POSSIBILITIES OF DIFFUSION-WEIGHTED MRI IN DETERMINING THE DEGREE OF

MALIGNANCY OF THE OROPHARYNGEAL CANCER

 

Volodina V.D.¹, Serova N.S.¹, Reshetov I.V.^1,2

 

1 - Sechenov University.

2 - Academy of postgraduate education, FMBA. Moscow, Russia.

T

o determine the possibilities of magnetic resonance imaging (MRI) in the diffusion-weighted imaging (DWI) mode in the assessment of squamous cell carcinoma (SCC) of the oral cavity and oropharynx.

Materials and Methods. All 144 (100%) patients with initially diagnosed and histologically confirmed SCC of the oral cavity and oropharynx were examined. All patients underwent standard MRI in DWI mode with automatic construction of аpparent diffusion coefficient (ADC) maps. The correlation between the data obtained during the MRI examination in the DWI mode and the clinical and histological characteristics of the SCC of the oral cavity and oropharynx was evaluated.

Results. While performing MRI with DWI mode for the calculation of ADC, the results of studies from 144 patients were analyzed. Among these patients, there were 97 males (67%) and 47 females (33%), with an average age of 59 ± 12 years. The mean ADC value was 0.001268 mm²/s (1.2x10⁻³ mm²/s). The average size of the tumor was 27.4 ± 15.3 mm (range, 11.0–66.0 mm). Despite the fact that the correlation between ADC values and histological characteristics of the tumor did not reach statistical significance, nonetheless, poorly differentiated tumors (G3) demonstrated lower diffusion coefficient values, with an average of 1008.3 ± 103.4 x 10⁶ mm²/s, compared to well-differentiated (G1-G2) tumors, for which this indicator was 1113.5 ± 101.6 x 10⁶ mm²/s. The correlation between the diffusion coefficient and the degree of malignancy influenced the determination of treatment tactics in 132 cases (92%).

Discussion. The data obtained from MRI in DWI mode provided additional information in determining the localization, extent of tumor spread, stage, and degree of malignancy which significantly influenced the choice of treatment tactics. The decrease in the diffusion coefficient index in our study in the case of poorly differentiated tumors, despite the lack of statistical significance, correlates with the findings of some foreign authors who have also identified differences in the diffusion coefficient metrics between moderately differentiated and poorly differentiated tumors of the oropharyngeal region.

Conclusion. MRI in DWI mode played a decisive role in assessing the malignancy of squamous cell carcinoma of the oral cavity and oropharynx, which influenced the treatment tactics.

 

Keywords: diffusion-weighted MRI, oropharyngeal region, squamous cell carcinoma, oral cavity, oropharynx, DWI.

 

Corresponding author: Volodina V.D., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Volodina V.D., Serova N.S., Reshetov I.V. Possibilities of diffusion-weighted MRI in determining the degree of malignancy of the oropharyngeal cancer. REJR 2024; 14(3):103-110. DOI: 10.21569/2222-7415-2024-14-3-103-110.

Received:        05.05.24                 Accepted: 14.09.24