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Kwon, Kim, Sol, Lee, Yeom, and Kim: Usefulness of Apparent Diffusion Coefficient Values in the Nasopharynx and the Oropharynx: Differentiation of Benign and Malignant Lesions
Head and Neck Radiology

Journal of the Korean Society of Radiology 2012; 66(2): 117-122.

Published online: 10 August 2015

DOI: https://doi.org/10.3348/jksr.2012.66.2.117

Usefulness of Apparent Diffusion Coefficient Values in the Nasopharynx and the Oropharynx: Differentiation of Benign and Malignant Lesions

Hoon Kwon, MD1, Hak Jin Kim, MD1, Yu Li Sol, MD1, Tae Hong Lee, MD1, Jeong A Yeom, MD1, Ah Rong Kim, MD2

1Department of Radiology, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.

2Department of Pathology, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.

Corresponding author: Hak Jin Kim, MD. Department of Radiology, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 602-739, Korea. Tel. 82-51-240-7371, Fax. 82-51-244-7534, hakjink@pusan.ac.kr

Received 18 August 2011       Accepted 12 January 2012

Copyright © 2012 The Korean Society of Radiology

Abstract

Purpose

In several previous studies, apparent diffusion coefficient (ADC) calculation was applied in the evaluation of head and neck tumors and is a promising technique for this application. As a result, we reevaluated the usefulness of ADC measurement with differentiation of benign and malignant pathology in the nasopharynx and oropharynx.

Materials and Methods

The study population consisted of 87 consecutive patients who had undergone routine nasopharyngeal and oropharyngeal MR imaging at our institution, which included diffusion weighted image and ADC map, with a clinically suspected primary tumor of nasopharynx and oropharynx. The mean ADC values in the benign and malignant groups were compared and the malignant group was divided into the lymphoma and carcinoma groups.

Results

A statistically significant difference in ADC values among the benign and malignant groups using independent samples t-test with a p < 0.001. The lymphoma and carcinoma groups were compared by the Man-Whitney U test, which revealed a statistically significant difference with a p = 0.002. When an ADC of 1.1 × 10-3 mm2/s was used to distinguish between benign and malignancy, accuracy was 85%.

Conclusion

ADC values were useful for distinguishing between benign and malignancy in the nasopharynx and oropharynx.

Keywords: MRI, Diffusion-Weighted Image, Nasopharynx, Oropharynx, Malignancy

Figures and Tables

Fig. 1

ADC values of benign and malignant lesions in the nasopharynx and the oropharynx (box plot).

Note.-ADC = apparent diffusion coefficient
jksr-66-117-g001
Fig. 2

A 66-year-old male with pleomorphic adenoma at the left soft palate. Mean ADC value is 1.382 × 10-3 mm2/s.

A. Axial contrast enhanced T1-weighted image demonstrates a mass with heterogeneous enhancement at the left soft palate (arrow).
B. DWI obtained with b = 1000 mm2/s shows a mass (arrow).
C. Corresponding ADC map shows the mean ADC value of the mass as 1.382 × 10-3 mm2/s.
Note.-ADC = apparent diffusion coefficient, DWI = diffusion weighted image
jksr-66-117-g002
Fig. 3

A 37-year-old female, nasopharyngeal undifferentiated carcinoma with skull base invasion.

A. Axial contrast enhanced T1-weighted image demonstrates a destructive mass with skull base invasion at the right nasopharynx (arrow).
B. DWI obtained with b = 1000 mm2/s shows a mass (arrow).
C. Corresponding ADC map shows the mean ADC value of the mass as 0.793 × 10-3 mm2/s.
Note.-ADC = apparent diffusion coefficient, DWI = diffusion weighted image
jksr-66-117-g003
Fig. 4

A 47-year-old male, diffuse large B cell lymphoma of the tongue base.

A. Axial contrast enhanced T1-weighted image demonstrates a enhancing mass in the right tongue base (arrow).
B. DWI obtained with b = 1000 mm2/s shows a mass (arrow).
C. Corresponding ADC map shows the mean ADC value of the mass as 0.687 × 10-3 mm2/s.
Note.-ADC = apparent diffusion coefficient, DWI = diffusion weighted image
jksr-66-117-g004
Table 1
ADC Values of Benign Lesions in the Nasopharynx and the Oropharynx
jksr-66-117-i001

Note.-ADC = apparent diffusion coefficient

Table 2
ADC Values of Malignant Lesions in the Nasopharynx and the Oropharynx
jksr-66-117-i002

Note.-ADC = apparent diffusion coefficient

Notes

This work was supported by a 2-Year Research Grant of Pusan National University.

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