La radiologia medica

, Volume 118, Issue 4, pp 534–539 | Cite as

Nasopharyngeal carcinoma: correlation of apparent diffusion coefficient value with prognostic parameters

  • Ahmed Abdel Khalek Abdel Razek
  • Elsharawey Kamal
Head and Neck Radiology / Radiologia del Capo e del Collo



The aim of this study was to correlate the apparent diffusion coefficient (ADC) value with the prognostic parameters of nasopharyngeal carcinoma (NPC).

Materials and methods

This was a prospective study conducted on 30 consecutive patients (19 men, 11 women; mean age 61 years) with NPC. Patients underwent diffusion-weighted magnetic resonance (DW-MR) singleshot echoplanar imaging at 1.5 Tesla. NPC ADC value was correlated with pathological tumour type, pathological tumour grade, tumour volume and nodal status.


Mean NPC ADC value was 0.99±0.11×10−3mm2/s. ADC values of well-differentiated and moderately differentiated tumours differed significantly (p=0.005) from those of poorly differentiated and undifferentiated NPC. There was also a significant difference in ADC value among small, medium and large tumour volume (p=0.03). ADC value was also significantly lower (p=0.003) when metastatic cervical lymph nodes were present. ADC value correlated inversely with tumour volume (r=−0.799, p=0.03).


ADC value can be considered a noninvasive prognostic parameter that correlates well with prognostic parameters of NPC.


Diffusion Nasopharynx Carcinoma MR imaging 

Carcinoma nasofaringeo: correlazione tra il valore del coefficiente apparente di diffusione e i parametri prognostici



Lo scopo di questo studio è stato quello di correlare il valore del coefficiente apparente di diffusione (ADC) con i parametri prognostici del carcinoma nasofaringeo (NPC).

Materiali e metodi

Questo è stato uno studio prospettico su 30 pazienti consecutivi (19 uomini e 11 donne, con un’età media di 61 anni) con NPC. I pazienti sono stati sottoposti a Risonanza Magnetica a 1,5 Tesla con studio di diffusione usando sequenze ecoplanari single-shot. Il valore di ADC del NPC è stato correlato con il tipo di tumore, il grado, il volume tumorale e lo stato linfonodale.


Il valore medio dell’ADC dei NPC è stato 0,99±0,11x10−3mm2/s. I valori di ADC dei tumori ben differenziati e moderatamente differenziati sono stati significativamente diversi (p=0,005) rispetto ai valori degli NPC scarsamente differenziati o indifferenziati. C’è stata anche una differenza significativa nei valori di ADC tra tumori di piccole, medie o grandi dimensioni (p=0,03). I valori di ADC sono inoltre stati significativamente inferiori (p=0,003) in caso di presenza di metastasi linfonodali cervicali. Il valore di ADC dei carcinomi nasofaringei è risultato essere inversamente proporzionale al volume tumorale (r=-0,799, p=0,03).


Il valore di ADC può essere considerato un parametro prognostico non invasivo che correla con i parametri prognostici per l’NPC.

