetic resonance exam. Sensitivity (Se) and specificity (Spe) of conventional criteria and DWI in detecting laterocervical lymph node metastases were calculated. Histological results from neck dissection were used as standard of reference. RESULTS In the 239 histologically proven metastatic lymphadenopathies, the mean apparent diffusion coefficient (ADC) value was 0.903 × 10(-3) mm(2)/sec. In the 412 pathologically confirmed benign lymph nodes, an average ADC value of 1.650 × 10(-3) mm(2)/sec was found. For differentiating between benign versus metastatic lymph nodes, DWI showed Se of 97% and Spe of 93%, whereas morphological criteria displayed Se of 61% and Spe of 98%. DWI showed an area under the ROC curve (AUC) of 0.964, while morphological criteria displayed an AUC of 0.715. CONCLUSIONS In a DWI negative neck for malignant lymph nodes, the planned dissection could be converted to a wait-and-scan policy, whereas DWI positive neck would support the decision to perform a neck dissection.
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