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Int J Radiat Oncol Biol Phys. 2012 Mar 1;82(3):1098-107. doi: 10.1016/j.ijrobp.2011.02.044. Epub 2011 Apr 20.

Diffusion-weighted magnetic resonance imaging early after chemoradiotherapy to monitor treatment response in head-and-neck squamous cell carcinoma.

Author information

1
Department of Radiology, University Hospitals Leuven, Leuven, Belgium. Vincent.Vandecaveye@uzleuven.be

Abstract

PURPOSE:

To evaluate diffusion-weighted imaging (DWI) for assessment of treatment response in head and neck squamous cell carcinoma (HNSCC) three weeks after the end of chemoradiotherapy (CRT).

METHODS AND MATERIALS:

Twenty-nine patients with HNSCC underwent magnetic resonance imaging (MRI) prior to and 3 weeks after CRT, including T(2)-weighted and pre- and postcontrast T(1)-weighted sequences and an echo-planar DWI sequence with six b values (0 to 1,000 s/mm(2)), from which the apparent diffusion coefficient (ADC) was calculated. ADC changes 3 weeks posttreatment compared to baseline (∆ADC) between responding and nonresponding primary lesions and adenopathies were correlated with 2 years locoregional control and compared with a Mann-Whitney test. In a blinded manner, the ∆ADC was compared to conventional MRI 3 weeks post-CRT and the routinely implemented CT, on average 3 months post-CRT, which used size-related and morphological criteria. Positive and negative predictive values (PPV and NPV, respectively) were compared between the ∆ADC and anatomical imaging.

RESULTS:

The ∆ADC of lesions with later tumor recurrence was significantly lower than lesions with complete remission for both primary lesions (-2.3% ± 0.3% vs. 80% ± 41%; p < 0.0001) and adenopathies (19.9% ± 32% vs. 63% ± 36%; p = 0.003). The ∆ADC showed a PPV of 89% and an NPV of 100% for primary lesions and a PPV of 70% and an NPV of 96% for adenopathies per neck side. DWI improved PPV and NPV compared to anatomical imaging.

CONCLUSION:

DWI with the ∆ADC 3 weeks after concluding CRT for HNSCC allows for early assessment of treatment response.

PMID:
21514067
DOI:
10.1016/j.ijrobp.2011.02.044
[Indexed for MEDLINE]

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