The diagnostic accuracy of diffusion weighted magnetic resonance (MR) imaging for discrimination of malignant from benign cervical lymphadenopathy in head and neck tumours using histopathology as the reference standard
Journal Title: International Journal of Medical Research and Review - Year 2017, Vol 5, Issue 12
Abstract
Head and neck cancers accounts for maximum number of cancer cases in Indian hospital settings. Involvement of neck nodes is a very important prognostic factor of its outcome. Differentiation between benign and metastatic lymphadenopathy often presents a diagnostic challenge with conventional imaging techniques. Diffusion-weighted imaging (DWI) has emerged as a powerful non-invasive imaging technique that is capable of characterisation of these lesions as benign or malignant with the help of apparent diffusion coefficient (ADC) maps. Aim: The aim of this cross-sectional study was to determine the diagnostic accuracy of DWI to differentiate benign from malignant cervical lymph nodes in head and neck tumours, subsequently confirming the results using histopathology as the reference standard. Materials and Methods: The cross-sectional study was conducted on 60 patients of either age or sex with enlarged neck lymph nodes over a period of 2 years, subsequently these patients underwent DW MRI imaging followed by histopathology of either neck dissection specimen or core biopsy or US guided FNAC as a part of the study. Results: Out of 60 patients, 41(68.33 percent) cases came out as malignant and 19 (31.67 percent) cases came out as benign. The results obtained were 36 true positives, 4 false positives, 15 true negatives and 5 false negatives. The overall sensitivity of DWI for differentiating malignant from benign cervical lymphadenopathy was 87.80% with specificity of 78.95%. The positive predictive value and negative predictive value were 90.00% and 75.00% respectively. The best ADC threshold value for distinguishing benign and malignant nodes was 1.005 × 10-3 mm2/sec. Conclusion: DWI is an important tool to differentiate benign vs malignant lymphadenopathy and helps in guiding the clinician to treat these nodes accordingly.
Authors and Affiliations
Manoj Mathur, Vikas Duhan, Rajiv Kamal Gupta, Saryu Gupta, Navkiran Kaur, Aditi Mathur
Keywords
Related Articles
- EP ID EP277645
- DOI -
- Views 139
- Downloads 0
A Hospital Based Study on Female Genital Tuberculosis in Central India
Introduction: In developing countries like India tuberculosis (TB) is common and still a major cause of infertility. Female genital tuberculosis is one form of extra pulmonary TB. Genital TB may be asymptomatic and diagn...
Anaesthetic management in the excision of large carotid body tumours: Surgeons perspectives
Objective(s): Carotid body tumours (CBT) are considered rare. Surgical excision is the treatment of choice and poses many anaesthetic challenges especially in large tumours. In this paper we present our experience of ana...
Patterns of failure in cases of carcinoma of esophagus treated with radical concurrent chemoradiation
Background: Radical chemoradiation has been the main stay of treatment in inoperable cases of carcinoma of thoracic oesophagus. The purpose of the study is to determine the pattern of recurrence after radical concurrent...
Atherosclerosis regression of intima-media wall thickness of internal carotid artery with long term use of flavonoids & antioxidants
Introduction: Free radicals of oxygen causes an abnormal intravascular lipid peroxidase activity and start process of atherosclerosis within blood vessels. Atherosclerosis reversal has been studied in humans and animals....
Study of relationship between ABO & Rh blood group and type 2 diabetic mellitus
Background & Objective: The findings of Arid et al, in 1953 regarding association between carcinoma of stomach and B blood group and successively in 1954 regarding association between peptic ulcer and O blood group opene...