Parole chiave

Diffusione Nasofaringe Carcinoma RM 


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  1. 1.
    King A, Bhatia KS (2010) Magnetic resonance imaging staging of nasopharyngeal carcinoma in the head and neck. World J Radiol 2:159–165PubMedCrossRefGoogle Scholar
  2. 2.
    Chong V, Ong C (2008) Nasopharyngeal carcinoma. Eur J Radiol 66:437–447PubMedCrossRefGoogle Scholar
  3. 3.
    Lin J (2010) Prognostic factors in nasopharyngeal cancer. In Lu JJ, Cooper JS, Lee AW (eds) Nasopharyngeal Cancer Multidisciplinary Management. Springer-Verlag Berlin Heidelberg, pp. 95–136CrossRefGoogle Scholar
  4. 4.
    Brandwein-Gensler M, Smith R (2010) Prognostic indicators in head and neck oncology including the new 7th edition of the AJCC staging system. Head and Neck Pathol 4:53–61CrossRefGoogle Scholar
  5. 5.
    Abdel Razek A (2010) Diffusionweighted magnetic resonance imaging of head and neck. J Comput Assist Tomogr 34:808–815CrossRefGoogle Scholar
  6. 6.
    Fong D, Bhatia KS, Yeung D et al (2010) Diagnostic accuracy of diffusion-weighted MR imaging for nasopharyngeal carcinoma, head and neck lymphoma and squamous cell carcinoma at the primary site. Oral Oncol 46:603–606PubMedCrossRefGoogle Scholar
  7. 7.
    Sumi M, Ichikawa Y, Nakamura T (2007) Diagnostic ability of apparent diffusion coefficients for lymphomas and carcinomas in the pharynx. Eur Radiol 17:2631–2637PubMedCrossRefGoogle Scholar
  8. 8.
    Ichikawa Y, Sumi M, Sasaki M et al (2012) 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. AJNR Am J Neuroradiol 33:761–766PubMedCrossRefGoogle Scholar
  9. 9.
    Abdel Razek A, Soliman N, Elkhammary S et al (2006) Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol 16:1468–1477PubMedCrossRefGoogle Scholar
  10. 10.
    King AD, Ahuja AT, Yeung DK et al (2007) Malignant cervical lymphadenopathy: diagnostic Accuracy of diffusion-weighted MR imaging. Radiology 245:806–813PubMedCrossRefGoogle Scholar
  11. 11.
    Abdel Razek A, Kandeel A, Soliman N et al (2007) Role of diffusionweighted echo-planar MR imaging in differentiation of residual or recurrent head and neck tumors and posttreatment changes. AJNR Am J Neuroradiol 28:1146–1152PubMedCrossRefGoogle Scholar
  12. 12.
    Abdel Razek A, Gaballa G, Denewer A (2010) Invasive ductal carcinoma: correlation of apparent diffusion coefficient value with pathological prognostic factors. NMR biomed 23:619–623CrossRefGoogle Scholar
  13. 13.
    Kim S, Cha E, Kim H et al (2009) Diffusion-weighted imaging of breast cancer: correlation of the apparent diffusion coefficient value with prognostic factors. J Magn Reson Imaging 30:615–620PubMedCrossRefGoogle Scholar
  14. 14.
    Abdel Razek A, Fathy A, Abdel Gawad T (2011) Correlation of apparent diffusion coefficient value with prognostic parameters of lung cancer. JCAT J Comput Assist Tomogr 35:248–252CrossRefGoogle Scholar
  15. 15.
    Abdel Razek A, Elkhamary S, Al-Mesfer S et al (2012) Correlation of apparent diffusion coefficient at 3 tesla with prognostic parameters of retinoblastoma. AJNR Am J Neuroradiol 33:944–948PubMedCrossRefGoogle Scholar
  16. 16.
    Barnes L, Eveson JW, Reichart PW et al (2005) World Health Organization Classification of Tumours: Pathology & Genetics Head and Neck Tumours. chapter 2. Lyon, France: IARC Press. Tumours of the nasopharynx, pp. 83–97Google Scholar
  17. 17.
    Abdel Razek A, King A (2012) MRI and CT of nasopharyngeal carcinoma. AJR Am J Roentegenol 98:11–18CrossRefGoogle Scholar
  18. 18.
    Lee CC, Huang TT, Lee MS et al (2010) Clinical application of tumor volume in advanced nasopharyngeal carcinoma to predict outcome. Radiat Oncol 5:20PubMedCrossRefGoogle Scholar
  19. 19.
    Sarisahin M, Cila A, Ozyar E et al (2011) Prognostic significance of tumor volume in nasopharyngeal carcinoma. Auris Nasus Larynx 38:250–254PubMedCrossRefGoogle Scholar
  20. 20.
    Liang SB, Sun Y, Liu LZ et al (2009) Extension of local disease in nasopharyngeal carcinoma detected by magnetic resonance imaging: improvement of clinical target volume delineation. Int J Radiat Oncol Biol Phys 75:742–750PubMedCrossRefGoogle Scholar
  21. 21.
    Chong V, Zhou J, Khoo J et al (2004) Nasopharyngeal carcinoma tumor volume measurement. Radiology 231:914–921PubMedCrossRefGoogle Scholar
  22. 22.
    Ng W, Lee A, Kan W et al (2007) N-staging by magnetic resonance imaging for patients with nasopharyngeal carcinoma: pattern of nodal involvement by radiological levels. Radiother Oncol 82:70–75PubMedCrossRefGoogle Scholar
  23. 23.
    Zhang G, Liu L, Wei W et al (2010) Retropharyngeal lymph node metastasis in nasopharyngeal carcinoma treated with radiation therapy. Radiology 255:605–612PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Ahmed Abdel Khalek Abdel Razek
    • 1
  • Elsharawey Kamal
    • 2
  1. 1.Department of RadiologyMansoura Faculty of MedicineMansouraEgypt
  2. 2.Department of ENT and Head and Neck SurgeryMansoura Faculty of MedicineMansouraEgypt

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