Purpose: The aim of this study was to investigate the utility of apparent diffusion coefficient (ADC) for prediction and early detection of treatment response in head and neck squamous cell carcinomas (HNSCC). Experimental Design: Diffusion-weighted magnetic resonance imaging studies were performed on 40 patients with newly diagnosed HNSCC before, during, and after the end of chemoradiation therapy. Analysis was done on data from 33 patients after exclusion of 7 patients that had incomplete data. Results: Pretreatment ADC value of complete responders (1.04 F 0.19 Â 10 -3 mm 2 /s) was significantly lower (P < 0.05) than that from partial responders (1.35 F 0.30 Â 10 -3 mm 2 /s). A significant increase in ADC was observed in complete responders within 1 week of treatment (P < 0.01), which remained high until the end of the treatment. The complete responders also showed significantly higher increase in ADC than the partial responders by the first week of chemoradiation (P < 0.01). When pretreatment ADC value was used for predicting treatment response, the area under the receiver operating characteristic curve was 0.80 with a sensitivity of 65% and a specificity of 86%. However, change in ADC within the first week of chemoradiation therapy resulted in an area under the receiver operating characteristic curve of 0.88 with 86% sensitivity and 83% specificity for prediction of treatment response. Conclusions: These results suggest that ADC can be used as a marker for prediction and early detection of response to concurrent chemoradiation therapy in HNSCC.

BACKGROUND AND PURPOSE: Tumor microenvironment, including blood flow and permeability, may provide crucial information regarding response to chemoradiation therapy. Thus, the objective of this study was to investigate the efficacy of pretreatment DCE-MR imaging for prediction of response to chemoradiation therapy in HNSCC.

This pilot study explores the potential of noninvasive diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) for monitoring early relative blood flow (rBF), tissue oxygen saturation (StO(2)), and total hemoglobin concentration (THC) responses to chemo-radiation therapy in patients with head and neck tumors. rBF, StO(2), and THC in superficial neck tumor nodes of eight patients are measured before and during the chemo-radiation therapy period. The weekly rBF, StO(2), and THC kinetics exhibit different patterns for different individuals, including significant early blood flow changes during the first two weeks. Averaged blood flow increases (52.7+/-9.7)% in the first week and decreases (42.4+/-7.0)% in the second week. Averaged StO(2) increases from (62.9+/-3.4)% baseline value to (70.4+/-3.2)% at the end of the second week, and averaged THC exhibits a continuous decrease from pretreatment value of (80.7+/-7.0) [microM] to (73.3+/-8.3) [microM] at the end of the second week and to (63.0+/-8.1) [microM] at the end of the fourth week of therapy. These preliminary results suggest daily diffuse-optics-based therapy monitoring is feasible during the first two weeks and may have clinical promise.

Purpose:To investigate the effect of transcytolemmal water exchange on the dynamic contrast-enhanced (DCE) T 1 -weighted MRI of human squamous cell carcinomas of the head and neck (HNSCC). Materials and Methods:Nine patients with HNSCC nodal metastasis underwent pretreatment DCE-MRI with a temporal resolution of 2.5 seconds and a spatial resolution of 1 mm ϫ 1 mm ϫ 5 mm at 1.5T. We used two pharmacokinetic models for data analysis: generalized kinetic model (GKM) without considering transcytolemmal water exchange and the shutter-speed model (SSM), based on a two-site exchange model for transcytolemmal water exchange. The results were compared in three subgroups of voxels in the tumor depending on the level of contrast enhancement.Results: SSM was found to be a better fit for more than 75% of pixels of all subjects (P Ͻ 0.01) in terms of residual size and Bayesian information criterion (BIC). For all three subgroups based on the contrast enhancement, the median K trans values of SSM were 42% to 55% higher than those of GKM and the median v e values of SSM were 116% to 176% larger than those of GKM. The median K trans and v e of two models were found significantly different (P Ͻ 0.01). The median i measured by SSM were from 211 to 364 msec. Conclusion:The effect of transcytolemmal water exchange is an important factor that needs to be incorporated for adequate modeling of contrast enhancement dynamics measured by MRI of HNSCC.

ERSCMRI produced greater overall accuracy in staging for rectal carcinoma than did EUS.