Can diffusion weighted image and apparent diffusion coefficient (ADC) differentiate benign from malignant cervical adenopathy?

Abstract

BackgroundCervical adenopathy is a common problem and the differentiation of benign and malignant node is of crucial importance for therapy management. ObjectiveThis prospective study aimed to know if Diffusion weighted images (DWI) and apparent diffusion coefficient (ADC) can differentiate benign from malignant cervical lymphadenopathy. Patients and methodsThirty patients with cervical adenopathy were included in this study. Doppler ultrasound, DWI and ADC maps were automatically reconstructed and used for the measurement of ADC values. ResultsThe sensitivity and specificity of the RI cut-off value <0.69 in differentiation between benign and malignant cervical L.Ns was 88.8% and 71.4%, respectively. The optimal ADC cut off value for differentiation between benign and malignant lymph nodes was ⩽1.0×10−3mm2/s with an accuracy 96.7%, a sensitivity 100%, a specificity 88.9%, PPV 95.4% and NPV 100% and statistically significant P-value=0.000. ConclusionDWI and ADC were useful for differentiation between benign and malignant cervical lymphadenopathy and recommended to decrease the need of invasive biopsies. However, CDUS techniques can be used as preliminary technique but, they had potential pitfalls in diagnosis of malignant cervical lymphadenopathy cases.