Diffusion-weighted MR Imaging in the Head and Neck
Abstract
Diffusion-weighted MR imaging shows a wide range of potential benefits in the head and neck, but more comparative studies with well-established imaging techniques are required before the true role of diffusion-weighted imaging can be defined.
Extracranial applications of diffusion-weighted (DW) magnetic resonance (MR) imaging are gaining increasing importance, including in head and neck radiology. The main indications for performing DW imaging in this relatively small but challenging region of the body are tissue characterization, nodal staging, therapy monitoring, and early detection of treatment failure by differentiating recurrence from posttherapeutic changes. Lower apparent diffusion coefficients (ADCs) have been reported in the head and neck region of adults and children for most malignant lesions, as compared with ADCs of benign lesions. For nodal staging, DW imaging has shown promise in helping detect lymph node metastases, even in small (subcentimeter) nodes with lower ADCs, as compared with normal or reactive nodes. Follow-up of early response to treatment is reflected in an ADC increase in the primary tumor and nodal metastases; whereas nonresponding lesions tend to reveal only a slight increase or even a decrease in ADC during follow-up. Optimization and standardization of DW imaging technical parameters, comparison of DW images with morphologic images, and increasing experience, however, are prerequisites for successful application of this challenging technique in the evaluation of various head and neck pathologic conditions.
© RSNA, 2012
References
- 1 . Diffusion-weighted MR imaging of the brain. Radiology 2000;217(2):331–345.
- 2 . Audit of a policy of magnetic resonance imaging with diffusion-weighted imaging as first-line neuroimaging for in-patients with clinically suspected acute stroke. Clin Radiol 2003;58(3):234–237.
- 3 . Extracranial applications of diffusion-weighted magnetic resonance imaging. Eur Radiol 2007;17(6):1385–1393.
- 4 . The functional diffusion map: an imaging biomarker for the early prediction of cancer treatment outcome. Neoplasia 2006;8(4):259–267.
- 5 . Diffusion-weighted MR imaging of kidneys in healthy volunteers and patients with parenchymal diseases: initial experience. Radiology 2005;235(3):911–917.
- 6 . Apparent diffusion coefficient: potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases. Radiology 2008;248(3):894–900.
- 7 . Longitudinal study of the assessment by MRI and diffusion-weighted imaging of tumor response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy. NMR Biomed 2009;22(1):104–113.
- 8 . Diffusion MRI for prediction of response of rectal cancer to chemoradiation. Lancet 2002;360(9329):307–308.
- 9 . Diffusion-weighted imaging of prostate cancer: correlation between apparent diffusion coefficient values and tumor proliferation. J Magn Reson Imaging 2009;29(6):1360–1366.
- 10 . Apparent diffusion coefficient of glial neoplasms: correlation with fluorodeoxyglucose-positron-emission tomography and gadolinium-enhanced MR imaging. AJNR Am J Neuroradiol 2010;31(6):1042–1048.
- 11 . Predicting and monitoring cancer treatment response with diffusion-weighted MRI. J Magn Reson Imaging 2010;32(1):2–16.
- 12 . Diffusion-weighted MRI in head and neck radiology: applications in oncology. Cancer Imaging 2011;10(1):209–214.
- 13 . Diffusion magnetic resonance imaging in the head and neck. Magn Reson Imaging Clin N Am 2011;19(1):55–67.
- 14 . Diffusion-weighted magnetic resonance imaging of head and neck. J Comput Assist Tomogr 2010;34(6):808–815.
- 15 . Salivary glands and lesions: evaluation of apparent diffusion coefficients with split-echo diffusion-weighted MR imaging—initial results. Radiology 2001;221(3):837–842.
- 16 . Measurement of the apparent diffusion coefficient in diffuse renal disease by diffusion-weighted echo-planar MR imaging. J Magn Reson Imaging 1999;9(6):832–837.
- 17 . Gustatory stimulation changes the apparent diffusion coefficient of salivary glands: initial experience. Radiology 2005;235(2):629–634.
- 18 . Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 1988;168(2):497–505.
- 19 . ZOnally-magnified Oblique Multislice (ZOOM) EPI [abstr]. In: Proceedings of the Eighth Meeting of the International Society for Magnetic Resonance in Medicine. Berkeley, Calif: International Society for Magnetic Resonance in Medicine, 2000; 160.
