BACKGROUND AND PURPOSE:Several studies have reported on the clinical utility of DWI in head and neck cancer, but none of these studies compared HASTE with EPI-DWI in patients with head and neck cancer. The aim of our study was to compare detection and delineation of primary tumors and lymph nodes by using HASTE and EPI-DWI techniques in patients with HNSCC.
Pretreatment primary tumor volume and lymph node ADC1000 were significant independent predictors of DFS in HNSCC treated with (C)RT. DFS could be predicted from ADC-values acquired without and with including CE-T1WI in image analysis. The inclusion of CE-T1WI did not result in significant improvements in the predictive value of DWI. DWI without including CE-T1WI was highly reproducible.
BACKGROUND AND PURPOSE:DWI is typically performed with EPI sequences in single-center studies. The purpose of this study was to determine the reproducibility of ADC values in the head and neck region in healthy subjects. In addition, the reproducibility of ADC values in different tissues was assessed to identify the most suitable reference tissue.
MR imaging-determined pre-epiglottic space involvement and abnormal signal intensities in the thyroid cartilage adjacent to the anterior commissure and/or the cricoid cartilage are strong predictors of local outcome in supraglottic carcinoma treated with definitive radiation therapy.
Intermediate T2 SI in cartilage, which may suggest cartilage invasion, and hypopharyngeal extension of tumor, predict greater likelihood of local failure, whereas high T2 SI, which may suggest inflammatory tissue in cartilage, predicts lower likelihood of local failure.
The purpose was to determine if pre-radiotherapy (RT) and/or post-radiotherapy magnetic resonance (MR) imaging can predict response in patients with laryngeal carcinoma treated with RT. Pre-and post-RT MR examinations of 80 patients were retrospectively reviewed and associated with regard to local control. Pre-RT MR imaging parameters such as tumor involvement of specific laryngeal anatomic subsites including laryngeal cartilages and post-RT changes, i.e., complete resolution of the tumor or focal mass/asymmetric obliteration of laryngeal tissue and signal pattern on T2-weighted images, were evaluated. Local control was defined as absence of a recurrence at the primary site for 2 years. Local control rates based on pretreatment MR findings were 73% for low pre-RT risk-profile and 29% for high pre-RT risk-profile patients (p=0.0001). Based on posttreatment MR findings, local control rates were 100% score 1, 64% score 2, and 4% score 3 (p< 0.0001). Using post-RT T2-weighted images, significant association was found between differences in signal pattern and local control: 77% hypointense, 54% isointense and 15% hyperintense lesions (p<0.001). Differences between means of delay of post-MRI examination were significantly associated with regard to local control (p=0.003); recurrent tumors followed 5 months after RT were more easily detectable on MRI than recurrent tumors within 4 months after RT. Sensitivity, specificity, accuracy, negative and positive predictive values of post-RT score 3 were 96%, 76%, 83%, 98% and 66%. Pre-and post-RT MRI evaluation of the larynx can identify patients at high risk for developing local failure.
ReferencesAndrade RS, Heron DE, Degirmenci B, Filho PAA, Branstet-[1] ter BF, Seethala RR, et al. Posttreatment assessment of response using FDG-PET CT for patients treated with definitive radiation therapy for head and neck cancers. Int J Radiat Oncol Biol Phys 2006;65:1315-22. Ong SC, Schoder H, Lee NY, Patel SG, Carlson D, Fury [2] M, et al. Clinical utility of 18 F-FDG-PET/CT in assessing the neck after concurrent chemoradiotherapy for locoregional advanced head and neck cancer. J Nucl Med 2008;49: 532-40.
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