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Research ArticleHead and Neck

Efficacy of Diffusion-Weighted Imaging for the Differentiation between Lymphomas and Carcinomas of the Nasopharynx and Oropharynx: Correlations of Apparent Diffusion Coefficients and Histologic Features

Y. Ichikawa, M. Sumi, M. Sasaki, T. Sumi and T. Nakamura
American Journal of Neuroradiology April 2012, 33 (4) 761-766; DOI: https://doi.org/10.3174/ajnr.A2834
Y. Ichikawa
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M. Sumi
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M. Sasaki
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T. Sumi
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T. Nakamura
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    Fig 1.

    Axial fat-suppressed T2-weighted images (left panels), color ADC maps (middle panels), and photomicrographs (right panels) of lymphomas and carcinomas of the nasopharynx and oropharynx. A, A 92-year-old woman with oropharyngeal lymphoma (overall ADC = 0.558 × 10−3 mm2/s; ADC mapping = 79%, extremely low; 21%, low; 0%, intermediate; and 0%, high). B, A 49-year-old woman with NPC (overall ADC = 0.566 × 10−3 mm2/s; ADC mapping = 55%, extremely low; 45%, low; 0%, intermediate; and 0%, high). C, A 52-year-old man with poorly differentiated SCC exhibiting homogeneous T2 signals (overall ADC = 0.576 × 10−3 mm2/s; ADC mapping = 21%, extremely low; 78%, low; 1%, intermediate; and 0%, high). D, A 66-year-old man with poorly differentiated SCC exhibiting heterogeneous T2 signals (overall ADC = 1.02 × 10−3 mm2/s; ADC mapping, = 4%, extremely low; 65%, low; 31%, intermediate; and 1%, high). E, A 67-year-old man with moderately differentiated SCC exhibiting homogeneous T2 signals (overall ADC = 0.752 × 10−3 mm2/s; ADC mapping = 22%, extremely low; 77%, low; 1%, intermediate; and 0%, high). F, A 62-year-old man with moderately differentiated SCC exhibiting heterogeneous T2 signals (overall ADC = 0.904 × 10−3 mm2/s; ADC mapping = 21%, extremely low; 61%, low; 15%, intermediate; and 3%, high). G, A 66-year-old man with well-differentiated SCC (overall ADC = 0.975 × 10−3 mm2/s; ADC mapping = 5%, extremely low; 83%, low; 12%, intermediate; and 1%, high). The color scale for ADC mapping is shown at the bottom. White curvilinear lines indicate ROIs. Bars in photomicrographs (H&E) are scale bars (50 μm).

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    Fig 2.

    Scatterplot shows overall ADCs of lymphomas and carcinomas of the nasopharynx or oropharynx. Ly indicates lymphomas; Ca, carcinomas. Horizontal bars indicate mean ADCs (P value, Mann-Whitney U test).

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    Fig 3.

    Scatterplot shows overall ADCs of lymphomas and carcinomas with different histologic subtypes. Ly indicates lymphomas; PD, poorly differentiated SCCs with homogeneous T2 signals (T2 homo) or heterogeneous T2 signals (T2 hetero); MD, moderately differentiated SCCs with homogeneous T2 signals (T2 homo) or heterogeneous T2 signals (T2 hetero); WD, well-differentiated SCCs. Horizontal bars indicate mean ADCs (P value, Mann-Whitney U test).

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  • ADC mapping of lymphomas and carcinomas in the nasopharynx and oropharynx

    ADC Mapping (× 10−3 mm2/s)Percentage of Tumor Area on ADC Map
    NasopharynxOropharynx
    LymphomaNPCLymphomaPD SCCMD SCCWD SCC
    T2 HomoT2 HeteroT2 HomoT2 Hetero
    No. of patients781754357
    Extremely low (<0.6)68 ± 1557 ± 1251 ± 35a,b,c,d34 ± 2510 ± 5a,b24 ± 2515 ± 13a,c15 ± 22a,d
    Low (0.6–1.2)32 ± 1443 ± 1248 ± 3464 ± 2574 ± 775 ± 2668 ± 1863 ± 14
    Intermediate (1.2–1.8)0 ± 01 ± 11 ± 2a,e,f1 ± 2a,g16 ± 10a,e,g2 ± 215 ± 19a,f19 ± 15
    High (>1.8)0 ± 00 ± 00 ± 00 ± 00 ± 00 ± 02 ± 33 ± 5
    • Note:—PD, poorly differentiated, MD, moderately differentiated; Homo, homogeneous; Hetero, heterogeneous; WD, well-differentiated; T2 homo/hetero, with homogeneous/heterogeneous T2 signals.

    • ↵a Significant differences between lymphomas and SCCs, and between PD SCCs with homogeneous T2 signals and heterogeneous T2 signals (Mann-Whitney U test).

    • ↵b P = .040.

    • ↵c P = .048.

    • ↵d P = .011.

    • ↵e P = .001.

    • ↵f P < .001.

    • ↵g P = .019.

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American Journal of Neuroradiology: 33 (4)
American Journal of Neuroradiology
Vol. 33, Issue 4
1 Apr 2012
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Y. Ichikawa, M. Sumi, M. Sasaki, T. Sumi, T. Nakamura
Efficacy of Diffusion-Weighted Imaging for the Differentiation between Lymphomas and Carcinomas of the Nasopharynx and Oropharynx: Correlations of Apparent Diffusion Coefficients and Histologic Features
American Journal of Neuroradiology Apr 2012, 33 (4) 761-766; DOI: 10.3174/ajnr.A2834

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Efficacy of Diffusion-Weighted Imaging for the Differentiation between Lymphomas and Carcinomas of the Nasopharynx and Oropharynx: Correlations of Apparent Diffusion Coefficients and Histologic Features
Y. Ichikawa, M. Sumi, M. Sasaki, T. Sumi, T. Nakamura
American Journal of Neuroradiology Apr 2012, 33 (4) 761-766; DOI: 10.3174/ajnr.A2834
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