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van der Hulst HJ, Braun L, Westerink B, Agrotis G, Ter Beek LC, Tissier R, Ahmadian M, Martens RM, Casselman JW, Beets-Tan RGH, van den Brekel MWM, Castelijns JA. Comparison of Diffusion-Weighted MRI Using Single-Shot Echo-Planar Imaging and Split Acquisition of Fast Spin-Echo Signal Imaging, a Non-EPI Technique, in Tumors of the Head and Neck. AJNR Am J Neuroradiol 2025; 46:774-783. [PMID: 39384329 PMCID: PMC11979853 DOI: 10.3174/ajnr.a8529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 10/07/2024] [Indexed: 10/11/2024]
Abstract
BACKGROUND AND PURPOSE DWI using single-shot echo-planar imaging (DWI-EPI) is susceptible to distortions around air-filled cavities and dental fillings, typical for the head and neck area. Non-EPI, split acquisition of fast spin-echo signals for diffusion imaging (DW-SPLICE) could reduce these distortions and enhance image quality, thereby potentially improving recurrence assessment in squamous cell carcinoma (SCC) of the head and neck region. This study evaluated whether DW-SPLICE is a viable alternative to DWI-EPI through quantitative and qualitative analyses. MATERIALS AND METHODS The DW-SPLICE sequence was incorporated into the standard 3T head and neck MRI protocol with DWI-EPI. Retrospective analysis was conducted on 2 subgroups: first benign or malignant lesions, and second, posttreatment SCC recurrence. In both subgroups, image quality and distortion were scored by 2 independent radiologists, blinded to the DWI technique and evaluated using mixed-effect linear models. Lesion ADC values were assessed with interclass correlation and Bland-Altman analyses. The delineation geometric similarity of DWI to T1-weighted postcontrast MRI was evaluated using the DSC before and after registration. Recurrence in posttreatment SCC scans was evaluated by the same 2 radiologists blinded to the DWI technique. Recurrence detection rates were then compared between DW-SPLICE and DWI-EPI using mixed logistic regression at 6 months and 1 year postscan follow-up data. RESULTS From August 2020 to January 2022, fifty-five benign or malignant lesion scans (55 patients) and 74 posttreatment SCC scans (66 patients) were analyzed. DW-SPLICE scored better on image quality and showed less overall distortion than DWI-EPI (0.04 CONCLUSIONS DW-SPLICE surpasses DWI-EPI on image distortion and quality and improves diagnostic reliability for detecting recurrent or residual SCC on 3T MRI of the head and neck. Consistent use of 1 method for follow-up is advised, because ADC values are not completely interchangeable. Integrating DW-SPLICE can significantly improve tumor assessments in clinical practice.
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Affiliation(s)
- Hedda J van der Hulst
- From the Department of Radiology (H.J.v.d.H., L.B., B.W., G.A., M.A., R.G.H.B.-T., J.A.C.), Netherlands Cancer Institute, Amsterdam, the Netherlands
- GROW School for Oncology and Developmental Biology (H.J.v.d.H., R.G.H.B.-T.), University of Maastricht, Maastricht, the Netherlands
- Department of Head and Neck Oncology and Surgery (H.J.v.d.H., M.A., M.W.M.v.d.B.), the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Loes Braun
- From the Department of Radiology (H.J.v.d.H., L.B., B.W., G.A., M.A., R.G.H.B.-T., J.A.C.), Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Bram Westerink
- From the Department of Radiology (H.J.v.d.H., L.B., B.W., G.A., M.A., R.G.H.B.-T., J.A.C.), Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Georgios Agrotis
- From the Department of Radiology (H.J.v.d.H., L.B., B.W., G.A., M.A., R.G.H.B.-T., J.A.C.), Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Radiology (G.A.), University Hospital of Larissa, Thessaly, Greece
| | - Leon C Ter Beek
- Department of Clinical Physics (L.C.t.B.), Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Renaud Tissier
- Biostatistics Unit (R.T.), Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Milad Ahmadian
- From the Department of Radiology (H.J.v.d.H., L.B., B.W., G.A., M.A., R.G.H.B.-T., J.A.C.), Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Head and Neck Oncology and Surgery (H.J.v.d.H., M.A., M.W.M.v.d.B.), the Netherlands Cancer Institute, Amsterdam, the Netherlands
- Amsterdam Center for Language and Communication (M.A.), University of Amsterdam, Amsterdam, the Netherlands
| | - Roland M Martens
- Department of Radiology and Nuclear Medicine (R.M.M.), Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jan W Casselman
- Department of Radiology (J.W.C.), Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Radiology (J.W.C.), Arizona St Lucas Gent, Ghent, Belgium
| | - Regina G H Beets-Tan
- From the Department of Radiology (H.J.v.d.H., L.B., B.W., G.A., M.A., R.G.H.B.-T., J.A.C.), Netherlands Cancer Institute, Amsterdam, the Netherlands
- GROW School for Oncology and Developmental Biology (H.J.v.d.H., R.G.H.B.-T.), University of Maastricht, Maastricht, the Netherlands
- Department of Regional Health Research (R.G.H.B.-T.), University of Southern Denmark, Odense, Denmark
| | - Michiel W M van den Brekel
- Department of Head and Neck Oncology and Surgery (H.J.v.d.H., M.A., M.W.M.v.d.B.), the Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery (M.W.M.v.d.B.), Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jonas A Castelijns
- From the Department of Radiology (H.J.v.d.H., L.B., B.W., G.A., M.A., R.G.H.B.-T., J.A.C.), Netherlands Cancer Institute, Amsterdam, the Netherlands
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Yasaka M, Okamura K, Shimizu M, Sagiyama K, Kiyoshima T, Kawano S, Moriyama M, Chikui T. Image findings and pathological findings of lymphoepithelial cysts with hyper internal echo-a comparison with dermoid cysts. Oral Radiol 2025:10.1007/s11282-025-00818-1. [PMID: 40088362 DOI: 10.1007/s11282-025-00818-1] [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: 01/09/2025] [Accepted: 02/26/2025] [Indexed: 03/17/2025]
Abstract
OBJECTIVE To summarize the ultrasonography (US) and magnetic resonance imaging (MRI) findings of lymphoepithelial cysts (LECs) and dermoid cysts (DCs) and to discuss the hyperinternal echo in LECs based on histopathological findings. METHODS Patients who underwent US and MRI before resection and whose lesions were pathologically diagnosed as LECs or DCs were included (January 2010 to December 2023). Internal echo, convective flow, and Doppler signals were evaluated on US, while on MRI, we measured the apparent diffusion coefficient (ADC). RESULTS Surprisingly, all lesions (4 LECs and 7 DCs) had hyperinternal echoes. Convective flow and Doppler signals were observed in 2 of the 4 cases of LEC, and the ADC was high in these cases (2.4 × 10-3 and 2.0 × 10-3 mm2/s). In the two cases where they were not, the ADC was low (1.4 × 10-3 and 0.81 × 10-3 mm2/s). Various cells, such as lymphocyte cells, foam cells, erythroid cells, and keratin, have been found in the cystic cavity, which are thought to be the cause of hyperecho. Considering the ADC, the presence or absence of convection and Doppler signals is thought to reflect the ease of movement of the contents. In the DCs, neither internal convection nor obvious Doppler signals were observed. ADCs were quite low for cysts, which was a characteristic finding (1.1 ± 0.13-3 mm2/s). CONCLUSION It is well known that DCs appear hyperechoic on US owing to the presence of keratin; however, it is necessary to recognize that some LECs are depicted as hyperechoic masses and have convective flow and Doppler signals depending on the content.
