Diffusion-Weighted MR Imaging in Evaluation of Malignant Lymphoma and Squamous Cell Carcinoma in the Head and Neck Regions

Document Type : Original Article

Authors

1 Department of Oral and maxillofacial Radiology, Faculty of Dentistry, Minia University.

2 Department of Oral and maxillofacial Radiology, Faculty of Dentistry, Minia University

3 Department of Clinical Oncology Faculty of medicine, Minia University.

4 Department of Diagnostic Radiology Faculty of medicine, Minia University.

Abstract

Objective: The aim of this study was to evaluate malignant lymphoma and SCC in head and neck 
region with diffusion-weighted MRI. Patients and methods: Twenty two patients with histologically 
proven, untreated head and neck malignant lymphoma and SCC underwent DW-MRIs with b values 
0, 1000 s/mm2 besides morphological sequences and corresponding ADC maps were generated. The 
mean ADCs were measured for both groups. We also measured ADC values of spinal cord and 
cerebrospinal fluid (CSF) in the upper neck area which served as an internal control. The diagnostic 
performance of DW- was evaluated by sensitivity and specificity at the optimum cutoff point and the 
area under the receiver operating characteristic curve. Result: The mean ADC for ML (0.76 ± 0.09 x 
10-3 mm2
/s) was significantly lower than that for HNSCC (1.03 ± 0.2 x 10-3 mm2
/s, p<0.0001) (Table 
2). A threshold ADC value of > 0.83 x 10-3 mm2
/s could be used to discriminate HNSCC from ML, 
with highest accuracy of 95.5 %, plus 90 % sensitivity, 100 % specificity, 100 % PPV, and 91.7 % 
NPV. Conclusion: Diffusion-weighted MRI when used in combination with conventional MRI 
techniques in head and neck imaging, provides clinically important information. The ADCs were a 
powerful tool for differentiating between ML and SCC. ADC values of lymphoma were significantly 
lower than those of SCC.

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