title: High b-Value Diffusion MRI to Differentiate Recurrent Tumors from Posttreatment Changes in Head and Neck Squamous Cell Carcinoma: A Single Center Prospective Study.
abstract: Recently DW-MR Imaging has shown promising results in distinguishing between recurrent tumors and posttreatment changes in Head and Neck Squamous Cell Carcinoma (HNSSC). Aim of this study was to evaluate the diagnostic performances of DWI at high b-value (b = 2000 s/mm(2)) compared to standard b-value (b = 1000 s/mm(2)) and ADCratio values (ADCratio = ADC2000/ADC1000 × 100) to differentiate recurrent tumors from posttreatment changes after treatment of HSNCC. 20 patients (16 M, 4 F) underwent MR Imaging between 2 and 16 months (mean 7) after treatment. Besides morphological sequences, we performed single-shot echo-planar DWI at b = 1000 s/mm(2) and b = 2000 s/mm(2), and corresponding ADC maps were generated (ADC1000 and ADC2000, resp.). By considering contrast-enhanced T1-weighted images as references, ROIs were drawn in order to evaluate mean ADC1000, ADC2000, and ADCratio. The mean ADC1000 and ADC2000 in recurrent tumors were significantly lower than those in posttreatment changes (P = 0.001 and P = 0.016, resp.). Moreover, the mean ADCratio between the two groups showed a statistically significant difference (P = 0.002). Sensitivity, specificity, and accuracy of ADCratio were 82.0%, 100%, and 90%, respectively, by considering an optimal cutoff value of 65.5%. ADCratio is a promising value to differentiate between recurrent tumors and posttreatment changes in HNSCC and may be more useful than ADC1000 and ADC2000.
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Radiology, University of Naples "Federico II", Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Acampora
authors.affiliation: Department of Neuroradiology, Umberto I Hospital, Viale San Francesco 2, 84014 Nocera Inferiore, Italy.
authors.forename: Gaetana
authors.initials: G
authors.lastname: Manzo
authors.affiliation: Department of Neuroradiology, Umberto I Hospital, Viale San Francesco 2, 84014 Nocera Inferiore, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Fenza
authors.affiliation: Department of Onco-Hematology, DEA Nocera-Pagani, Umberto I Hospital, Viale San Francesco 2, 84014 Nocera Inferiore, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Busto
authors.affiliation: Department of Neuroradiology, Umberto I Hospital, Viale San Francesco 2, 84014 Nocera Inferiore, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Serino
authors.affiliation: Department of Neuroradiology, Umberto I Hospital, Viale San Francesco 2, 84014 Nocera Inferiore, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Manto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck