Article Figures & Data
Figures
- Fig 1.
A 51-year-old patient with T3N2c carcinoma of the base of the tongue. A, Axial T1-weighted MR image of the head and neck shows 3 lymph nodes (arrows). Axial corresponding HASTE-DWI (B) with a b-value of 1000 s/mm2 and a HASTE ADC map (C) demonstrate moderate delineation of these lesions assessed by both radiologists. Axial corresponding EPI-DWI (D) with a b-value of 1000 s/mm2 and the EPI ADC map (E) demonstrate good delineation of the same lesions by both radiologists.
- Fig 2.
A 58-year-old patient with T3N2c hypopharyngeal carcinoma. Axial T1-weighted MR image (A) and postcontrast T1-weighted MR image (B) of the head and neck region present a hypopharyngeal carcinoma (arrow) with laryngeal extension and a subdigastric lymph node (arrowhead) on the right side. Axial corresponding HASTE-DWI (C) with a b-value of 1000 s/mm2 and HASTE ADC (D) demonstrate mainly diffusion restriction of these lesions by using HASTE-DWI. The tumor and lymph node on these HASTE-DWI images were moderately and well-delineated, respectively, by both radiologists. Axial corresponding EPI-DWI (E) with a b-value of 1000 s/mm2 and EPI ADC (F) again show mainly diffusion restriction of these lesions by using EPI-DWI. Both the tumor and lymph node on these EPI-DWI images were well-delineated by both radiologists.
- Fig 3.
Bland-Altman plots representing interobserver agreement regarding ADC values of primary tumors (triangle) and lymph nodes (circle) detected by 2 observers on EPI-DWI (A) and HASTE-DWI (B). Bland-Altman plots representing agreement regarding ADC values of primary tumors (triangle) and lymph nodes (circle) of EPI versus HASTE-DWI determined by observer 1 (C) and observer 2 (D).
- Fig 4.
A 68-year-old patient with T2N2b tonsillar carcinoma. A, Axial T1-weighted MR image of the head and neck region shows susceptibility artifacts due to the presence of a dental implant. Axial corresponding HASTE-DWI (B) with a b-value of 0 s/mm2 and a HASTE ADC map (C) demonstrate the influence of these susceptibility artifacts, resulting in signal-intensity loss. Axial corresponding EPI-DWI (D) with a b-value of 0 s/mm2 and the EPI-ADC map (E) show the effect of these susceptibility artifacts, resulting in geometric distortion.
Tables
- Table 1:
Visualization of primary tumors and lymph nodes defined by detection and delineation on EPI- and HASTE-DWI and determined by radiologists 1 and 2
Visualization No. of Delineated Lesions on EPI-DWI No. of Delineated Lesions on HASTE-DWI Radiologist 1 Tumors pretreatment Good 11 6 Moderate 1 5 Bad 0 1 Total 12 12 Lymph nodes pretreatment Good 67 18 Moderate 8 36 Bad 2 8 Total 77 62 Radiologist 2 Tumors pretreatment Good 10 7 Moderate 2 4 Bad 0 1 Total 12 12 Lymph nodes pretreatment Good 73 24 Moderate 3 22 Bad 0 6 Total 76 52 - Table 2:
Interobserver agreement and differences of detection using EPI- and HASTE-DWI determined pretreatment
Agreement in % κ (95% CI) Difference of Proportions McNemar (P Value) EPI-DWI observer 1 versus EPI-DWI observer 2 99% 0.85 (0.57–1.00) −0.01 1.00 HASTE-DWI observer 1 versus HASTE-DWI observer 2 90% 0.74 (0.58–0.90) −0.09 .004 - Table 3:
Interobserver agreement and differences of delineation using EPI- and HASTE-DWI determined pretreatmenta
Agreement in % Weighted κ (95% CI) Differences of Means Wilcoxon Signed Rank (P Value) EPI-DWI observer 1 versus EPI-DWI observer 2 98% 0.52 (0.16–0.76) 0.09 .07 HASTE-DWI observer 1 versus HASTE-DWI observer 2 90% 0.54 (0.34–0.73) 0.17 .18 -
↵a The delineation of primary tumors and lymph nodes is determined by using a 3-point scale: score 1 = poor delineation, score 2 = moderate delineation, and score 3 = good delineation.
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- Table 4:
Agreement and differences of detection between EPI- and HASTE-DWI determined pretreatment
Agreement in % κ (95% CI) Difference of Proportions McNemar (P Value) HASTE-DWI observer 1 versus EPI-DWI observer 1 84% 0.24 (0.01–0.47) 0.17 <.0005 HASTE-DWI observer 2 versus EPI-DWI observer 2 75% 0.20 (0.03–0.37) 0.25 <.0005 - Table 5:
Agreement and differences of delineation between EPI- and HASTE-DWI determined pretreatmenta
Agreement in % Weighted κ (95% CI) Differences of Means Wilcoxon Signed Rank (P Value) HASTE-DWI observer 1 versus EPI-DWI observer 1 78% 0.12 (−0.01–0.28) 0.65 <.0005 HASTE-DWI observer 2 versus EPI-DWI observer 2 81% 0.07 (−0.04–0.18) 0.57 <.0005 -
↵a The delineation of primary tumors and lymph nodes is determined by using a 3-point scale: score 1 = poor delineation, score 2 = moderate delineation, and score 3 = good delineation.
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- Table 6:
Interobserver agreement of ADC values regarding primary tumors and lymph nodes using EPI- and HASTE-DWI
Bias (10–5 mm2/s) LoA (10–5 mm2/s) ICC (95% CI) EPI-DWI observer 1 versus EPI-DWI observer 2 2.50 −19.75, 24.75 0.76 (0.66–0.84) HASTE-DWI observer 1 versus HASTE-DWI observer 2 −0.92 −20.91, 19.07 0.92 (0.87–0.95) -
Note:—LoA indicates limits of agreement.
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- Table 7:
Agreement of ADC values regarding primary tumors and lymph nodes between EPI- and HASTE DWI
Bias (10–5 mm2/s) LoA (10–5 mm2/s) ICC (95% CI) EPI-DWI observer 1 versus HASTE-DWI observer 1 −5.74 −49.60; 38.12 0.42 (0.22–0.60) EPI-DWI observer 2 versus HASTE-DWI observer 2 −8.62 −57.97; 40.74 0.31 (0.08–0.51) -
Note:—LoA indicates limits of agreement.
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