title: Differentiation of Benign and Malignant Head and Neck Lesions With Diffusion Tensor Imaging and DWI.
abstract: OBJECTIVE
  The purpose of this study was to determine whether diffusion tensor imaging (DTI) can be used to differentiate between benign and malignant head and neck lesions.
  
  
  METHODS
  This retrospective study included patients with head and neck lesions who underwent clinical MRI at 1.5 or 3 T with DWI or DTI parameters. ROI analysis was performed, with lesion-to-medulla apparent diffusion coefficient (ADC) ratios generated.
  
  
  RESULTS
  Sixty-five patients with head and neck lesions were included (71 benign, 40 malignant). Twenty-one patients had multiple lesions. Statistically significant differences (p < 0.001) were seen in the mean ADC values ± SD of malignant and benign lesions (0.55 × 10-3± 0.14 × 10-3mm2/s vs 0.89 × 10-3± 0.29 × 10-3mm2/s, respectively) and in the mean ADC ratios of malignant and benign lesions (0.88 ± 0.21 vs 1.40 ± 0.44, respectively) with DTI parameters. DTI and DWI parameters produced similar mean ADC ratio values for malignant (0.88 ± 0.21 and 0.92 ± 0.54, respectively) and benign lesions (1.40 ± 0.44 and 1.79 ± 0.52, respectively). ADC ratio thresholds for predicting malignancy for DTI (ADC ratio ≤ 1) and DWI (ADC ratio ≤ 0.94) were also similar.
  
  
  CONCLUSIONS
  DTI is a useful predictor of malignancy for head and neck lesions, with ADC values of malignant lesions significantly lower than those of benign lesions. DTI ADC values were lower than DWI ADC values for all head and neck lesions in our study group, often below reported malignant DWI threshold values. Normalization of ADC values to an internal control resulted in similar ADC ratios on DWI and DTI.
authors.affiliation: 1 Department of Radiology, University of Utah Health Sciences Center, Salt Lake City, UT.|2 Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N University Blvd, Rm 0663, Indianapolis, IN 46202.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Koontz
authors.forename: Richard H
authors.initials: RH
authors.lastname: Wiggins
mesh_terms: D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: DWI; apparent diffusion coefficient; diffusion-tensor imaging; head and neck lesions