Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-Analysis

Background: The purpose of the present meta-analysis was to provide evident data about use of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign lesions in the head and neck region.Material and Methods: MEDLINE and Scopus databases were screened for associations betw...

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Main Authors: Alexey Surov, Hans Jonas Meyer, Andreas Wienke
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-01-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fonc.2019.01362/full
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author Alexey Surov
Hans Jonas Meyer
Andreas Wienke
author_facet Alexey Surov
Hans Jonas Meyer
Andreas Wienke
author_sort Alexey Surov
collection DOAJ
description Background: The purpose of the present meta-analysis was to provide evident data about use of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign lesions in the head and neck region.Material and Methods: MEDLINE and Scopus databases were screened for associations between ADC and malignancy/benignancy of head and neck lesions up to December 2018. Overall, 22 studies met the inclusion criteria. The following data were extracted: authors, year of publication, study design, number of patients/lesions, lesion type, mean value, and standard deviation of ADC. The primary endpoint of the systematic review was the analysis of the association between lesion nature and ADC values. The methodological quality of the involved studies was checked according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malignant lesions.Results: The acquired 22 studies comprised 1,227 lesions. Different malignant lesions were diagnosed in 818 cases (66.7%) and benign lesions in 409 cases (33.3%). The mean ADC value of the malignant lesions was 1.04 × 10−3 mm2/s, and the mean value of the benign lesions was 1.46 × 10−3 mm2/s. Lymphomas and sarcomas showed the lowest calculated mean ADC values, 0.7 and 0.79 × 10−3 mm2/s, respectively. Adenoid cystic carcinomas had the highest ADC values (1.5 × 10−3 mm2/s). None of the analyzed malignant tumors had mean ADC values above 1.75 × 10−3 mm2/s.Conclusion: ADC values play a limited role in distinguishing between malignant and benign lesions in the head and neck region. It may be only suggested that lesions with mean ADC values above 1.75 × 10−3 mm2/s are probably benign. Further large studies are needed for the analysis of the role of diffusion-weighted imaging (DWI)/ADC in the discrimination of benign and malignant lesions in the head and neck region.
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spelling doaj.art-17af17ec06d04ec3805d8dd322cc89952022-12-21T18:23:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-01-01910.3389/fonc.2019.01362487218Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-AnalysisAlexey Surov0Hans Jonas Meyer1Andreas Wienke2Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, GermanyDepartment of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, GermanyInstitute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, GermanyBackground: The purpose of the present meta-analysis was to provide evident data about use of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign lesions in the head and neck region.Material and Methods: MEDLINE and Scopus databases were screened for associations between ADC and malignancy/benignancy of head and neck lesions up to December 2018. Overall, 22 studies met the inclusion criteria. The following data were extracted: authors, year of publication, study design, number of patients/lesions, lesion type, mean value, and standard deviation of ADC. The primary endpoint of the systematic review was the analysis of the association between lesion nature and ADC values. The methodological quality of the involved studies was checked according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malignant lesions.Results: The acquired 22 studies comprised 1,227 lesions. Different malignant lesions were diagnosed in 818 cases (66.7%) and benign lesions in 409 cases (33.3%). The mean ADC value of the malignant lesions was 1.04 × 10−3 mm2/s, and the mean value of the benign lesions was 1.46 × 10−3 mm2/s. Lymphomas and sarcomas showed the lowest calculated mean ADC values, 0.7 and 0.79 × 10−3 mm2/s, respectively. Adenoid cystic carcinomas had the highest ADC values (1.5 × 10−3 mm2/s). None of the analyzed malignant tumors had mean ADC values above 1.75 × 10−3 mm2/s.Conclusion: ADC values play a limited role in distinguishing between malignant and benign lesions in the head and neck region. It may be only suggested that lesions with mean ADC values above 1.75 × 10−3 mm2/s are probably benign. Further large studies are needed for the analysis of the role of diffusion-weighted imaging (DWI)/ADC in the discrimination of benign and malignant lesions in the head and neck region.https://www.frontiersin.org/article/10.3389/fonc.2019.01362/fullhead and necktumorsapparent diffusion coefficientADCmagnetic resonance imagingMRI
spellingShingle Alexey Surov
Hans Jonas Meyer
Andreas Wienke
Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-Analysis
Frontiers in Oncology
head and neck
tumors
apparent diffusion coefficient
ADC
magnetic resonance imaging
MRI
title Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-Analysis
title_full Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-Analysis
title_fullStr Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-Analysis
title_full_unstemmed Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-Analysis
title_short Apparent Diffusion Coefficient for Distinguishing Between Malignant and Benign Lesions in the Head and Neck Region: A Systematic Review and Meta-Analysis
title_sort apparent diffusion coefficient for distinguishing between malignant and benign lesions in the head and neck region a systematic review and meta analysis
topic head and neck
tumors
apparent diffusion coefficient
ADC
magnetic resonance imaging
MRI
url https://www.frontiersin.org/article/10.3389/fonc.2019.01362/full
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