Diffusion weighted magnetic resonance imaging of pre and post treatment nasopharyngeal carcinoma. (September 2019)

• Record Type: Journal Article
• Authors: Hirshoren, Nir; Damti, Shiri; Weinberger, JeffreyM.; Meirovitz, Amichay; Sosna, Jacob; Eliashar, Ron; Eliahou, Ruth
• Is Part Of: Surgical oncology. Volume 30(2019)
• Page Start: 122
• Page End: 125
• Publication Date: 2019-09
• Subjects: Apparent diffusion coefficient -- Diffused weighted magnetic resonance imaging -- Nasopharyngeal carcinoma -- Cancer detection; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2019.07.005
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Objectives: To evaluate the utility of different Apparent Diffusion Coefficient (ADC) values on Diffused Weighted Magnetic Resonance Imaging (DW-MRI) for nasopharyngeal carcinoma (NPC). Study design and setting: A retrospective cohort study in a single tertiary medical center. Subjects and methods: The study group consists of patients with pathology proven NPC that underwent DW-MRI prior or/and following a non-surgical chemo radiation treatment between the years 2007 and 2017. ADC thresholds were analyzed and compared for primary (pre-treatment) and expected post-irradiation NPC cases and healthy controls. Results: We recruited 144 patients who underwent 195 MRI's for NPC. 25 DW-MRI were performed before (primary, active NPC) and 56 following (no residual NPC) treatment. 45 out of 225 patients who had brain DW-MRI for other reasons (control group) had measurable nasopharynx tissue (N = 33, adjusted for age and gender). The mean ADC of NPC prior to treatment (0.69 ± 0.13 × 10 −3 mm 2 /s) was significantly lower (ANOVA, P < 0.001) compared to the mean ADC of the adjusted controls (1.11 ± 0.25 × 10 −3 mm 2 /s) and post-treatment (1.49 ± 0.28 × 10 −3 mm 2 /s) groups. An ADC threshold of 0.805 × 10 −3 mm 2 /s had 94% and 93.9% sensitivity and specificity rates, respectively and an odds ratio of 175[95%CI(23.25–1000)], comparing ADC levels of pre-treatment NPC patients and adjusted control group. An ADC threshold of 0.965 × 10 −3 mm 2 /s yielded 100% positive and negative predicted values distinguishing pre-treatment and post-treatment NPC patients (free of disease). There was no statistical association between ADC levels and tumor volume/stage, nodal stage or group staging. Conclusions: ADC levels have distinct values in newly diagnosed and follow up of NPC. Highlights: Diffusion-weighted imaging (DWI) detects the random motion of water molecules. We present the role of DWI for nasopharyngeal carcinoma tissue characterization. We found a lower mean ADC level (0.69 ± 0.13 × 10 −3 mm 2 /s) in pretreatment NPC. We depicted the ADC thresholds for pre-treatment NPC diagnosis and tumor recurrence.