title: Apparent diffusion coefficient calculated with relatively high b-values correlates with local failure of head and neck squamous cell carcinoma treated with radiotherapy.
abstract: OBJECTIVE
  Few studies have investigated the relationship between ADC and clinical outcome in HNSCC. Our hypothesis has that relatively high pretreatment ADC would correlate with local failure of HNSCC treated with radiation therapy.
  
  
  METHODS
  This includes prospective and validation studies. Seventeen patients treated with radiation therapy for primary HNSCC completed the prospective study. Variables considered to affect local failure including MR imaging-related parameters such as ADC and its change ratio were compared between patients with local failure and controls, and those showing difference or association with local failure were further tested by survival analysis. Furthermore, variables were analyzed in 40 patients enrolled in the validation study.
  
  
  RESULTS
  Relatively high ADC calculated with b-values (300, 500, 750, and 1000 s/mm(2)) before treatment, high ADC increase ratio, and treatment method (chemoradiotherapy versus radiation therapy alone) revealed significant difference between patients with local failure and controls or association with local failure. In Cox proportional hazard testing, high ADC before treatment alone showed significant association with local failure (P = .0186). In the validation study, tumor volume before treatment, high ADC before treatment, T stage (T12 versus T34), and treatment method showed significance. Tumor volume before treatment (P = .0217) and high ADC before treatment (P = .0001) revealed significant association with local failure in Cox proportional hazard testing. High ADC before treatment was superior to tumor volume before treatment regarding association with local failure.
  
  
  CONCLUSIONS
  These results suggest pretreatment ADC obtained at high b-values as well as tumor volume correlate with local failure of HNSCC treated with radiation therapy.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan. mhatake@radiol.med.kyushuu.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Hatakenaka
authors.forename: Y
authors.initials: Y
authors.lastname: Shioyama
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Yabuuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuo
authors.forename: S
authors.initials: S
authors.lastname: Sunami
authors.forename: T
authors.initials: T
authors.lastname: Kamitani
authors.forename: T
authors.initials: T
authors.lastname: Yoshiura
authors.forename: T
authors.initials: T
authors.lastname: Nakashima
authors.forename: K
authors.initials: K
authors.lastname: Nishikawa
authors.forename: H
authors.initials: H
authors.lastname: Honda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017211:Treatment Failure