Diffusion-Weighted Imaging (DWI) derived from PET/MRI for lymph node assessment in patients with Head and Neck Squamous Cell Carcinoma (HNSCC).

ABSTRACT: BACKGROUND:To determine the usefulness of Diffusion Weighted Imaging (DWI) derived from PET/MRI in discriminating normal from metastatic lymph nodes and the correlation between the metastatic lymph nodes with the grade and the localization of the primary tumor. METHODS:Retrospective study of 90 lymph nodes from 90 subjects; 65 patients who had proven histopathological metastatic lymph nodes from (HNSCC) who had undergone 18F- PET/MRI for clinical staging and assessment and twenty-five lymph nodes were chosen from 25 healthy subjects. Apparent Diffusion Coefficient (ADC) map was generated from DWI with b values (0 and 800?s/mm2). ADC values of the metastatic lymph nodes were calculated and compared to the normal lymph nodes ADC values, ROC was used to determine the best cut-off values to differentiate between the two group. Metastatic lymph nodes ADC mean values were compared to primary tumor grade and localization. RESULTS:ADCmean value of the metastatic lymph nodes in the overall sample (0.899?±?0.98*10-?3?mm2/sec) was significantly lower than the normal lymph nodes' ADCmean value (1.267?±?0.88*10-?3?mm2/sec); (P?=?0.001). The area under the curve (AUC) was 98.3%, sensitivity and specificity were 92.3 and 98.6%, respectively, when using a threshold value of (1.138?±?0.75*10-?3?mm2/sec) to differentiate between both groups. Significant difference was found between metastatic lymph nodes (short-axis diameter??10?mm, ADCmean (0.899?±?0.89*10-?3?mm2/sec), (P?=?0.967). No significant differences were found between metastatic lymph nodes ADCmean values and different primary tumor grades or different primary tumor localization, (P >?0.05). CONCLUSION:DWI-ADC is an effective and efficient imaging technique in differentiating between normal and malignant lymph nodes, and might be helpful to discriminate sub-centimeters lymph nodes. TRIAL REGISTRATION:The trial is registered in clinical trials under ID: NCT04360993 , registration date: 17/04/2020.

SUBMITTER: Freihat O 

PROVIDER: S-EPMC7414722 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature