RT Journal Article
SR Electronic
T1 Discrimination of Metastatic Cervical Lymph Nodes with Diffusion-Weighted MR Imaging in Patients with Head and Neck Cancer
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1627
OP 1634
VO 24
IS 8
A1 Sumi, Misa
A1 Sakihama, Noriyuki
A1 Sumi, Tadateru
A1 Morikawa, Minoru
A1 Uetani, Masataka
A1 Kabasawa, Hiroyuki
A1 Shigeno, Koichiro
A1 Hayashi, Kuniaki
A1 Takahashi, Haruo
A1 Nakamura, Takashi
YR 2003
UL http://www.ajnr.org/content/24/8/1627.abstract
AB BACKGROUND AND PURPOSE: Metastasis to the regional cervical lymph nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic nodes.METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic cervical lymph nodes (25 nodes), benign lymphadenopathy (25 nodes), and nodal lymphomas (five nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm2).RESULTS: The ADC was significantly greater in metastatic lymph nodes (0.410 ± 0.105 × 10−3 mm2/s, P < .01) than in benign lymphadenopathy (0.302 ± 0.062 × 10−3 mm2/s). Nodal lymphomas showed even lower levels of the ADC (0.223 ± 0.056 × 10−3 mm2/s). ADC criteria for metastatic nodes (≥ 0.400 × 10−3 mm2/s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (Az = 0.8437 ± 0.0230) and ADC (Az = 0.8440 ± 0.0538) provided similar levels of diagnostic ability in differentiating metastatic nodes. The ADC from metastatic nodes from highly or moderately differentiated cancers (0.440 ± 0.020 × 10−3 mm2/s, P < .01) was significantly greater than that from poorly differentiated cancers (0.356 ± 0.042 × 10−3 mm2/s).CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic nodes.