- 20 . In vivo diffusion tensor imaging of the human optic nerve: pilot study in normal controls. Magn Reson Med 2006;56(2):446–451.
- 21 . Basic principles of diffusion-weighted imaging. Eur J Radiol 2003;45(3):169–184.
- 22 . Diffusion-weighted imaging of the parotid gland: Influence of the choice of b-values on the apparent diffusion coefficient value. J Magn Reson Imaging 2004;20(5):786–790.
- 23 . Functional evaluation of transplanted kidneys with diffusion-weighted and BOLD MR imaging: initial experience. Radiology 2006;241(3):812–821.
- 24 . Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 2009;11(2):102–125.
- 25 . Head and neck squamous cell carcinoma: value of diffusion-weighted MR imaging for nodal staging. Radiology 2009;251(1):134–146.
- 26 . A feasibility study of parametric response map analysis of diffusion-weighted magnetic resonance imaging scans of head and neck cancer patients for providing early detection of therapeutic efficacy. Transl Oncol 2009;2(3):184–190.
- 27 . Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 2001;220(3):621–630.
- 28 . Differentiation of benign and malignant pathology in the head and neck using 3T apparent diffusion coefficient values: early experience. AJNR Am J Neuroradiol 2008;29(1):40–44.
- 29 . Characterization of pediatric head and neck masses with diffusion-weighted MR imaging. Eur Radiol 2009;19(1):201–208.
- 30 . Comparison of echo-planar diffusion-weighted imaging and delayed postcontrast weighted MR imaging in cervical lymphadenopathy. Eur Radiol 2006;16(7):1468–1477.
- 31 . Diffusion-weighted MR imaging of cholesteatoma in pediatric and adult patients who have undergone middle ear surgery. AJR Am J Roentgenol 2003;181(1):261–265.
- 32 . Diffusion-weighted MR imaging in postoperative follow-up: reliability for detection of recurrent cholesteatoma. Eur J Radiol 2010;74(1):121–123.
- 33 . The value of diffusion-weighted MR imaging in the diagnosis of primary acquired and residual cholesteatoma: a surgical verified study of 100 patients. Eur Radiol 2006;16(7):1461–1467.
- 34 . The utility of diffusion-weighted imaging for cholesteatoma evaluation. AJNR Am J Neuroradiol 2011;32(3):430–436.
- 35 . Efficacy of diffusion-weighted magnetic resonance imaging in the diagnosis of middle ear cholesteatoma. Auris Nasus Larynx 2011;38(3):329–334.
- 36 . Diffusion-weighted MRI of cholesteatomas of the petrous bone. J Magn Reson Imaging 2002;15(6):636–641.
- 37 . Diffusion-weighted MR imaging sequence in the detection of postoperative recurrent cholesteatoma. Radiology 2006;238(2):604–610.
- 38 . Middle ear cholesteatoma: non-echo-planar diffusion-weighted MR imaging versus delayed gadolinium-enhanced T1-weighted MR imaging—value in detection. Radiology 2010;255(3): 866–872.
- 39 . Warthin tumor of the parotid gland: diagnostic value of MR imaging with histopathologic correlation. AJNR Am J Neuroradiol 2004;25(7):1256–1262.
- 40 . Parotid gland tumors: can addition of diffusion-weighted MR imaging to dynamic contrast-enhanced MR imaging improve diagnostic accuracy in characterization? Radiology 2008;249(3):909–916.
- 41 . Diffusion-weighted echo-planar MR imaging of primary parotid gland tumors: is a prediction of different histologic subtypes possible? AJNR Am J Neuroradiol 2009;30(3):591–596.
- 42 . Diffusion-weighted echo-planar MRI: a valuable tool for differentiating primary parotid gland tumors? Rofo 2005;177(7):940–945.
- 43 . A surgeon looks at cervical lymph nodes. Radiology 1990;175(3):607–610.
- 44 . Role of diffusion-diotherapy for head and neck squamous cell carcinoma. Eur Radiol 2010;20(7):1703–1714.
- 45 . Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma. Neuroradiology 2009;51(3):183–192.
- 46 . Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes. Eur J Radiol 2009;72(3):381–387.
- 47 . Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer. AJNR Am J Neuroradiol 2003;24(8):1627–1634.
- 48 . Usefulness of the apparent diffusion coefficient in line scan diffusion-weighted imaging for distinguishing between squamous cell carcinomas and malignant lymphomas of the head and neck. AJNR Am J Neuroradiol 2005;26(5):1186–1192.
- 49 . Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 2007;245(3):806–813.
- 50 . Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. AJNR Am J Neuroradiol 2008;29(3):563–568.
- 51 . Diffusion-weighted images differentiate benign from malignant thyroid nodules. J Magn Reson Imaging 2010;31(1):94–100.
- 52 . Diffusion-weighted MR imaging of thyroid nodules. Neuroradiology 2009;51(3):193–198.
- 53 . Diffusion-weighted magnetic resonance imaging for predicting and detecting early response to chemoradiation therapy of squamous cell carcinomas of the head and neck. Clin Cancer Res 2009;15(3):986–994.
- 54 . Pretreatment apparent diffusion coefficient of the primary lesion correlates with local failure in head-and-neck cancer treated with chemoradiotherapy or radiotherapy. Int J Radiat Oncol Biol Phys 2011;81(2):339–345.
- 55 . Squamous cell carcinoma of the head and neck: diffusion-weighted MR imaging for prediction and monitoring of treatment response. Eur Radiol 2010;20(9):2213–2220.
- 56 . Diffusion magnetic resonance imaging: an imaging treatment response biomarker to chemoradiotherapy in a mouse model of squamous cell cancer of the head and neck. Transl Oncol 2008;1(4):187–194.
- 57 . Predictive value of diffusion-weighted magnetic resonance imaging during chemora T1-weighted MR imaging for the detection of residual cholesteatoma. AJNR Am J Neuroradiol 2008;29(7):1363–1368.
- 58 . Diffusion weighted imaging in predicting progression free survival in patients with squamous cell carcinomas of the head and neck treated with induction chemotherapy. Acad Radiol 2011;18(10):1225–1232.
- 59 . Diffusion-weighted magnetic resonance imaging early after chemoradiotherapy to monitor treatment response in head and neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 2011 Apr 20. [Epub ahead of print]
- 60 . Radionecrosis or tumor recurrence after radiation of laryngeal and hypopharyngeal carcinomas. Otolaryngol Head Neck Surg 2006;135(6):838–843.
- 61 . Role of diffusion-weighted echo-planar MR imaging in differentiation of residual or recurrent head and neck tumors and posttreatment changes. AJNR Am J Neuroradiol 2007;28(6):1146–1152.
- 62 . Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo)radiotherapy: correlation between radiologic and histopathologic findings. Int J Radiat Oncol Biol Phys 2007;67(4):960–971.
- 63 . Current status of FDG-PET for head and neck cancer. J Surg Oncol 2008;97(8):649–652.
- 64 . Diffusion-weighted echoplanar MR imaging of the salivary glands. AJR Am J Roentgenol 2002;178(4):959–965.
- 65 . Functional evaluation with intravoxel incoherent motion echo-planar MRI in irradiated salivary glands: a correlative study with salivary gland scintigraphy. J Magn Reson Imaging 2001;14(3):223–229.
- 66 . Functional imaging of parotid glands: diffusion-weighted echo-planar MRI before and after stimulation. Rofo 2004;176(10): 1385–1389.
- 67 . Diffusion-weighted magnetic resonance imaging to evaluate major salivary gland function before and after radiotherapy. Int J Radiat Oncol Biol Phys 2008;71(5):1365–1371.
- 68 . MR imaging of the thyroid: correlation between apparent diffusion coefficient and thyroid gland scintigraphy. J Magn Reson Imaging 2003; 17(2):163–169.
- 69 . Diffusion-weighed MR of the thyroid gland in Graves’ disease: assessment of disease activity and prediction of outcome. Acad Radiol 2010;17(6):779–783.
Article History
Received September 11, 2010; revision requested November 3; revision received December 28; accepted January 10, 2011; final version accepted January 20; final review by H.C.T. November 24.Published online: Apr 2012
Published in print: Apr 2012