Abstract：
OBJECTIVE: Laryngeal and Hypopharyngeal Carcinomas (LC/HPC) constitute about 24 % of head and neck cancers, causing more than 90,000 annual deaths worldwide. Diffusion-Weighted Imaging (DWI), is currently widely studied in oncologic imaging and can aid in distinguishing cellular tumors from other tissues. Our objective was to review the effectiveness of DWI in three areas: diagnosing, predicting prognosis, and predicting treatment response in patients with LC/HPC.
METHODS: A systematic search was conducted in PubMed, Web of Science, and Embase. A meta-analysis by calculating Standardized Mean Difference (SMD) and 95 % Confidence Interval (CI) was conducted on diagnostic studies.
RESULTS: A total of 16 studies were included. All diagnostic studies (n = 9) were able to differentiate between the LC/HPC and other benign laryngeal/hypopharyngeal lesions. These studies found that LC/HPC had lower Apparent Diffusion Coefficient (ADC) values than non-cancerous lesions. Our meta-analysis of 7 diagnostic studies, that provided ADC values of malignant and non-malignant tissues, demonstrated significantly lower ADC values in LC/HPC compared to non-malignant lesions (SMD = -1.71, 95 %CI: [-2.00, -1.42], ADC cut-off = 1.2 × 103 mm2/s). Furthermore, among the studies predicting prognosis, 67 % (4/6) accurately predicted outcomes based on pretreatment ADC values. Similarly, among studies predicting treatment response, 50 % (2/4) successfully predicted outcomes based on pretreatment ADC values. Overall, the studies that looked at prognosis or treatment response in LC/HPC found a positive correlation between pretreatment ADC values in larynx/hypopharynx and favorable outcomes.
CONCLUSIONS: DWI aids significantly in the LC/HPC diagnosis. However, further research is needed to establish DWI\'s reliability in predicting prognosis and treatment response in patients with LC/HPC.
METHODS: A systematic search was conducted in PubMed, Web of Science, and Embase. A meta-analysis by calculating Standardized Mean Difference (SMD) and 95 % Confidence Interval (CI) was conducted on diagnostic studies.
RESULTS: A total of 16 studies were included. All diagnostic studies (n = 9) were able to differentiate between the LC/HPC and other benign laryngeal/hypopharyngeal lesions. These studies found that LC/HPC had lower Apparent Diffusion Coefficient (ADC) values than non-cancerous lesions. Our meta-analysis of 7 diagnostic studies, that provided ADC values of malignant and non-malignant tissues, demonstrated significantly lower ADC values in LC/HPC compared to non-malignant lesions (SMD = -1.71, 95 %CI: [-2.00, -1.42], ADC cut-off = 1.2 × 103 mm2/s). Furthermore, among the studies predicting prognosis, 67 % (4/6) accurately predicted outcomes based on pretreatment ADC values. Similarly, among studies predicting treatment response, 50 % (2/4) successfully predicted outcomes based on pretreatment ADC values. Overall, the studies that looked at prognosis or treatment response in LC/HPC found a positive correlation between pretreatment ADC values in larynx/hypopharynx and favorable outcomes.
CONCLUSIONS: DWI aids significantly in the LC/HPC diagnosis. However, further research is needed to establish DWI\'s reliability in predicting prognosis and treatment response in patients with LC/HPC.
摘要：
目的：喉癌和下咽癌（LC/HPC）约占头颈部癌的24％，导致全球每年超过9万人死亡。扩散加权成像(DWI)目前在肿瘤成像中被广泛研究，可以帮助区分细胞肿瘤与其他组织。我们的目标是回顾DWI在三个方面的有效性：诊断，预测预后，并预测LC/HPC患者的治疗反应。
方法：在PubMed中进行了系统搜索，WebofScience,和Embase。通过计算标准化平均差（SMD）和95％置信区间（CI）对诊断研究进行荟萃分析。
结果：共纳入16项研究。所有诊断研究（n=9）都能够区分LC/HPC和其他良性喉/下咽病变。这些研究发现LC/HPC具有比非癌性病变更低的表观扩散系数(ADC)值。我们对7项诊断研究的荟萃分析，提供恶性和非恶性组织的ADC值，与非恶性病变相比，LC/HPC的ADC值显着降低（SMD=-1.71，95CI：[-2.00，-1.42]，ADC截止值=1.2×103mm2/s)。此外，在预测预后的研究中，67%(4/6)基于治疗前ADC值准确预测结果。同样，在预测治疗反应的研究中，50%(2/4)基于预处理ADC值成功预测结果。总的来说,观察LC/HPC预后或治疗反应的研究发现,喉/下咽治疗前ADC值与良好结局之间存在正相关.
结论：DWI对LC/HPC诊断有显著帮助。然而,需要进一步的研究来确定DWI在预测LC/HPC患者预后和治疗反应方面的可靠性.
方法：在PubMed中进行了系统搜索，WebofScience,和Embase。通过计算标准化平均差（SMD）和95％置信区间（CI）对诊断研究进行荟萃分析。
结果：共纳入16项研究。所有诊断研究（n=9）都能够区分LC/HPC和其他良性喉/下咽病变。这些研究发现LC/HPC具有比非癌性病变更低的表观扩散系数(ADC)值。我们对7项诊断研究的荟萃分析，提供恶性和非恶性组织的ADC值，与非恶性病变相比，LC/HPC的ADC值显着降低（SMD=-1.71，95CI：[-2.00，-1.42]，ADC截止值=1.2×103mm2/s)。此外，在预测预后的研究中，67%(4/6)基于治疗前ADC值准确预测结果。同样，在预测治疗反应的研究中，50%(2/4)基于预处理ADC值成功预测结果。总的来说,观察LC/HPC预后或治疗反应的研究发现,喉/下咽治疗前ADC值与良好结局之间存在正相关.
结论：DWI对LC/HPC诊断有显著帮助。然而,需要进一步的研究来确定DWI在预测LC/HPC患者预后和治疗反应方面的可靠性.
