title: Intravoxel incoherent motion diffusion-weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma.
abstract: Characterize and monitor treatment response in human papillomavirus (HPV) head and neck squamous cell carcinoma (HNSCC) using intra-treatment (intra-TX) imaging metrics derived from intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (DW-MRI).
  
  
  
  Thirty-four (30 HPV positive [+] and 4 HPV negative [-]) HNSCC patients underwent a total of 136 MRI including multi-b value DW-MRI (pretreatment [pre-TX] and intra-TX weeks 1, 2, and 3) at 3.0 Tesla. All patients were treated with chemo-radiation therapy. Monoexponential (yielding apparent diffusion coefficient [ADC]) and bi-exponential (yielding perfusion fraction [f], diffusion [D], and pseudo-diffusion [D*] coefficients) fits were performed on a region of interest and voxel-by-voxel basis, on metastatic neck nodes. Response was assessed using RECISTv1.1. The relative percentage change in D, f, and D* between the pre- and intra-TX weeks were used for hierarchical clustering. A Wilcoxon rank-sum test was performed to assess the difference in metrics within and between the complete response (CR) and non-CR groups.
  
  
  
  The delta (Δ) change in volume (V)1wk-0wkfor the CR group differed significantly (P = 0.016) from the non-CR group, while not for V2wk-0wkand V3wk-0wk(P > 0.05). The mean increase in ΔD3wk-0wkfor the CR group was significantly higher (P = 0.017) than the non-CR group. ADC and D showed an increasing trend at each intra-TX week when compared with pre-TX in CR group (P < 0.003). Hierarchical clustering demonstrated the existence of clusters in HPV + patients.
  
  
  
  After appropriate validation in a larger population, these IVIM imaging metrics may be useful for individualized treatment in HNSCC patients.
  
  
  
  2 J. Magn. Reson. Imaging 2017;45:1013-1023.
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Paudyal
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Riaz
authors.affiliation: Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Praveen
authors.initials: P
authors.lastname: Venigalla
authors.affiliation: Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.|Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang, P.R. China.
authors.forename: Jingao
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Vaios
authors.initials: V
authors.lastname: Hatzoglou
authors.affiliation: Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Leeman
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: David Aramburu
authors.initials: DA
authors.lastname: Nunez
authors.affiliation: Department of Radiation Oncology, Washington University in St. Louis, St. Louis, Missouri, USA.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Deasy
authors.affiliation: Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Lee
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.|Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Amita
authors.initials: A
authors.lastname: Shukla-Dave
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009038:Motion; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000000981:diagnostic imaging* / Q000628:therapy*; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
keywords: head and neck squamous cell carcinoma; human papillomavirus; intravoxel incoherent motion; multi b-value diffusion-weighted MRI