MRI evaluation using DWI and T2WI of residual lymph nodes in patients affected by head and neck squamous cell carcinoma treated with chemo-radiotherapy

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Abstract

Objective: the purpose of this study was to assess residual neck nodes after Chemo-Radiotherapy (CRT) using diffusion and T2 weighted imaging. Methods: Apparent Diffusion Coefficient (ADC) and T2 signal intensity were retrospectively analyzed in 45 residual nodes 8 weeks after the end of CRT. Sensitivity, specificity, Positive and Negative Predictive Values (PPV, NPV) and accuracy of diffusion and T2 weighted sequences were calculated. In a subgroup of 25 patients ADC and T2 signal intensity were compared to Positron Emission Tomography-Computed Tomography (PET-CT) results. Histopathology and a 24 months follow-up after CRT were used as reference standard. Results: T2 signal intensity showed an accuracy of 63%, a sensitivity of 73.3%, a specificity of 55.6%, a PPV of 53.8% and a NPV of 75%. ADC showed an accuracy of 71.1%, using a threshold of 1.25 10-3 mm2/s, a sensitivity of 52.6%, a specificity of 84.6%, a PPV of 71.4% and a NPV of 71%. The combination of T2 signal intensity and ADC showed an accuracy of 73.3%, a sensitivity of 50%, a specificity of 84.6%, a PPV of 60% and a NPV of 78.7%. In the subset of 25 patients we correlated ADC and T2 data with PET-CT data: the latter showed higher accuracy, sensitivity and NPV and lower specificity; the PPV was similar between the two methods. Conclusion: Our results demonstrated that MRI, using diffusion and T2 weighted imaging, has high specificity in detecting post-CRT residual neck nodes but it has a lower accuracy, sensitivity and NPV than PET-CT.

Original languageEnglish
Pages (from-to)599-608
Number of pages10
JournalCurrent Medical Imaging Reviews
Volume14
Issue number4
DOIs
Publication statusPublished - Jan 1 2018

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Radiotherapy
Lymph Nodes
Neck
Diffusion Magnetic Resonance Imaging
Carcinoma, squamous cell of head and neck
Sensitivity and Specificity
Positron Emission Tomography Computed Tomography

Keywords

  • Diffusion weighted imaging
  • Head and neck squamous cell carcinoma
  • Lymph nodes
  • Magnetic resonance imaging
  • Residual tumour
  • T2 weighted imaging
  • Treatment response

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{d767c673fbad483badbeb519775d376a,
title = "MRI evaluation using DWI and T2WI of residual lymph nodes in patients affected by head and neck squamous cell carcinoma treated with chemo-radiotherapy",
abstract = "Objective: the purpose of this study was to assess residual neck nodes after Chemo-Radiotherapy (CRT) using diffusion and T2 weighted imaging. Methods: Apparent Diffusion Coefficient (ADC) and T2 signal intensity were retrospectively analyzed in 45 residual nodes 8 weeks after the end of CRT. Sensitivity, specificity, Positive and Negative Predictive Values (PPV, NPV) and accuracy of diffusion and T2 weighted sequences were calculated. In a subgroup of 25 patients ADC and T2 signal intensity were compared to Positron Emission Tomography-Computed Tomography (PET-CT) results. Histopathology and a 24 months follow-up after CRT were used as reference standard. Results: T2 signal intensity showed an accuracy of 63{\%}, a sensitivity of 73.3{\%}, a specificity of 55.6{\%}, a PPV of 53.8{\%} and a NPV of 75{\%}. ADC showed an accuracy of 71.1{\%}, using a threshold of 1.25 10-3 mm2/s, a sensitivity of 52.6{\%}, a specificity of 84.6{\%}, a PPV of 71.4{\%} and a NPV of 71{\%}. The combination of T2 signal intensity and ADC showed an accuracy of 73.3{\%}, a sensitivity of 50{\%}, a specificity of 84.6{\%}, a PPV of 60{\%} and a NPV of 78.7{\%}. In the subset of 25 patients we correlated ADC and T2 data with PET-CT data: the latter showed higher accuracy, sensitivity and NPV and lower specificity; the PPV was similar between the two methods. Conclusion: Our results demonstrated that MRI, using diffusion and T2 weighted imaging, has high specificity in detecting post-CRT residual neck nodes but it has a lower accuracy, sensitivity and NPV than PET-CT.",
keywords = "Diffusion weighted imaging, Head and neck squamous cell carcinoma, Lymph nodes, Magnetic resonance imaging, Residual tumour, T2 weighted imaging, Treatment response",
author = "Francesca Piludu and Emma Gangemi and Laura Marucci and Antonino Guerrisi and Raul Pellini and Renato Covello and Paolo Carlini and Giuseppe Spriano and Giuseppe Sanguineti and Simona Marzi and Antonello Vidiri",
year = "2018",
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doi = "10.2174/1573405613666170511144943",
language = "English",
volume = "14",
pages = "599--608",
journal = "Current Hypertension Reviews",
issn = "1573-4021",
publisher = "Bentham Science Publishers B.V.",
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}

