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


METHODS
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.
Kim
Sungheon
S
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Sungheon.Kim@nyumc.org
Loevner
Laurie
L
Quon
Harry
H
Sherman
Eric
E
Weinstein
Gregory
G
Kilger
Alex
A
Poptani
Harish
H
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D003131:Combined Modality Therapy; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D016896:Treatment Outcome