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Affiliation(s)
- Misa Yasaka
- Section of Oral and Maxillofacial Radiology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Kazutoshi Okamura
- Department of Oral and Maxillofacial Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Mayumi Shimizu
- Department of Oral and Maxillofacial Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Sagiyama
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tamotsu Kiyoshima
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shintaro Kawano
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Masafumi Moriyama
- Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Toru Chikui
- Section of Oral and Maxillofacial Radiology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
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Boeke S, Habrich J, Kübler S, Boldt J, Schick F, Nikolaou K, Kübler J, Gani C, Niyazi M, Zips D, Thorwarth D. Longitudinal assessment of diffusion-weighted imaging during magnetic resonance-guided radiotherapy in head and neck cancer. Radiat Oncol 2025; 20:15. [PMID: 39881423 PMCID: PMC11780986 DOI: 10.1186/s13014-025-02589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 01/17/2025] [Indexed: 01/31/2025] Open
Abstract
BACKGROUND For radiotherapy of head and neck cancer (HNC) magnetic resonance imaging (MRI) plays a pivotal role due to its high soft tissue contrast. Moreover, it offers the potential to acquire functional information through diffusion weighted imaging (DWI) with the potential to personalize treatment. The aim of this study was to acquire repetitive DWI during the course of online adaptive radiotherapy on an 1.5 T MR-linear accelerator (MR-Linac) for HNC patients and to investigate temporal changes of apparent diffusion coefficient (ADC) values of the tumor and subvolume levels. METHODS 27 patients treated with curative RT on the 1.5 T MR-Linac with at least weekly DWI in treatment position were included into this prospective analysis and divided in four risk groups (HPV-status and localisation). Tumor and lymph node volumes (GTV-P/GTV-N) were delineated on b = 500 s/mm2 images while ADC maps were calculated using b = 150/200 and 500 s/mm2 images. Absolute and relative temporal changes of mean ADC values, tumor volumes and a high-risk subvolume (HRS) defined by low ADC tumor voxels (600 < ADC < 900 × 10-6 mm2/s) were analyzed. Relative changes of mean ADC values, tumor volumes and HRS were statistically tested using Wilcoxon-signed-rank test. RESULTS Median pretreatment ADC value for all patients resulted in 1167 × 10-6 mm2/s for GTV-P and 1002 × 10-6 mm2/s for GTV-N while absolute pretreatment tumor volume yielded 9.1 cm3 for GTV-P and 6.0 cm3 for GTV-N, respectively. Pretreatment HRS volumes were 1.5 cm3 for GTV-P and 1.3 cm3 for GTV-P and GTV-N. Median ADC values increase during 35 fractions of RT was 49% for GTV-P and 24% for GTV-N during RT. Median tumor volume decrease was 68% and 52% for GTV-P and GTV-N with a median HRS decrease of 93% and 87%. Significant differences from 0 for mean ADC were observed starting from week 1, for tumor volumes from week 2 for GTV-P and week 1 for GTV-N and for HRS in week 1 for GTV-P and week 2 for GTV-N. CONCLUSION Longitudinal DWI acquisition in HNC is feasible on a MR-Linac during the course of online adaptive MR-guided radiotherapy. Changes in ADC and volumes can be assessed, but future work needs to explore the potential for biologically guided treatment individualization. TRIAL REGISTRATION NCT04172753, actual study start: 09.05.2018.
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Affiliation(s)
- Simon Boeke
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK), partner site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jonas Habrich
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany.
| | - Sarah Kübler
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - Jessica Boldt
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - Fritz Schick
- Section for Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Jens Kübler
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Cihan Gani
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK), partner site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maximilian Niyazi
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK), partner site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Daniel Zips
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
- German Cancer Consortium (DKTK), partner site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Charité Clinic for Radiation Oncology and Radiation Therapy - University Medicine Berlin, Berlin, Germany
| | - Daniela Thorwarth
- German Cancer Consortium (DKTK), partner site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
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Guerreiro F, van Houdt P, Navest R, Hoekstra N, de Jong M, Heijnen B, Zijlema S, Verbist B, van der Heide U, Astreinidou E. Validation of quantitative magnetic resonance imaging techniques in head and neck healthy structures involved in the salivary and swallowing function: Accuracy and repeatability. Phys Imaging Radiat Oncol 2024; 31:100608. [PMID: 39071157 PMCID: PMC11283017 DOI: 10.1016/j.phro.2024.100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/20/2024] [Accepted: 06/27/2024] [Indexed: 07/30/2024] Open
Abstract
Background and Purpose Radiation-induced damage to the organs at risk (OARs) in head-and-neck cancer (HNC) patient can result in long-term complications. Quantitative magnetic resonance imaging (qMRI) techniques such as diffusion-weighted imaging (DWI), DIXON for fat fraction (FF) estimation and T2 mapping could potentially provide a spatial assessment of such damage. The goal of this study is to validate these qMRI techniques in terms of accuracy in phantoms and repeatability in-vivo across a broad selection of healthy OARs in the HN region. Materials and Methods Scanning was performed at a 3 T diagnostic MRI scanner, including the calculation of apparent diffusion coefficient (ADC) from DWI, FF and T2 maps. Phantoms were scanned to estimate the qMRI techniques bias using Bland-Altman statistics. Twenty-six healthy subjects were scanned twice in a test-retest study to determine repeatability. Repeatability coefficients (RC) were calculated for the parotid, submandibular, sublingual and tubarial salivary glands, oral cavity, pharyngeal constrictor muscle and brainstem. Additionally, a linear mixed-effect model analysis was used to evaluate the effect of subject-specific characteristics on the qMRI values. Results Bias was 0.009x10-3 mm2/s for ADC, -0.7 % for FF and -7.9 ms for T2. RCs ranged 0.11-0.25x10-3 mm2/s for ADC, 1.2-6.3 % for FF and 2.5-6.3 ms for T2. A significant positive linear relationship between age and the FF and T2 for some of the OARs was found. Conclusion These qMRI techniques are feasible, accurate and repeatable, which is promising for treatment response monitoring and/or differentiating between healthy and unhealthy tissues due to radiation-induced damage in HNC patients.
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Affiliation(s)
- F. Guerreiro
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - P.J. van Houdt
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - R.J.M. Navest
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - N. Hoekstra
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - M. de Jong
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - B.J. Heijnen
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - S.E. Zijlema
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - B. Verbist
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
- HollandPTC, Delft, the Netherlands
| | - U.A. van der Heide
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - E. Astreinidou
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
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Yoon D, Lutz AM. Diffusion Tensor Imaging of Peripheral Nerves: Current Status and New Developments. Semin Musculoskelet Radiol 2023; 27:641-648. [PMID: 37935210 DOI: 10.1055/s-0043-1775742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Diffusion tensor imaging (DTI) is an emerging technique for peripheral nerve imaging that can provide information about the microstructural organization and connectivity of these nerves and complement the information gained from anatomical magnetic resonance imaging (MRI) sequences. With DTI it is possible to reconstruct nerve pathways and visualize the three-dimensional trajectory of nerve fibers, as in nerve tractography. More importantly, DTI allows for quantitative evaluation of peripheral nerves by the calculation of several important parameters that offer insight into the functional status of a nerve. Thus DTI has a high potential to add value to the work-up of peripheral nerve pathologies, although it is more technically demanding. Peripheral nerves pose specific challenges to DTI due to their small diameter and DTI's spatial resolution, contrast, location, and inherent field inhomogeneities when imaging certain anatomical locations. Numerous efforts are underway to resolve these technical challenges and thus enable wider acceptance of DTI in peripheral nerve MRI.
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Affiliation(s)
- Daehyun Yoon
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California at San Francisco, San Francisco, California
| | - Amelie M Lutz
- Department of Radiology, Kantonal Hospital Thurgau, Muensterlingen, Switzerland
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Tezuka Y, Ogura I. Evaluation of the efficacy of diffusion-weighted magnetic resonance imaging and apparent diffusion coefficients in the diagnosis of maxillary diseases. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:753-758. [PMID: 37517952 DOI: 10.1016/j.oooo.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE We investigated the efficacy of using diffusion-weighted imaging (DWI) with quantitative apparent diffusion coefficient (ADC) mapping in the diagnosis of maxillary diseases. STUDY DESIGN We evaluated 146 cases of maxillary diseases (32 malignant tumors, 11 benign tumors, 28 maxillary cysts, 60 cases of maxillary sinusitis, and 15 maxillary sinus retention cysts) that had been examined using magnetic resonance imaging. The DWI sequence was obtained with b values of 0 and 800 s/mm2 and ADC values were calculated. We used one-way analysis of variance and the Tukey honestly significant difference test to identify differences within and between the types of diseases. RESULTS Mean ADC values for malignant tumors (1.07 × 10-3 mm2 s-1) were significantly lower than ADCs for benign tumors (1.85 × 10-3 mm2 s-1), maxillary cysts (1.77 × 10-3 mm2 s-1), maxillary sinusitis (2.34 × 10-3 mm2 s-1), and maxillary sinus retention cysts (2.52 × 10-3 mm2 s-1), with P < 0.001. Mean ADC differed significantly between all disease types except between maxillary sinusitis and maxillary sinus retention cysts. ADC values also significantly differed between specific lesions within the malignant tumor and maxillary cyst groups. CONCLUSIONS The use of ADC values can be useful in the differential diagnosis of malignant maxillary diseases, benign lesions, cysts, and inflammatory and reactive conditions.
