Diagnostic value of diffusion-weighted magnetic resonance imaging for solid tumors affecting the base of tongue and glossopharynx

doi:10.19439/j.sjos.2017.04.019

Abstract

Abstract: The objective of the present study was to evaluate the potential application value of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate solid benign from malignant tumors affecting the base of tongue and glossopharynx. METHODS: Sixty-one patients who presented with solid tumors affecting the base of tongue and glossopharynx underwent conventional MRI and DW-MRI before pathologic verification. Based on pathologic findings, the tumors were classified into 4 groups: Group 1, solid benign tumor (n=10); Group 2, epithelial carcinoma (n=35); Group 3: non- epithelial malignant tumor (n=16); and Group 4: malignant tumor (n=51, a combination of Group 2 and 3). The mean apparent diffusion coefficients (ADCs) were computed from DW-MRI scans obtained with b factors of 0 and 1000 s/mm2. SAS 9.1 software package was used for Wilcoxon test. RESULTS: The mean ADCs were significantly different (P<0.05) between group 1 and the other 3 groups, and between group 2 and group 3, respectively. Among all kinds of pathological types of lesions, non-Hodgkin lymphoma had a lowest mean ADC value, and schwannoma had a highest mean ADC value. In addition, the mean ADCs among epithelial carcinoma subtypes were not significantly different(P>0.05). CONCLUSIONS: DW-MRI has differential diagnostic value of solid tumors affecting the base of tongue and glossopharynx, especially in distinguishing between benign solid tumors and malignant tumors, and between epithelial carcinomas and non-epithelial malignant tumors.

Key words: Magnetic resonance imaging, Diffusion-weighted imaging, Base of tongue, Glossopharynx

CLC Number:

R739.8

ZHU Wen-jing, YU Qiang, WANG Ping-zhong, SHI Hui-min. Diagnostic value of diffusion-weighted magnetic resonance imaging for solid tumors affecting the base of tongue and glossopharynx[J]. Shanghai Journal of Stomatology, 2017, 26(4): 441-446.

References

[1] Herneth AM, Guccione S, Bednarski M. Apparent diffusion coefficient: a quantitative parameter for in vivo tumor characterization [J]. Eur J Radiol, 2003, 45(3): 208-213.
[2] Ichikawa Y, Sumi M, Sasaki M, et al. Efficacy of diffusion-weighted imaging for the differentiation between lymphomas and carcinomas of the nasopharynx and oropharynx: correlations of apparent diffusion coefficients and histologic features [J]. AJNR Am J Neuroradiol, 2012, 33(4): 761-766.
[3] Wang P, Yang J, Yu Q, et al. Evaluation of solid lesions affecting masticator space with diffusion-weighted MR imaging [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Eendod, 2010, 109(6): 900-907.
[4] Abdel Razek AA, Nada N. Role of diffusion-weighted MRI in differentiation of masticator space malignancy from infection [J]. Dentomaxillofac Radiol, 2013, 42(4): 20120183.
[5] Abdel Razek AA, Gaballa G, Elhawarey G, et al. Characterization of pediatric head and neck masses with diffusion-weighted MR imaging [J]. Eur Radiol, 2009, 19(1): 201-208.
[6] Sakamoto J, Sasaki Y, Otonari-Yamamoto M, et al. Comparison of various methods for quantification of apparent diffusion coefficient of head and neck lesions with HASTE diffusion-weighted MR imaging [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114(2): 226-276.
[7] Abdel Razek AA, Kandeel AY, Soliman N, et al. Role of diffusion-weighted echo-planar MR imaging in differentiation of residual or recurrent head and neck tumors and posttreatment changes [J]. AJNR Am J Neuroradiol, 2007, 28(6): 1146-1152.
[8] Wang J, Takashima S, Takayama F, et al. Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging [J]. Radiology, 2001, 220(3): 621-630.
[9] Koc O, Paksoy Y, Erayman I, et al. Role of diffusion weighted MR in the discrimination diagnosis of the cystic and/or necrotic head and neck lesions [J]. Eur J Radiol, 2007, 62(2): 205-213.
[10] Sumi M, Sakihama N, Sumi T, et al. Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer [J]. AJNR Am J Neuroradiol, 2003, 24(8): 1627-1634.
[11] Srinivasan A, Dvorak R, Perni K, et al. Differentiation of benign and malignant pathology in the head and neck using 3T apparent diffusion coefficient values: early experience [J]. AJNR Am J Neuroradiol, 2008, 29(1): 40-44.
[12] Chawla S, Kim S, Wang S, et al. Diffusion-weighted imaging in head and neck cancers [J]. Future Oncol, 2009, 5(7): 959-975
[13] Thoeny HC, De Keyzer F, King AD. Diffusion-weighted MR imaging in the head and neck[J]. Radiology, 2012, 263(1): 19-32.
[14] Thoeny HC. Diffusion-weighted MRI in head and neck radiology: applications in oncology [J]. Cancer Imaging, 2011, 10: 209-214.
[15] Razek AA. Diffusion-weighted magnetic resonance imaging of head and neck[J]. J Comput Assist Tomogr, 2010, 34(6): 808-815.
[16] Ai S, Zhu W, Liu Y, et al. Combined DCE and DW-MRI in the diagnosis of benign and malignant tumors of the tongue [J]. Front Biosci (Landmark Ed), 2013, 18: 1098-1111.
[17] Szafer A, Zhong J, Gore JC. Theoretical model for water diffusion in tissues [J]. Magn Reson Med, 1995, 33(5): 697-712.
[18] Leeds NE, Kumar AJ, Zhou XJ, et al. Magnetic resonance imaging of benign spinal lesions simulating metastasis: role of diffusion-weighted imaging [J]. Top Magn Reson Imaging, 2000, 11(4): 224-234.
[19] Spuentrup E, Buecker A, Adam G, et al. Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body [J]. AJR Am J Roentgenol, 2001, 176(2): 351-358.
[20] Friedrich KM, Matzek W, Gentzsch S, et al. Diffusion-weighted magnetic resonance imaging of head and neck squamous cell carcinomas [J]. Eur J Radiol, 2008, 68(3): 493-498.
[21] Kotsenas AL, Roth TC, Manness WK, et al. Abnormal diffusion-weighted MRI in medulloblastoma: does it reflect small cell histology? [J]. Pediatr Radiol, 1999, 29(7): 524-526.
[22] Maeda M, Kato H, Sakuma H, et al. Usefulness of the apparent diffusion coefficient in line scan diffusion-weighted imaging for distinguishing between squamous cell carcinomas and malignant lymphomous of the head and neck [J]. AJNR Am J Neuroradiol, 2005, 26(5): 1186-1192.
[23] Maeda M, Maier SE, Sakuma H, et al. Apparent diffusion coefficient in malignant lymphoma and carcinoma involving cavernous sinus evaluated by line scan diffusion-weighted imaging [J]. J Magn Reson Imaging, 2006, 24(3): 543-548.
[24] Holzapfel K, Duetsch S, Fauser C, et al. Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes [J]. Eur J Radiol, 2009, 72(3): 381-387.
[25] King AD, Ahuja AT, Yeung DK, et al. Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging [J]. Radiology, 2007, 245(3): 806-813.
[26] Yamauchi H, Srinivasan A. Diffusion imaging of the head and neck [J]. Curr Radiol Rep, 2014, 2: 49.