title: Changes in functional imaging parameters following induction chemotherapy have important implications for individualised patient-based treatment regimens for advanced head and neck cancer.
abstract: BACKGROUND
  When induction chemotherapy (IC) is used prior to chemoradiotherapy (CRT) in head and neck cancer (HNC), functional imaging (FI) may inform adaptation of treatment plans with the aim of optimising outcomes. Understanding the impact of IC on FI parameters is, therefore, essential.
  
  
  OBJECTIVE
  To prospectively evaluate the feasibility of acquiring serial FI ((18)F-FDG-PET, diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI) and its role in defining individualised treatment regimens following IC in HNC.
  
  
  METHODS
  Ten patients with stage III and IV HNC underwent conventional (CT and MRI) and functional (DW, DCE-MRI and (18)F-FDG-PET/CT) imaging at baseline and following two cycles of IC prior to definitive CRT.
  
  
  RESULTS
  One patient withdrew due to claustrophobia. Seven out of nine patients had a complete metabolic response to IC on (18)F-FDG-PET imaging. DCE-MRI showed a significant fall in transfer constant (K(trans)) (0.209 vs 0.129 min(-1)P<0.01) and integrated area under gadolinium curve at 60s (IAUGC6O) (18.4 vs 11.9 mmol/min, P<0.01) and DW-MRI a rise in ADC (0.89 vs 1.06 × 10(-3) mm(2)/s, P<0.01) following IC.
  
  
  CONCLUSIONS
  Acquiring FI sequences is feasible in HNC. There are marked changes in FI parameters following IC which may guide adaptation of individualised treatment regimens.
authors.affiliation: The Royal Marsden NHS Trust, Surrey, United Kingdom.
authors.forename: Ceri
authors.initials: C
authors.lastname: Powell
authors.forename: Maria
authors.initials: M
authors.lastname: Schmidt
authors.forename: Marco
authors.initials: M
authors.lastname: Borri
authors.forename: Dow-Mu
authors.initials: DM
authors.lastname: Koh
authors.forename: Mike
authors.initials: M
authors.lastname: Partridge
authors.forename: Angela
authors.initials: A
authors.lastname: Riddell
authors.forename: Gary
authors.initials: G
authors.lastname: Cook
authors.forename: Shreerang A
authors.initials: SA
authors.lastname: Bhide
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Nutting
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Harrington
authors.forename: Katie L
authors.initials: KL
authors.lastname: Newbold
mesh_terms: D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D060828:Induction Chemotherapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18