title: DCE-MRI for Pre-Treatment Prediction and Post-Treatment Assessment of Treatment Response in Sites of Squamous Cell Carcinoma in the Head and Neck.
abstract: OBJECTIVE
  It is important to identify patients with head and neck squamous cell carcinoma (SCC) who fail to respond to chemoradiotherapy so that they can undergo post-treatment salvage surgery while the disease is still operable. This study aimed to determine the diagnostic performance of dynamic contrast enhanced (DCE)-MRI using a pharmacokinetic model for pre-treatment predictive imaging, as well as post-treatment diagnosis, of residual SCC at primary and nodal sites in the head and neck.
  
  
  METHODS
  Forty-nine patients with 83 SCC sites (primary and/or nodal) underwent pre-treatment DCE-MRI, and 43 patients underwent post-treatment DCE-MRI, of which 33 SCC sites had a residual mass amenable to analysis. Pre-treatment, post-treatment and % change in the mean Ktrans, kep, ve and AUGC were obtained from SCC sites. Logistic regression was used to correlate DCE parameters at each SCC site with treatment response at the same site, based on clinical outcome at that site at a minimum of two years.
  
  
  RESULTS
  None of the pre-treatment DCE-MRI parameters showed significant correlations with SCC site failure (SF) (29/83 sites) or site control (SC) (54/83 sites). Post-treatment residual masses with SF (14/33) had significantly higher kep (p = 0.05), higher AUGC (p = 0.02), and lower % reduction in AUGC (p = 0.02), than residual masses with SC (19/33), with the % change in AUGC remaining significant on multivariate analysis.
  
  
  CONCLUSIONS
  Pre-treatment DCE-MRI did not predict which SCC sites would fail treatment, but post-treatment DCE-MRI showed potential for identifying residual masses that had failed treatment.
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China.
authors.forename: Ann D
authors.initials: AD
authors.lastname: King
authors.affiliation: School of Physics, Faculty of Engineering and Information Sciences, University of Wollongong, Australia.
authors.forename: Steven Kwok Keung
authors.initials: SK
authors.lastname: Chow
authors.affiliation: Alpha Oncology Centre, Hong Kong S.A.R., China.
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Yu
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China.
authors.forename: Frankie Kwok Fai
authors.initials: FK
authors.lastname: Mo
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China.
authors.forename: David K W
authors.initials: DK
authors.lastname: Yeung
authors.affiliation: Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong S.A.R., China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China.
authors.forename: Benjamin King Hong
authors.initials: BK
authors.lastname: Law
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China.
authors.forename: Kunwar S
authors.initials: KS
authors.lastname: Bhatia
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R. China.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Vlantis
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China.
authors.forename: Anil T
authors.initials: AT
authors.lastname: Ahuja
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D059248:Chemoradiotherapy; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis; D017063:Outcome Assessment, Health Care / Q000379:methods; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D016879:Salvage Therapy / Q000379:methods*; D017211:Treatment Failure
chemical_list: D003287:Contrast Media