Comparison of accuracy of intravoxel incoherent motion and apparent diffusion coefficient techniques for predicting malignancy of head and neck tumors using half-Fourier single-shot turbo spin-echo diffusion-weighted imaging

• Published in: Magnetic resonance imaging Vol. 32; no. 7; pp. 860 - 866
• Main Authors: Sakamoto, Junichiro, Imaizumi, Akiko, Sasaki, Yoshinori, Kamio, Takashi, Wakoh, Mamoru, Otonari-Yamamoto, Mika, Sano, Tsukasa
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.09.2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Diffusion Magnetic Resonance Imaging - methods; Diffusion magnetic resonance imaging/MT; Echo-Planar Imaging - methods; Female; Fourier Analysis; Head and Neck Neoplasms - pathology; Head and neck neoplasms/CL; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Intravoxel incoherent motion; Magnetic resonance imaging; Male; Middle Aged; Motion; Pattern Recognition, Automated - methods; Radiology; Reproducibility of Results; Sensitivity and Specificity; Spin Labels; Young Adult; Diffusion magnetic resonance imaging/MT; Magnetic resonance imaging; Head and neck neoplasms/CL; Intravoxel incoherent motion
• ISSN: 0730-725X; 1873-5894
• DOI: 10.1016/j.mri.2014.05.002

Abstract Purpose To evaluate the use of the intravoxel incoherent motion (IVIM) technique in half-Fourier single-shot turbo spin-echo (HASTE) diffusion-weighted imaging (DWI), and to compare its accuracy to that of apparent diffusion coefficient (ADC) to predict malignancy in head and neck tumors. Patients and methods HASTE DW images of 33 patients with head and neck tumors (10 benign and 23 malignant) were evaluated. Using the IVIM technique, parameters ( D , true diffusion coefficient; f , perfusion fraction; D* , pseudodiffusion coefficient) were calculated for each tumor. ADC values were measured over a range of b values from 0 to 1000 s/mm2 . IVIM parameters and ADC values in benign and malignant tumors were compared using Student's t test, receiver operating characteristics (ROC) analysis, and multivariate logistic regression modeling. Results Mean ADC and D values of malignant tumors were significantly lower than those of benign tumors ( P < 0.05). Mean D * values of malignant tumors were significantly higher than those of benign tumors ( P < 0.05). There was no significant difference in mean f values between malignant and benign tumors ( P > 0.05). The technique of combining D and D * was the best for predicting malignancy; accuracy for this model was higher than that for ADC. Conclusions The IVIM technique may be applied in HASTE DWI as a diagnostic tool to predict malignancy in head and neck masses. The use of D and D* in combination increases the diagnostic accuracy in comparison with ADC.