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Affiliation(s)
- Yasuhito Tezuka
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan.
| | - Ichiro Ogura
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan; Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
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Wamasing N, Yomtako S, Watanabe H, Sakamoto J, Kayamori K, Kurabayashi T. The magnetic resonance imaging characteristics of radicular cysts and granulomas. Dentomaxillofac Radiol 2023; 52:20220336. [PMID: 36688723 PMCID: PMC9944013 DOI: 10.1259/dmfr.20220336] [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] [Received: 10/16/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES Limited studies have differentiated radicular cysts and granulomas with MRI. Therefore, we investigated the MRI characteristics of the two lesions and clarified features for distinguishing between them. METHODS We collected data of 27 radicular cysts and 9 granulomas definitively diagnosed by histopathology and reviewed the fat-saturated T2 weighted, T1 weighted, and contrast-enhanced fat-saturated T1 weighted images. We measured the maximum diameter and apparent diffusion coefficient values of the lesions. We employed Fisher's exact test, the Mann-Whitney U test, and independent t-tests to compare the two lesions and created a decision tree for discriminating between them. RESULTS There were significant differences between radicular cysts and granulomas with respect to five imaging characteristics-signal intensity of the lesion centre on fat-saturated T2 weighted images; signal intensity, texture, and contrast enhancement of the lesion centre on contrast-enhanced fat-saturated T1 weighted images; and maximum diameter of the lesion. The cut-off diameter for radicular cysts was 15.9 mm. The area under the receiver operating characteristic curve, sensitivity, and specificity were 0.971, 85.2%, and 100%, respectively. CONCLUSIONS From the decision tree analysis, maximum diameter, lesion centre contrast enhancement on contrast-enhanced fat-saturated T1 weighted images, and lesion centre signal intensity on fat-saturated T2 weighted images were important for discriminating between radicular cysts and granulomas.
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Affiliation(s)
- Natnicha Wamasing
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | | | - Hiroshi Watanabe
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | - Junichiro Sakamoto
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | - Kou Kayamori
- Oral Pathology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
| | - Tohru Kurabayashi
- Dental Radiology and Radiation Oncology, Graduate School of Dentistry, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan
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Cheng J, Shao S, Chen W, Zheng N. Application of Diffusion Kurtosis Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Differentiating Benign and Malignant Head and Neck Lesions. J Magn Reson Imaging 2021; 55:414-423. [PMID: 34378259 DOI: 10.1002/jmri.27885] [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: 05/24/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Preoperative differentiation of head and neck lesions is important for treatment plan selection. PURPOSE To evaluate the diagnostic value of diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign from malignant head and neck lesions and subgroups, including lymphoma subgroup (LS), Warthin's tumor subgroup (WS), malignant tumor subgroup (excluding lymphoma) (MTS), and benign tumor subgroup (excluding Warthin's tumor) (BTS). STUDY TYPE Retrospective. POPULATION Seventy-four patients with 79 head and neck lesions (44 benign, 35 malignant), divided into four subgroups: LS (14), WS (12), MTS (21), and BTS (32). FIELD STRENGTH/SEQUENCES A 3.0 T, single-shot echo-planar sequence with 5 b-values for DKI and enhanced T1 high-resolution isotropic volume excitation (eTHRIVE) sequence for DCE-MRI. ASSESSMENT The mean diffusivity (MD) and mean kurtosis (MK) derived from DKI and the time-signal intensity curve (TIC), peak time (Tpeak ), and washout ratio (WR) based on DCE-MRI were measured. The diagnostic efficiencies of DKI and DCE-MRI, alone and in combination, were calculated and compared. The parameters mentioned above were compared between the four subgroups. STATISTICAL TEST Mann-Whitney U test, chi-square test, receiver operating characteristic curve, Delong test, one-way analysis of variance test, and Kruskal-Wallis H test. A P value < 0.05 was considered statistically significant. RESULTS The combination of TIC and parameters of DKI and DCE-MRI for differentiating benign and malignant lesions with 94.94% accuracy is superior to DKI or DCE-MRI alone with approximately 75% accuracy. MD, MK, Tpeak , and WR showed significant differences among the four subgroups. The accuracy of MD and MK was 91.14% and 92.41% for differentiating BTS from the other three subgroups. WR achieved 100% accuracy for discriminating WS from LS or MTS. MD and MK both differentiated LS from MTS with 97.14% accuracy. DATA CONCLUSION A combination of DKI and DCE-MRI can effectively differentiate head and neck lesions with good accuracy. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jingfeng Cheng
- Department of Radiology, Wuhu Second People's Hospital, Wuhu, China
| | - Shuo Shao
- Department of Radiology, Jining No.1 People's Hospital, Jining, China
| | | | - Ning Zheng
- Department of Radiology, Jining No.1 People's Hospital, Jining, China
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Baiomy A, Nada A, Gabr A, Youssef A, Mahmoud E, Zaky I. Characterization of pediatric head and neck masses with quantitative analysis of diffusion-weighted imaging and measurement of apparent diffusion coefficients. Indian J Radiol Imaging 2021; 30:473-481. [PMID: 33737777 PMCID: PMC7954155 DOI: 10.4103/ijri.ijri_129_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 11/30/2019] [Accepted: 08/11/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose: Our objective was to investigate the accuracy of quantitative diffusion-weighted imaging (DWI) to determine the histopathologic diagnosis of pediatric head and neck lesions. Materials and Methods: This retrospective study included 100 pediatric patients recently diagnosed with head and neck tumors. All patients underwent preoperative conventional magnetic resonance imaging (MRI) and DWI. Each lesion was evaluated according to signal characteristics, enhancement pattern, and diffusivity. The average apparent diffusion coefficient (ADC) obtained from each tumor was compared to the histological diagnosis of benign, locally malignant, or malignant categories. Results: Our retrospective study showed a significant negative correlation between average ADC and tumor histopathologic diagnosis (P < 0.001, r = -0.54). The mean ADC values of benign, locally malignant lesions, and malignant tumors were 1.65 ± 0.58 × 10–3, 1.43 ± 0.17 × 10–3, and 0.83 ± 0.23 × 10–3 mm2 s-1, respectively. The ADC values of benign and locally malignant lesions were overlapped. We found a cut-off value of ≥1.19 × 10–3 mm2s-1 to differentiate benign from malignant pediatric head and neck masses with a sensitivity of 97.3%, specificity of 80.0%, positive predictive value of 94.7%, and negative predictive value of 88.9%. Conclusion: Diffusion-weighted MRI study is an accurate, fast, noninvasive, and nonenhanced technique that can be used to characterize head and neck lesions. DWI helps to differentiate malignant from benign lesions based on calculated ADC values. Additionally, DWI is helpful to guide biopsy target sites and decrease the rate of unnecessary invasive procedures.
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Affiliation(s)
- Ali Baiomy
- Texas Tech University Health Sciences Center El Paso, TX, USA
| | - Ayman Nada
- Department of Radiology, University of Missouri, MO, USA.,Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Egypt
| | - Ahmed Gabr
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Egypt
| | - Ayda Youssef
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Egypt
| | - Esmat Mahmoud
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Egypt
| | - Iman Zaky
- Department of Radiology, Children's Cancer Hospital, Egypt
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10
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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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11
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Messina C, Bignone R, Bruno A, Bruno A, Bruno F, Calandri M, Caruso D, Coppolino P, De Robertis R, Gentili F, Grazzini I, Natella R, Scalise P, Barile A, Grassi R, Albano D, on behalf of the Young SIRM Working Group. Diffusion-Weighted Imaging in Oncology: An Update. Cancers (Basel) 2020; 12:1493. [PMID: 32521645 PMCID: PMC7352852 DOI: 10.3390/cancers12061493] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the "functional" information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.
