Apparent diffusion coefficient measurements in the differentiation between benign and malignant neck masses

Abstract

Aim: Evaluate the role of ADC value measurements in the differentiation between benign and malignant neck masses. Methods: From April 2011 to February 2013, prospective study was conducted on 30 patients (17 male and 13 female), with the mean age 43.3 ± 6 years. Collected from wards and clinics of General Surgery and Otolaryngology Departments complaining from neck masses. MRI, Diffusion-Weighted Imaging (b value 0, 100, 500 and 1000 s/mm) and ADC value calculation were performed and the results were correlated with histopathological results and/or follow up. Results: The present study include 30 patients (Lymphadenopathy {(n = 15) (11 as single entity), (4 associated with other entities)}, Focal thyroid swelling (n = 5), Salivary gland masses (n = 3) {Parotitis (1 case), Parotid carcinoma (2 cases)}, Nasopharyngeal masses (n = 5), Oropharyngeal masses (n = 2), Ludwig angina (n = 2) and Laryngeal masses (n = 2). The mean ADC of the malignant neck masses was (0.699 + 0.267 × 10-3 mm2/s) while that of the benign masses was (1.879 + 0.751 × 10-3 mm2/s). The results confirmed by biopsy in 23 cases and follow up (7 cases). The sensitivity, specificity, PPV, NPV and overall accuracy of quantitative diffusion WI in differentiating benign from malignant neck masses were 95.4%, 83.3%, 95.4%, 83%, and 92%. Conclusion: ADC value calculation are promising noninvasive imaging approach that can be used in distinguishing between benign and malignant neck masses. Benign lesions have higher mean ADC values than malignant lesions, the cutoff value was 1.25 × 10-3 mm2/s while 0.8 × 10-3 mm2/s in thyroid lesions.

Keywords

• Neck
• ADC
• Diffusion
• Benign
• Malignant