TY - JOUR

T1 - MRI evaluation using DWI and T2WI of residual lymph nodes in patients affected by head and neck squamous cell carcinoma treated with chemo-radiotherapy

AU - Piludu, Francesca

AU - Gangemi, Emma

AU - Marucci, Laura

AU - Guerrisi, Antonino

AU - Pellini, Raul

AU - Covello, Renato

AU - Carlini, Paolo

AU - Spriano, Giuseppe

AU - Sanguineti, Giuseppe

AU - Marzi, Simona

AU - Vidiri, Antonello

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: the purpose of this study was to assess residual neck nodes after Chemo-Radiotherapy (CRT) using diffusion and T2 weighted imaging. Methods: Apparent Diffusion Coefficient (ADC) and T2 signal intensity were retrospectively analyzed in 45 residual nodes 8 weeks after the end of CRT. Sensitivity, specificity, Positive and Negative Predictive Values (PPV, NPV) and accuracy of diffusion and T2 weighted sequences were calculated. In a subgroup of 25 patients ADC and T2 signal intensity were compared to Positron Emission Tomography-Computed Tomography (PET-CT) results. Histopathology and a 24 months follow-up after CRT were used as reference standard. Results: T2 signal intensity showed an accuracy of 63%, a sensitivity of 73.3%, a specificity of 55.6%, a PPV of 53.8% and a NPV of 75%. ADC showed an accuracy of 71.1%, using a threshold of 1.25 10-3 mm2/s, a sensitivity of 52.6%, a specificity of 84.6%, a PPV of 71.4% and a NPV of 71%. The combination of T2 signal intensity and ADC showed an accuracy of 73.3%, a sensitivity of 50%, a specificity of 84.6%, a PPV of 60% and a NPV of 78.7%. In the subset of 25 patients we correlated ADC and T2 data with PET-CT data: the latter showed higher accuracy, sensitivity and NPV and lower specificity; the PPV was similar between the two methods. Conclusion: Our results demonstrated that MRI, using diffusion and T2 weighted imaging, has high specificity in detecting post-CRT residual neck nodes but it has a lower accuracy, sensitivity and NPV than PET-CT.

AB - Objective: the purpose of this study was to assess residual neck nodes after Chemo-Radiotherapy (CRT) using diffusion and T2 weighted imaging. Methods: Apparent Diffusion Coefficient (ADC) and T2 signal intensity were retrospectively analyzed in 45 residual nodes 8 weeks after the end of CRT. Sensitivity, specificity, Positive and Negative Predictive Values (PPV, NPV) and accuracy of diffusion and T2 weighted sequences were calculated. In a subgroup of 25 patients ADC and T2 signal intensity were compared to Positron Emission Tomography-Computed Tomography (PET-CT) results. Histopathology and a 24 months follow-up after CRT were used as reference standard. Results: T2 signal intensity showed an accuracy of 63%, a sensitivity of 73.3%, a specificity of 55.6%, a PPV of 53.8% and a NPV of 75%. ADC showed an accuracy of 71.1%, using a threshold of 1.25 10-3 mm2/s, a sensitivity of 52.6%, a specificity of 84.6%, a PPV of 71.4% and a NPV of 71%. The combination of T2 signal intensity and ADC showed an accuracy of 73.3%, a sensitivity of 50%, a specificity of 84.6%, a PPV of 60% and a NPV of 78.7%. In the subset of 25 patients we correlated ADC and T2 data with PET-CT data: the latter showed higher accuracy, sensitivity and NPV and lower specificity; the PPV was similar between the two methods. Conclusion: Our results demonstrated that MRI, using diffusion and T2 weighted imaging, has high specificity in detecting post-CRT residual neck nodes but it has a lower accuracy, sensitivity and NPV than PET-CT.

KW - Diffusion weighted imaging

KW - Head and neck squamous cell carcinoma

KW - Lymph nodes

KW - Magnetic resonance imaging

KW - Residual tumour

KW - T2 weighted imaging

KW - Treatment response

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EP - 608

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