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Affiliation(s)
- Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milano, Italy;
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milano, Italy
| | - Rodolfo Bignone
- Radiology Unit, University of Palermo, 90127 Palermo, Italy; (R.B.); (A.B.)
| | - Alberto Bruno
- Radiology Unit, University of Palermo, 90127 Palermo, Italy; (R.B.); (A.B.)
| | - Antonio Bruno
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, S.Orsola-Malpighi Hospital, 40126 Bologna, Italy;
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (F.B.); (A.B.)
| | - Marco Calandri
- Radiology Unit, A.O.U. San Luigi Gonzaga di Orbassano, Department of Oncology, University of Torino, 10043 Turin, Italy;
| | - Damiano Caruso
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Sant’Andrea University Hospital, 00161 Rome, Italy;
| | - Pietro Coppolino
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”-Radiology I Unit, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy;
| | - Riccardo De Robertis
- Department of Radiology, Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata Verona, 37134 Verona, Italy;
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
| | - Irene Grazzini
- Department of Radiology, Section of Neuroradiology, San Donato Hospital, 52100 Arezzo, Italy;
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (R.N.); (R.G.)
| | - Paola Scalise
- Department of Diagnostic Imaging, Pisa University Hospital, 56124 Pisa, Italy;
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (F.B.); (A.B.)
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (R.N.); (R.G.)
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milano, Italy;
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Section of Radiological Sciences, University of Palermo, 90127 Palermo, Italy
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12
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Munhoz L, Nishimura DA, Hisatomi M, Yanagi Y, Asaumi J, Arita ES. Application of diffusion-weighted magnetic resonance imaging in the diagnosis of odontogenic lesions: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 130:85-100.e1. [PMID: 32007494 DOI: 10.1016/j.oooo.2019.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This systematic literature review addresses the use of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) for the evaluation of benign maxillomandibular odontogenic lesions. STUDY DESIGN Databases were searched, and original research studies or case report manuscripts up to April 2019 were included, using the keyword "diffusion," combined with the keywords "maxillofacial pathology," "oral pathology," "odontogenic tumors," "dental tissue neoplasms," "odontogenic cysts," and the histologic denomination of benign odontogenic lesions, according to the World Health Organization classification. Only English language articles and studies pertaining to DWI were selected. RESULTS Fifteen investigations (11 original articles and 4 case reports) of distinct benign odontogenic lesions were included. Most studies did not include exclusively odontogenic lesions in their samples. CONCLUSIONS It is too early to reach a conclusion that DWI and ADC can provide useful information in the differentiation of the histologic type of some benign odontogenic lesions on the basis of available data in the literature.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil.
| | | | - Miki Hisatomi
- Department of Dentomaxillofacial Radiology and Oral Diagnosis, Okayama University Hospital, Okayama, Japan
| | - Yoshinobu Yanagi
- Department of Dentomaxillofacial Radiology and Oral Diagnosis, Okayama University Hospital, Okayama, Japan
| | - Junich Asaumi
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
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13
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Abdel Razek AAK, Sherif FM. Differentiation of sublingual thyroglossal duct cyst from midline dermoid cyst with diffusion weighted imaging. Int J Pediatr Otorhinolaryngol 2019; 126:109623. [PMID: 31400658 DOI: 10.1016/j.ijporl.2019.109623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 01/31/2023]
Abstract
PURPOSE to differentiate sublingual thyroglossal duct cyst (TGDC) from midline dermoid cyst (DC) with diffusion weighted imaging (DWI). MATERIALS AND METHODS Retrospective analysis of 22 consecutive patients (11 male and 11 female aged 5-15 years) with midline cystic lesion at floor of mouth. They underwent DWI of floor of mouth. Apparent diffusion coefficient (ADC) of the cystic lesions was calculated and correlated with surgical findings. RESULTS The mean ADC value of TGDC of 1st observer was (2.20 ± 0.28 × 10-3 mm2/s) and of 2nd observer was (2.28 ± 0.27 × 10-3 mm2/s) was significantly higher than that of DC (P = 0.001) whose ADC of 1st observer was (1.55 ± 0.15 × 10-3 mm2/s) and of 2nd observer was (1.53 ± 0.11 × 10-3 mm2/s). There was excellent inter-observer agreement of both readings (r = 92%, P = 0.001). When ADC of 1.76 and 1.62 × 10-3 mm2/s was used as a threshold value for differentiating TGDC from DC, the best results were obtained with area under the curve of 0.94 and 0.96, accuracy of 90% and 86%, sensitivity of 91% and 91%%, specificity of 90% and 80%, negative predictive value of 90% and 88% and positive predictive value of 92% and 84% of both reviewers respectively. CONCLUSION DWI is reliable and reproducible imaging modality for differentiation sublingual TGDC from DC.
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Affiliation(s)
| | - Fatma Mohamed Sherif
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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14
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Panyarak W, Chikui T, Yamashita Y, Kamitani T, Yoshiura K. Image Quality and ADC Assessment in Turbo Spin-Echo and Echo-Planar Diffusion-Weighted MR Imaging of Tumors of the Head and Neck. Acad Radiol 2019; 26:e305-e316. [PMID: 30528753 DOI: 10.1016/j.acra.2018.11.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/03/2018] [Accepted: 11/20/2018] [Indexed: 02/07/2023]
Abstract
RATIONALE AND OBJECTIVES We aimed to compare the distortion ratio (DR), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) between turbo spin-echo (TSE)-diffusion-weighted imaging (DWI) and echo-planar imaging (EPI)-DWI of the orofacial region and prove the usefulness of TSE-DWI for the differential diagnosis of orofacial lesions. MATERIALS AND METHODS The DR, SNR, and CNR of both sequences were compared in 42 cases. Then, the apparent diffusion coefficient (ADC) of various orofacial lesions obtained by TSE-DWI was investigated in 143 lesions. RESULTS In the first study, 38 of 42 cases were analyzed. TSE-DWI showed a significantly lower DR (p < 0.05) and higher SNR and CNR than EPI-DWI (p < 0.05), indicating the superiority of TSE-DWI. In the second study, 114 cases (79.3%) were successfully analyzed. When lesions were divided into cysts, benign tumors, squamous cell carcinoma, malignant lymphoma, and other malignant tumors (OT), significant differences were observed in all pairs of lesions (p < 0.05) except squamous cell carcinoma and OT (p = 0.877). The area under the curve for distinguishing benign from malignant tumors was 0.80 with a cutoff ADC of 1.29 × 10-3 mm²/s. CONCLUSION TSE-DWI produced better quality images than EPI-DWI. TSE-DWI yields the high possibility of obtaining ADC in the orofacial region, and this value was considered useful for the differential diagnosis of orofacial lesions.
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Affiliation(s)
- Wannakamon Panyarak
- Graduate School of Dental Science, Kyushu University, Fukuoka, Japan; Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
| | - Toru Chikui
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yasuo Yamashita
- Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Takeshi Kamitani
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazunori Yoshiura
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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15
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Payabvash S. Quantitative diffusion magnetic resonance imaging in head and neck tumors. Quant Imaging Med Surg 2018; 8:1052-1065. [PMID: 30598882 DOI: 10.21037/qims.2018.10.14] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In patients with head and neck cancer, conventional anatomical magnetic resonance imaging (MRI) scans are commonly used for identification of primary lesion, assessment of structural distortion, and presence of metastatic lymph nodes. However, quantitative analysis of diffusion MRI can provide added value to structural and anatomical evaluation of head and neck tumors (HNT), by differentiation of primary malignant process, prognostic prediction, and treatment monitoring. In this article, we will review the applications of quantitative diffusion MRI in identification of primary malignant tissue, differentiation of tumor pathology, prediction of molecular phenotype, monitoring of treatment response, and evaluation of posttreatment changes in patient with HNT.
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Affiliation(s)
- Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
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16
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Ogura I, Sasaki Y, Kameta A, Sue M, Oda T. Diffusion-Weighted Imaging in the Oral and Maxillofacial Region: Usefulness of Apparent Diffusion Coefficient Maps and Maximum Intensity Projection for Characterization of Normal Structures and Lesions. Pol J Radiol 2018; 82:571-577. [PMID: 29657621 PMCID: PMC5894033 DOI: 10.12659/pjr.902524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/25/2016] [Indexed: 01/07/2023] Open
Abstract
Background The aim of this study was to investigate diffusion-weighted imaging (DWI) in the oral and maxillofacial region, with a special focus on the usefulness of apparent diffusion coefficient (ADC) maps and maximum intensity projection (MIP) for characterization of normal structures and lesions. Material/Methods Thirty-five patients who underwent magnetic resonance imaging (MRI) for diagnosis of oral and maxillofacial lesions were included in this prospective study. DWI was performed on a 1.5 T unit, with b factor of 0 and 800 s/mm2; moreover, ADC maps were generated. ADC values were measured for normal structures, odontogenic infections, squamous cell carcinomas (SCC), and hemangiomas. Results As regards the normal structures, the mean ADC value of the cerebrospinal fluid (3.65±0.60×10–3 mm2/s) in the upper neck area was higher than that of the spinal cord (0.74±0.15×10–3 mm2/s, P=0.000), lymph nodes (0.87±0.17×10–3 mm2/s, P=0.000), and Waldeyer’s ring (0.92±0.29×10–3 mm2/s, P=0.000). The mean ADC value of hemangiomas (1.52±0.31×10–3 mm2/s) was higher than that of odontogenic infections (0.85±0.36×10–3 mm2/s, P=0.034) and SCC (1.38±0.22×10–3 mm2/s, P=0.840). Furthermore, MIP (DWI) showed the normal structures and lesions in the oral and maxillofacial region in an improved way. Conclusions DWI, ADC maps, and MIP can be used to characterize and differentiate normal structures and lesions in the oral and maxillofacial region.
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Affiliation(s)
- Ichiro Ogura
- Department of Radiology, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Yoshihiko Sasaki
- Department of Radiology, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Ayako Kameta
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Mikiko Sue
- Department of Radiology, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Takaaki Oda
- Department of Radiology, The Nippon Dental University Niigata Hospital, Niigata, Japan
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17
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Oda T, Sue M, Sasaki Y, Ogura I. Diffusion-weighted magnetic resonance imaging in oral and maxillofacial lesions: preliminary study on diagnostic ability of apparent diffusion coefficient maps. Oral Radiol 2017; 34:224-228. [PMID: 30484031 DOI: 10.1007/s11282-017-0303-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 08/02/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the usefulness of diffusion-weighted magnetic resonance imaging (DWI) in oral and maxillofacial lesions, especially the utility of apparent diffusion coefficient (ADC) maps for differential diagnosis of these lesions. METHODS Fifty-seven patients who underwent magnetic resonance imaging for diagnosis of oral and maxillofacial lesions were included in this prospective study. DWI was performed on a 1.5 T unit with b-factors of 0 and 800 s/mm2, and ADC maps were generated. ADC values were measured for all 57 oral and maxillofacial lesions (19 squamous cell carcinoma, 10 medication-related osteonecrosis of the jaw, 6 odontogenic abscess, 4 ranula, 4 osteoradionecrosis, 4 hemangioma, 3 pleomorphic adenoma, 3 odontogenic keratocyst, 2 nasopalatine duct cyst, 1 malignant melanoma, and 1 basal cell carcinoma). RESULTS The mean ADC values for ranula (2.69 ± 0.59 × 10-3 mm2/s) and nasopalatine duct cyst (2.34 ± 0.12 × 10-3 mm2/s) were significantly higher than those for the other oral and maxillofacial lesions (p = 0.000). In contrast, the mean ADC value for odontogenic abscess (0.67 ± 0.36 × 10-3 mm2/s) was significantly lower than those for the other oral and maxillofacial lesions (p = 0.000). CONCLUSIONS The present study suggests the usefulness of DWI in oral and maxillofacial lesions, especially the utility of ADC maps for differential diagnosis of these lesions.
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Affiliation(s)
- Takaaki Oda
- Department of Radiology, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan.
| | - Mikiko Sue
- Department of Radiology, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
| | - Yoshihiko Sasaki
- Department of Radiology, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
| | - Ichiro Ogura
- Department of Radiology, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, Niigata, 951-8580, Japan
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18
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Schakel T, Hoogduin JM, Terhaard CHJ, Philippens MEP. Technical Note: Diffusion-weighted MRI with minimal distortion in head-and-neck radiotherapy using a turbo spin echo acquisition method. Med Phys 2017; 44:4188-4193. [PMID: 28543364 DOI: 10.1002/mp.12363] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 05/18/2017] [Accepted: 05/18/2017] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Diffusion-weighted (DW) MRI, showing high contrast between tumor and background tissue, is a promising technique in radiotherapy for tumor delineation. However, its use for head-and-neck patients is hampered by poor geometric accuracy in conventional echo planar imaging (EPI) DW-MRI. An alternative turbo spin echo sequence, DW-SPLICE, is implemented and demonstrated in patients. METHODS The DW-SPLICE sequence was implemented on a 3.0 T system and evaluated in 10 patients. The patients were scanned in treatment position, using a customized head support and immobilization mask. Image distortions were quantified at the gross tumor volume (GTV) using field map analysis. The apparent diffusion coefficient (ADC) was evaluated using an ice water phantom. RESULTS The DW images acquired by DW-SPLICE showed no image distortions. Field map analysis at the gross tumor volumes resulted in a median distortion of 0.2 mm for DW-SPLICE, whereas for the conventional method this was 7.2 mm. ADC values, measured using an ice water phantom were in accordance with literature values. CONCLUSIONS The implementation of DW-SPLICE allows for diffusion-weighted imaging of patients in treatment position with excellent geometrical accuracy. The images can be used to facilitate target volume delineation in RT treatment planning.
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Affiliation(s)
- Tim Schakel
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Johannes M Hoogduin
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marielle E P Philippens
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Tao X, Yang G, Wang P, Wu Y, Zhu W, Shi H, Gong X, Gao W, Yu Q. The value of combining conventional, diffusion-weighted and dynamic contrast-enhanced MR imaging for the diagnosis of parotid gland tumours. Dentomaxillofac Radiol 2017; 46:20160434. [PMID: 28299943 DOI: 10.1259/dmfr.20160434] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine the value of combining conventional MRI, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE)-MRI in diagnosing solid neoplasms in the parotid gland. METHODS A total of 148 subjects (101 subjects with benign and 47 subjects with malignant tumours) were evaluated with conventional MRI, DWI and DCE-MRI prior to surgery and pathologic verification. The items observed with conventional MRI included the shape, capsule and signal intensity of parotid masses. The apparent diffusion coefficient (ADC) was calculated from DWI that was obtained with a b-factor of 0 and 1000 s mm-2. A time-intensity curve (TIC) was obtained from DCE-MRI. RESULTS There were significant differences (p < 0.01) in the shape, capsule, ADC and TIC between benign and malignant parotid tumours. Irregular neoplasms without a capsule, ADC <1.12 × 10-3 mm2 s-1 and a plateau enhancement pattern were valuable parameters for predicting malignant neoplasms. A combination of all of these parameters yielded sensitivity, specificity, accuracy, positive-predictive value and negative-predictive value of 85.1%, 94.1%, 91.2%, 87.0% and 93.1%, respectively. CONCLUSIONS A combined analysis using conventional MRI, DWI and DCE-MRI is helpful in distinguishing benign from malignant tumours in the parotid gland.
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Affiliation(s)
- Xiaofeng Tao
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Gongxin Yang
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pingzhong Wang
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingwei Wu
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjing Zhu
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Huimin Shi
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Gong
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weiqing Gao
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiang Yu
- Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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20
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El-Gerby KM, El-Anwar MW. Differentiating Benign from Malignant Sinonasal Lesions: Feasibility of Diffusion Weighted MRI. Int Arch Otorhinolaryngol 2017; 21:358-365. [PMID: 29018499 PMCID: PMC5629089 DOI: 10.1055/s-0036-1597323] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/06/2016] [Indexed: 01/20/2023] Open
Abstract
Introduction
Appearance of nasal masses on routine CT and MRI are not pathognomonic. We utilized the apparent diffusion coefficient (ADC) value obtained from diffusion weighted image (DWI) to detect the differences in the microstructures of tumor and non-tumor tissues.
Objective
The objective of our study was to evaluate the diagnostic role of DWI and ADC values in differentiating between malignant and benign sinonasal lesions and its correlation with histopathological results as the reference standard.
Methods
Patients with nasal and / or paranasal mass underwent CT, MRI, and DWI before any surgical intervention. We used diagnostic sinonasal endoscopy and biopsy to confirm the diagnosis after MRI.
Results
When we used ADC value of (1.2 × 10–3 mm2/s) as a cut-off value for differentiating benign from malignant sinonasal lesions, we achieved 90% accuracy, 100% sensitivity, 88.4% specificity, 77.8% positive predictive value, and 100% negative predictive value. At this cut-off, benign lesions show statistically significant higher ADC value than malignant tumors.
Conclusion
DW MRI and ADC value calculation are promising quantitative methods helping to differentiate between malignant and benign sinonasal lesions. Thus, they are effective methods compared with other conventional methods with short imaging time thus it is recommended to be incorporated into routine evaluations.
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Affiliation(s)
- Khaled M El-Gerby
- Radiodiagnosis Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohammad Waheed El-Anwar
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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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: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Şerifoğlu İ, Oz İİ, Damar M, Tokgöz Ö, Yazgan Ö, Erdem Z. Diffusion-weighted imaging in the head and neck region: usefulness of apparent diffusion coefficient values for characterization of lesions. Diagn Interv Radiol 2016; 21:208-14. [PMID: 25910284 DOI: 10.5152/dir.2014.14279] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE We aimed to evaluate the role of apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging for head and neck lesion characterization in daily routine, in comparison with histopathological results. METHODS Ninety consecutive patients who underwent magnetic resonance imaging (MRI) at a university hospital for diagnosis of neck lesions were included in this prospective study. Diffusion-weighted echo-planar MRI was performed on a 1.5 T unit with b factor of 0 and 1000 s/mm2 and ADC maps were generated. ADC values were measured for benign and malignant whole lesions seen in daily practice. RESULTS The median ADC value of the malignant tumors and benign lesions were 0.72×10-3 mm2/s, (range, 0.39-1.51×10-3 mm2/s) and 1.17×10-3 mm2/s, (range, 0.52-2.38×10-3 mm2/s), respectively, with a significant difference between them (P < 0.001). A cutoff ADC value of 0.98×10-3 mm2/s was used to distinguish between benign and malignant lesions, yielding 85.3% sensitivity and 78.6% specificity. The median ADC value of lymphomas (0.44×10-3 mm2/s; range, 0.39-0.58×10-3 mm2/s) was significantly smaller (P < 0.001) than that of squamous cell carcinomas (median ADC value 0.72×10-3 mm2/s; range, 0.65-1.06×10-3 mm2/s). There was no significant difference between median ADC values of inflammatory (1.13×10-3 mm2/s; range, 0.85-2.38×10-3 mm2/s) and noninflammatory benign lesions (1.26×10-3 mm2/s; range, 0.52-2.33×10-3 mm2/s). CONCLUSION Diffusion-weighted imaging and the ADC values can be used to differentiate and characterize benign and malignant head and neck lesions.
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Affiliation(s)
- İsmail Şerifoğlu
- Department of Radiology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey.
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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: 0.9] [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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Li S, Cheng J, Zhang Y, Zhang Z. Differentiation of benign and malignant lesions of the tongue by using diffusion-weighted MRI at 3.0 T. Dentomaxillofac Radiol 2015; 44:20140325. [PMID: 25823772 DOI: 10.1259/dmfr.20140325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Diffusion-weighted MRI (DWI) has been introduced in head and neck lesions and adds important information to the findings obtained through conventional MRI. The purpose of this study was to assess the role of DWI in differentiating benign and malignant lesions of the tongue at 3.0-T field strength imaging. METHODS 78 patients with 78 lingual lesions underwent conventional MRI and DWI with b-values of 0 and 1000 s mm(-2) before therapy. The apparent diffusion coefficient (ADC) maps were reconstructed, and the ADC values of the lingual lesions were calculated and compared between benign and malignant lesions of the tongue. RESULTS The mean ADC values of the malignant tumours, benign solid lesions and cystic lesions were (1.08±0.16)×10(-3), (1.68±0.33)×10(-3) and (2.21±0.35)×10(-3) mm2 s(-1), respectively. The mean ADC values of malignant tumours were significantly lower (p<0.001) than those of benign solid lesions, and the mean ADC values of benign solid lesions were significantly lower (p<0.001) than those of cystic lesions. Receiver operating characteristic analysis showed that when an ADC value<.31×10(-3) mm2 s(-1) was used for predicting malignancy, the highest accuracy of 95.3%, sensitivity of 92.6% and specificity of 97.3% were obtained. CONCLUSIONS ADC values of benign and malignant lesions are significantly different at 3.0-T imaging. DWI can be applied as a complementary tool in the differentiation of benign and malignant lesions of the tongue.
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Affiliation(s)
- S Li
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - J Cheng
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Y Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Z Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Sakamoto J, Imaizumi A, Sasaki Y, Kamio T, Wakoh M, Otonari-Yamamoto M, Sano T. Comparison of accuracy of intravoxel incoherent motion and apparent diffusion coefficient techniques for predicting malignancy of head and neck tumors using half-Fourier single-shot turbo spin-echo diffusion-weighted imaging. Magn Reson Imaging 2014; 32:860-6. [PMID: 24832359 DOI: 10.1016/j.mri.2014.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 03/27/2014] [Accepted: 05/03/2014] [Indexed: 12/23/2022]
Abstract
PURPOSE To evaluate the use of the intravoxel incoherent motion (IVIM) technique in half-Fourier single-shot turbo spin-echo (HASTE) diffusion-weighted imaging (DWI), and to compare its accuracy to that of apparent diffusion coefficient (ADC) to predict malignancy in head and neck tumors. PATIENTS AND METHODS HASTE DW images of 33 patients with head and neck tumors (10 benign and 23 malignant) were evaluated. Using the IVIM technique, parameters (D, true diffusion coefficient; f, perfusion fraction; D*, pseudodiffusion coefficient) were calculated for each tumor. ADC values were measured over a range of b values from 0 to 1000s/mm(2). IVIM parameters and ADC values in benign and malignant tumors were compared using Student's t test, receiver operating characteristics (ROC) analysis, and multivariate logistic regression modeling. RESULTS Mean ADC and D values of malignant tumors were significantly lower than those of benign tumors (P<0.05). Mean D* values of malignant tumors were significantly higher than those of benign tumors (P<0.05). There was no significant difference in mean f values between malignant and benign tumors (P>0.05). The technique of combining D and D* was the best for predicting malignancy; accuracy for this model was higher than that for ADC. CONCLUSIONS The IVIM technique may be applied in HASTE DWI as a diagnostic tool to predict malignancy in head and neck masses. The use of D and D* in combination increases the diagnostic accuracy in comparison with ADC.
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Affiliation(s)
- Junichiro Sakamoto
- Oral and Maxillofacial Radiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan; Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Akiko Imaizumi
- Oral and Maxillofacial Radiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan.
| | - Yoshinori Sasaki
- Oral and Maxillofacial Radiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan.
| | - Takashi Kamio
- Oral and Maxillofacial Radiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan.
| | - Mamoru Wakoh
- Oral and Maxillofacial Radiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan.
| | - Mika Otonari-Yamamoto
- Oral and Maxillofacial Radiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan.
| | - Tsukasa Sano
- Oral and Maxillofacial Radiology, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan; Division of Radiology, Dept. of Oral Diagnostic Sciences, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan.
