Chawla Sanjeev, Kim Sungheon, Wang Sumei, Poptani Harish
Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
Future Oncol. 2009 Sep;5(7):959-75. doi: 10.2217/fon.09.77.
This article reviews the utility of diffusion-weighted imaging (DWI) in the diagnosis, prognosis and monitoring of treatment response in tumors arising in the head and neck region. The apparent diffusion coefficient (ADC) value, determined from DWI, can help in cancer staging and detection of subcentimeter nodal metastasis. The ADC value also discriminates carcinomas from lymphomas, benign lesions from malignant tumors and tumor necrosis from abscesses. Low pretreatment ADC values typically predict a favorable response to chemoradiation therapy. These promising reports indicate the potential of DWI as a potential biomarker for diagnosis and monitoring of treatment response in head and neck cancers. In view of the overlapping ADC values between different salivary gland tumors, care should be taken when interpreting these results and other imaging parameters should be considered for a better diagnosis. Susceptibility and motion-induced artifacts may sometimes degrade DWI image quality; however, novel techniques are being developed to overcome these drawbacks.
本文综述了扩散加权成像（DWI）在头颈部肿瘤的诊断、预后评估及治疗反应监测中的应用价值。由DWI测定的表观扩散系数（ADC）值有助于癌症分期及检测亚厘米级别的淋巴结转移。ADC值还可用于鉴别癌与淋巴瘤、良性病变与恶性肿瘤以及肿瘤坏死与脓肿。治疗前低ADC值通常预示着对放化疗有良好反应。这些有前景的报告表明DWI作为头颈部癌症诊断及治疗反应监测潜在生物标志物的可能性。鉴于不同唾液腺肿瘤之间ADC值存在重叠，解读这些结果时应谨慎，并应考虑其他成像参数以获得更好的诊断。敏感性及运动引起的伪影有时可能会降低DWI图像质量；然而，正在开发新技术以克服这些缺点。
