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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:1146-1152, June-July 2007
DOI 10.3174/ajnr.A0491
© 2007 American Society of Neuroradiology

HEAD & NECK

Role of Diffusion-Weighted Echo-Planar MR Imaging in Differentiation of Residual or Recurrent Head and Neck Tumors and Posttreatment Changes

A.A.K. Abdel Razek^a, A.Y. Kandeel^a, N. Soliman^a, H.M. El-shenshawy^b, Y. Kamel^c, N. Nada^e and A. Denewar^d

^a Departments of Diagnostic Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
^b Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
^c ENT and Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
^d Oncology Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
^e Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Address correspondence to Ahmed Abdel Khalek Abdel Razek, Diagnostic Radiology Department, Mansoura Faculty of Medicine, 62 El Nokrasi St, Mansoura, Egypt; e-mail: arazek{at}mans.eun.eg

BACKGROUND AND PURPOSE: The purpose of this work was to evaluate whether diffusion-weighted MR imaging can be used in differentiating residual or recurrent head and neck tumors from postoperative or postradiation changes.

MATERIALS AND METHODS: This study included 32 patients clinically suspected for recurrent head and neck tumor after surgery (n=3), radiation therapy (n=13), or both (n=16). Diffusion-weighted MR imaging was done by using a single-shot spin-echo echo-planar sequence. The apparent diffusion coefficient (ADC) value of the suspected lesion was calculated and correlated with pathologic results.

RESULTS: Adequate diffusion-weighted MR images and ADC maps were obtained in 30 patients (93.8%). The mean ADC value of residual or recurrent lesions (1.17 ± 0.33 x 10^–3 mm²/s) was less than that of posttherapeutic changes (2.07 ± 0.25 x 10^–3 mm²/s), and the difference was statistically significant (P < .001). When an ADC value of 1.30 x 10^–3 mm²/s was used as a threshold value for differentiation, the best results were obtained with an accuracy of 87%, sensitivity of 84%, specificity of 90%, positive predictive value of 94%, and negative predictive value of 76%.

CONCLUSIONS: Diffusion-weighted MR imaging with ADC measurement has promising results for differentiating residual or recurrent head and neck tumors from postoperative or postradiation changes.

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