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Chen X, Xian J, Wang X, Wang Y, Zhang Z, Guo J, Li J. Role of periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted imaging in correcting distortion and evaluating head and neck masses using 3 T MRI. Clin Radiol 2014; 69:403-9. [DOI: 10.1016/j.crad.2013.11.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/25/2013] [Accepted: 11/07/2013] [Indexed: 01/18/2023]
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Driessen JP, van Kempen PMW, van der Heijden GJ, Philippens MEP, Pameijer FA, Stegeman I, Terhaard CHJ, Janssen LM, Grolman W. Diffusion-weighted imaging in head and neck squamous cell carcinomas: A systematic review. Head Neck 2014; 37:440-8. [DOI: 10.1002/hed.23575] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 11/17/2013] [Accepted: 12/10/2013] [Indexed: 12/24/2022] Open
Affiliation(s)
- Juliette P. Driessen
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Rudolf Magnus Institute of Neuroscience; Utrecht The Netherlands
| | - Paulina M. W. van Kempen
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Geert J. van der Heijden
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht; Utrecht The Netherlands
| | | | - Frank A. Pameijer
- Department of Radiology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Rudolf Magnus Institute of Neuroscience; Utrecht The Netherlands
| | - Chris H. J. Terhaard
- Department of Radiotherapy; University Medical Center Utrecht; Utrecht The Netherlands
| | - Luuk M. Janssen
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht The Netherlands
- Rudolf Magnus Institute of Neuroscience; Utrecht The Netherlands
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Maehara M, Ikeda K, Kurokawa H, Ohmura N, Ikeda S, Hirokawa Y, Maehara S, Utsunomiya K, Tanigawa N, Sawada S. Diffusion-weighted echo-planar imaging of the head and neck using 3-T MRI: Investigation into the usefulness of liquid perfluorocarbon pads and choice of optimal fat suppression method. Magn Reson Imaging 2014; 32:440-5. [PMID: 24582547 DOI: 10.1016/j.mri.2014.01.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 11/27/2013] [Accepted: 01/13/2014] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate whether image quality can be improved using liquid perfluorocarbon pads (Sat Pad) and clarify the optimal fat-suppression method among chemical shift selective (CHESS), water excitation (WEX), and short TI inversion recovery (STIR) methods in diffusion-weighted imaging (DWI) of the head and neck using 3-T magnetic resonance imaging. Correlations between results of visual inspection and quantitative analysis were also examined. MATERIAL AND METHODS This study was approved by our Institutional Review Board and informed consent was waived. DWI was performed on 25 subjects with/without Sat Pad and using three fat-suppression methods (6 patterns). Image quality was evaluated visually (4-point scales and lesion-depiction capability) and by quantitative analysis (signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)). Two-way repeated-measures analysis of variance (ANOVA) was used to detect significant differences in scores of visual evaluation, SNR, and CNR. RESULTS Mean visual evaluation scores were significantly higher with Sat Pad using STIR than without Sat Pad for all fat-suppression methods (P<0.05). DWI with Sat Pad using STIR tended to be useful for depicting lesions. DWI using STIR showed reduced W-SNR (W: whole area of depicted structure) and CNR (between semispinalis capitis muscle and subcutaneous fat) due to fewer artifacts and uniform fat suppression. CONCLUSION Combining Sat Pad with STIR provides good image quality for visual inspections. When numerous artifacts are present and fat suppression is insufficient, higher SNR and CNR do not always provide good diagnostic image quality.
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Affiliation(s)
- Minoru Maehara
- Department of Radiology, Kansai Medical University Hirakata Hospital, Osaka 573-1010, Japan.
| | - Koshi Ikeda
- Department of Radiology, Kansai Medical University Takii Hospital, Osaka 570-8507, Japan
| | - Hiroaki Kurokawa
- Department of Radiology, Kansai Medical University Hirakata Hospital, Osaka 573-1010, Japan
| | - Naoto Ohmura
- Department of Radiology, Kansai Medical University Kori Hospital, Osaka 572-8551, Japan
| | - Shigeki Ikeda
- Department of Radiology, Kansai Medical University Hirakata Hospital, Osaka 573-1010, Japan
| | - Yuzo Hirokawa
- Department of Radiology, Kansai Medical University Hirakata Hospital, Osaka 573-1010, Japan
| | - Saori Maehara
- Department of Radiology, Kansai Medical University Hirakata Hospital, Osaka 573-1010, Japan
| | - Keita Utsunomiya
- Department of Radiology, Kansai Medical University Takii Hospital, Osaka 570-8507, Japan
| | - Noboru Tanigawa
- Department of Radiology, Kansai Medical University Hirakata Hospital, Osaka 573-1010, Japan
| | - Satoshi Sawada
- Department of Radiology, Kansai Medical University Hirakata Hospital, Osaka 573-1010, Japan
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Xu ZF, Yong F, Yu T, Chen YY, Gao Q, Zhou T, Pan AZ, Wu RH. Different histological subtypes of parotid gland tumors: CT findings and diagnostic strategy. World J Radiol 2013; 5:313-320. [PMID: 24003357 PMCID: PMC3758499 DOI: 10.4329/wjr.v5.i8.313] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/22/2013] [Accepted: 08/01/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To present computed tomography (CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.
METHODS: From January 2009 to November 2011, 56 patients were collected through the histopathology and Picture Archiving and Communication Systems records, which revealed 5 basal cell adenoma (BCA), 16 pleomorphic adenoma (PA), 25 Warthin’s tumor (War-T), 3 Kimura’s disease (KD) and 7 parotid carcinoma (PCa) cases. All the CT images were retrospectively analyzed by two radiologists in consensus, based on their description of morphology (location, number, size, margin and fibrous capsule) and enhancement patterns of masses. In addition, the diagnostic efficiency of diagnostic strategy is tested.
RESULTS: War-T and BCA patients’ mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years; the significant difference was seen in War-T vs PA and BCA vs PA. About 40% of War-Ts presented with bilateral multifocal lesions, a higher ratio than others. Seventy two percent of War-Ts were limited to the superficial lobe, followed by BCA 60% and PA 40%. Vessel facing sign and enlarged lymph nodes were both frequent in War-T, which respectively accounts for 84% and 76% of cases. Rapid contrast enhancement and decreases were unique for War-T. BCA and PA showed obvious delayed enhancement. The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency, with high accuracy, sensitivity and specificity.
CONCLUSION: Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data. A diagnostic strategy with high diagnostic efficiency was established.
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Yang RM, Li L, Wei XH, Guo YM, Huang YH, Lai LS, Chen AM, Liu GS, Xiong WF, Luo LP, Jiang XQ. Differentiation of central lung cancer from atelectasis: comparison of diffusion-weighted MRI with PET/CT. PLoS One 2013; 8:e60279. [PMID: 23593186 PMCID: PMC3617228 DOI: 10.1371/journal.pone.0060279] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 02/24/2013] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Prospectively assess the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiation of central lung cancer from atelectasis. MATERIALS AND METHODS 38 consecutive lung cancer patients (26 males, 12 females; age range: 28-71 years; mean age: 49 years) who were referred for thoracic MR imaging examinations were enrolled. MR examinations were performed using a 1.5-T clinical scanner and scanning sequences of T1WI, T2WI, and DWI. Cancers and atelectasis were measured by mapping of the apparent diffusion coefficients (ADCs) obtained with a b-value of 500 s/mm(2). RESULTS PET/CT and DW-MR allowed differentiation of tumor and atelectasis in all 38 cases, but T2WI did not allow differentiation in 9 cases. Comparison of conventional T2WI and DW-MRI indicated a higher contrast noise ratio of the central lung carcinoma than the atelectasis by DW-MRI. ADC maps indicated significantly lower mean ADC in the central lung carcinoma than in the atelectasis (1.83±0.58 vs. 2.90±0.26 mm(2)/s, p<0.0001). ADC values of small cell lung carcinoma were significantly greater than those from squamous cell carcinoma and adenocarcinoma (p<0.0001 for both). CONCLUSIONS DW-MR imaging provides valuable information not obtained by conventional MR and may be useful for differentiation of central lung carcinoma from atelectasis. Future developments may allow DW-MR imaging to be used as an alternative to PET-CT in imaging of patients with lung cancer.
