Utility of MRI with morphologic and diffusion weighted imaging in the detection of post-treatment nodal disease in head and neck squamous cell carcinoma
Utility of MRI with morphologic and diffusion weighted imaging in the detection of post-treatment nodal disease in head and neck squamous cell carcinoma
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DOI：
10.1016/j.ejrad.2018.02.026
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发表时间：
2018-04-01
影响因子：
3.3
通讯作者：
Becker, Minerva
中科院分区：
文献类型：
--
作者：
Mundada, Pravin;Varoquaux, Arthur Damien;Becker, Minerva
目的：为了确定诊断性能的形态MRI与扩散加权成像（DWIMRI）的检测治疗后淋巴结（LN）复发的头颈部鳞状细胞癌（HNSCC.Methods）：这项回顾性研究是基于33例HNSCC患者进行DWIMRI与表观扩散系数（ADC）测量可疑治疗后局部区域失败。两名对临床/组织病理学数据不知情的放射科医生根据已建立的形态学标准分析MR图像，并通过在每个正常/异常外观淋巴结（LN）上绘制感兴趣区域来测量ADC值。结果：恶性淋巴结的ADC均值低于良性淋巴结（1.15 +/- 0.35x10（-3）mm（2）/s对1.28 +/- 0.28x10（-3）mm（2）/s，p = 0.028）。鉴别良恶性淋巴结的最佳ADC平均阈值为1.1695 × 10（-3）mm（2）/s。DWIMRI与形态学标准和ADC平均值的敏感性、特异性、阳性（PPV）和阴性（NPV）预测值（括号内为95% CI）
Purpose: To determine the diagnostic performance of morphologic MRI with diffusion weighted imaging (DWIMRI) for the detection of post-treatment lymph node (LN) recurrence of head and neck squamous cell carcinoma (HNSCC).Methods: This retrospective study is based on 33 HNSCC patients who underwent DWIMRI with apparent diffusion coefficient (ADC) measurements for suspected post-treatment loco-regional failure. Two radiologists, blinded to clinical/histopathological data, analyzed MR images according to established morphologic criteria and measured ADC values by drawing regions of interest on each normal/abnormal looking lymph node (LN). Histopathological findings in 40 neck dissections, 133 LN-levels and 755 LNs served as gold standard.Results: Malignant LNs had lower ADCmean values than benign LNs (1.15 +/- 0.35x10(-3) mm(2)/s versus 1.28 +/- 0.28x10(-3) mm(2)/s, p = .028). The optimal ADCmean threshold to differentiate malignant from benign LNs was 1.1695x10(-3) mm(2)/s. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values (95% CI in parentheses) of DWIMRI with morphologic criteria and ADCmean