Diffusion-weighted magnetic resonance imaging for predicting and detecting early response to chemoradiation therapy of squamous cell carcinomas of the head and neck.

TitleDiffusion-weighted magnetic resonance imaging for predicting and detecting early response to chemoradiation therapy of squamous cell carcinomas of the head and neck.
Publication TypeJournal Article
Year of Publication2009
AuthorsKim S, Loevner L, Quon H, Sherman E, Weinstein G, Kilger A, Poptani H
JournalClin Cancer Res
Volume15
Issue3
Pagination986-94
Date Published2009 Feb 01
ISSN1078-0432
KeywordsAdult, Aged, Carcinoma, Squamous Cell, Combined Modality Therapy, Diffusion Magnetic Resonance Imaging, Early Diagnosis, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Prognosis, Sensitivity and Specificity, Treatment Outcome
Abstract

PURPOSE: The aim of this study was to investigate the utility of apparent diffusion coefficient (ADC) for prediction and early detection of treatment response in head and neck squamous cell carcinomas (HNSCC).

EXPERIMENTAL DESIGN: Diffusion-weighted magnetic resonance imaging studies were performed on 40 patients with newly diagnosed HNSCC before, during, and after the end of chemoradiation therapy. Analysis was done on data from 33 patients after exclusion of 7 patients that had incomplete data.

RESULTS: Pretreatment ADC value of complete responders (1.04 +/- 0.19 x 10(-3) mm2/s) was significantly lower (P < 0.05) than that from partial responders (1.35 +/- 0.30 x 10(-3) mm2/s). A significant increase in ADC was observed in complete responders within 1 week of treatment (P < 0.01), which remained high until the end of the treatment. The complete responders also showed significantly higher increase in ADC than the partial responders by the first week of chemoradiation (P < 0.01). When pretreatment ADC value was used for predicting treatment response, the area under the receiver operating characteristic curve was 0.80 with a sensitivity of 65% and a specificity of 86%. However, change in ADC within the first week of chemoradiation therapy resulted in an area under the receiver operating characteristic curve of 0.88 with 86% sensitivity and 83% specificity for prediction of treatment response.

CONCLUSIONS: These results suggest that ADC can be used as a marker for prediction and early detection of response to concurrent chemoradiation therapy in HNSCC.

DOI10.1158/1078-0432.CCR-08-1287
Alternate JournalClin Cancer Res
PubMed ID19188170
PubMed Central IDPMC2673914
Grant ListR01 CA102756 / CA / NCI NIH HHS / United States
R01 CA102756-04 / CA / NCI NIH HHS / United States
R01-CA102756 / CA / NCI NIH HHS / United States
Related Institute: 
MRI Research Institute (MRIRI)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065