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Affiliation(s)
- Rui-Meng Yang
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Long Li
- Department of Radiology, Guangdong Provincial Corps Hospital, Chinese People’s Armed Police, Guangzhou, China
| | - Xin-Hua Wei
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Yong-Mei Guo
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Yun-Hai Huang
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Li-Sha Lai
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - A-Mei Chen
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Guo-Shun Liu
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Wei-Feng Xiong
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Liang-Ping Luo
- Department of Radiology, The First Clinic Medical College, Jinan University, Guangzhou, China
- * E-mail: (LPL); (XQJ)
| | - Xin-Qing Jiang
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
- * E-mail: (LPL); (XQJ)
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Ilica AT, Artaş H, Ayan A, Günal A, Emer O, Kilbas Z, Meric C, Atasoy MM, Uzuner O. Initial experience of 3 tesla apparent diffusion coefficient values in differentiating benign and malignant thyroid nodules. J Magn Reson Imaging 2012; 37:1077-82. [DOI: 10.1002/jmri.23913] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 09/26/2012] [Indexed: 12/31/2022] Open
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Sakamoto J, Sasaki Y, Otonari-Yamamoto M, Sano T. Comparison of various methods for quantification of apparent diffusion coefficient of head and neck lesions with HASTE diffusion-weighted MR imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:266-76. [DOI: 10.1016/j.oooo.2012.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 03/07/2012] [Accepted: 03/12/2012] [Indexed: 01/29/2023]
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Diffusion-weighted imaging of the head and neck with HASTE: influence of imaging parameters on image quality. Oral Radiol 2012. [DOI: 10.1007/s11282-012-0091-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fruehwald-Pallamar J, Czerny C, Mayerhoefer ME, Halpern BS, Eder-Czembirek C, Brunner M, Schuetz M, Weber M, Fruehwald L, Herneth AM. Functional imaging in head and neck squamous cell carcinoma: correlation of PET/CT and diffusion-weighted imaging at 3 Tesla. Eur J Nucl Med Mol Imaging 2011; 38:1009-19. [PMID: 21465255 DOI: 10.1007/s00259-010-1718-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Accepted: 12/16/2010] [Indexed: 12/20/2022]
Abstract
PURPOSE The purposes of this study were: (a) to prospectively assess the correlation between apparent diffusion coefficient (ADC) values and maximum standardized uptake values (SUVmax) in patients with head and neck squamous cell carcinomas (SCC); and (b) to assess ADC and SUVmax values in relation to different tumour grades and stages in our patient population. METHODS The study group comprised 31 consecutive patients with biopsy-proven head and neck squamous cell carcinoma who were examined using a 3T MRI scanner with a 16-channel head and neck coil. In addition to routine sequences, axial (DWIBS) and sagittal (DW-EPI) diffusion-weighted sequences were obtained using b-values of 0 mm(2)/s and 800 mm(2)/s. The ADC maps were calculated automatically. The ADC values of the tumours were measured with three regions of interest (ROIs) of standard size, and an ROI covering the entire tumour. In all patients, contrast-enhanced, whole-body (18)F-FDG PET/CT was performed within 2 weeks of the MRI examination. SUVmax was measured for every tumour using a 3-D freehand ROI that covered the entire tumour. Two-way repeated measures ANOVA was used for group comparisons. The Spearman rank correlation test was performed for ADC values. RESULTS Mean ADC values in the 31 SCC were 0.902 (± 0.134) with a ROI of standard size, and 0.928 (± 0.160) with the large ROI measurements on the axial DWIBS sequence. The ADC values of the tumours were significantly higher when measured with the sagittal DW-EPI sequence: 1.051 (± 0.211) and 1.082 (± 0.208). We observed no significant differences in ADC values and SUVmax between the various T stages or histological grades of the tumours. SUVmax values (26.5 ± 12) did not correlate with ADC values on DWIBS or EPI. CONCLUSION There is no correlation between the FDG uptake and the ADC value in head and neck SCC. The three different tumour grades and four tumour stages present in our study population could not be differentiated based on ADC values or SUV.
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Affiliation(s)
- Julia Fruehwald-Pallamar
- Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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Evaluation of solid lesions affecting masticator space with diffusion-weighted MR imaging. ACTA ACUST UNITED AC 2010; 109:900-7. [DOI: 10.1016/j.tripleo.2010.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/23/2009] [Accepted: 01/07/2010] [Indexed: 11/18/2022]
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Dietrich O, Biffar A, Baur-Melnyk A, Reiser MF. Technical aspects of MR diffusion imaging of the body. Eur J Radiol 2010; 76:314-22. [PMID: 20299172 DOI: 10.1016/j.ejrad.2010.02.018] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 02/23/2010] [Indexed: 02/06/2023]
Abstract
In diffusion-weighted magnetic resonance imaging (DWI), the intensity of the acquired magnetic resonance signal depends on the self-diffusion of the excited spins, i.e., on the microscopic stochastic Brownian molecular motion. Since the extent and orientation of molecular motion is influenced by the microscopic structure and organization of biological tissues, DWI can depict various pathological changes of organs or tissues. While DWI of the brain can be considered an established technique since the mid-1990s, significantly fewer studies have been published about DWI in body imaging, mainly because of the relatively low robustness of conventional DWI methods in non-neurological applications. Consequently, the image quality in such applications was rather limited. This situation, however, improved considerably in recent years due to better hardware as well as new pulse sequences, and several new applications of DWI (e.g., in the abdominal organs, in musculoskeletal applications, or in whole-body protocols) have been described. Unfortunately, DWI of the body is complicated by frequently low signal-to-noise ratios due to shorter transversal (T2) relaxation times and by strong variations of susceptibility. The latter result in severe distortion artifacts when standard echo-planar DWI techniques are applied. Hence, several alternative (non-echo-planar) diffusion-weighting pulse sequence types were proposed and evaluated for DWI applications in the body. In this review article, first the basics of molecular diffusion and of diffusion-weighted MRI are introduced and then several specific MRI techniques, which have been used for DWI of the body, are described. Finally, protocol recommendations for different DWI applications in the body are provided.
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Affiliation(s)
- Olaf Dietrich
- Josef Lissner Laboratory for Biomedical Imaging, Department of Clinical Radiology - Grosshadern, LMU Ludwig Maximilian University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
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Imaging findings in craniofacial childhood rhabdomyosarcoma. Pediatr Radiol 2010; 40:1723-38; quiz 1855. [PMID: 20725831 PMCID: PMC2950273 DOI: 10.1007/s00247-010-1787-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 06/07/2010] [Accepted: 06/14/2010] [Indexed: 12/12/2022]
Abstract
Rhabdomyosarcoma (RMS) is the commonest paediatric soft-tissue sarcoma constituting 3-5% of all malignancies in childhood. RMS has a predilection for the head and neck area and tumours in this location account for 40% of all childhood RMS cases. In this review we address the clinical and imaging presentations of craniofacial RMS, discuss the most appropriate imaging techniques, present characteristic imaging features and offer an overview of differential diagnostic considerations. Post-treatment changes will be briefly addressed.
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Chawla S, Kim S, Wang S, Poptani H. Diffusion-weighted imaging in head and neck cancers. Future Oncol 2009; 5:959-75. [PMID: 19792966 DOI: 10.2217/fon.09.77] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
This article reviews the utility of diffusion-weighted imaging (DWI) in the diagnosis, prognosis and monitoring of treatment response in tumors arising in the head and neck region. The apparent diffusion coefficient (ADC) value, determined from DWI, can help in cancer staging and detection of subcentimeter nodal metastasis. The ADC value also discriminates carcinomas from lymphomas, benign lesions from malignant tumors and tumor necrosis from abscesses. Low pretreatment ADC values typically predict a favorable response to chemoradiation therapy. These promising reports indicate the potential of DWI as a potential biomarker for diagnosis and monitoring of treatment response in head and neck cancers. In view of the overlapping ADC values between different salivary gland tumors, care should be taken when interpreting these results and other imaging parameters should be considered for a better diagnosis. Susceptibility and motion-induced artifacts may sometimes degrade DWI image quality; however, novel techniques are being developed to overcome these drawbacks.
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Affiliation(s)
- Sanjeev Chawla
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
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Assessment of nasal and paranasal sinus masses by diffusion-weighted MR imaging. J Neuroradiol 2009; 36:206-11. [PMID: 19577300 DOI: 10.1016/j.neurad.2009.06.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2009] [Revised: 06/03/2009] [Accepted: 06/04/2009] [Indexed: 11/22/2022]
Abstract
PURPOSE To assess nasal and paranasal sinus masses by diffusion-weighted echoplanar magnetic resonance imaging (MRI). PATIENTS AND METHODS This prospective study included 55 consecutive patients (34 males, 21 females; aged 14-64 years, mean 39 years) with nasal and paranasal sinus masses. All underwent diffusion-weighted MRI using single-shot echoplanar imaging (EPI) with a b factor of 0.500 and 1000 s/mm2. Apparent diffusion coefficient (ADC) maps were constructed, allowing ADC values of the mass to be calculated and correlated with histopathological findings. RESULTS The mean ADC value of nasal and paranasal sinus malignant lesions (1.10+/-0.25x10(-3) mm2/s) was significantly different (P=0.001) from that of benign lesions (1.78+/-0.41x10(-3) mm2/s). Also, there was a significant ADC difference between carcinoma and sarcoma (P=0.01) as well as between well differentiated and poorly differentiated malignancies (P=0.005). Using an ADC value of 1.53x10(-3) mm2/s as the threshold value for differentiating malignant from benign lesions, the best result obtained had an accuracy of 93%, sensitivity of 94%, specificity of 92%, a positive predictive value of 92% and negative predictive value of 94%. However, the use of 0.97x10(-3) mm2/s and 1.16x10(-3) mm2/s as threshold values to differentiate carcinomas from sarcomas and poorly differentiated malignancy, respectively, gave the best results. CONCLUSION The ADC value is a non-invasive imaging parameter that can be used to assess nasal and paranasal sinus masses, as it can help in the differentiation of malignant tumors from benign lesions, and in the characterization and grading of malignancies.
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