Apparent diffusion coefficient is a prognostic factor of head and neck squamous cell carcinoma treated with radiotherapy

Hatakenaka, Masamitsu; Nakamura, Katsumasa; Yabuuchi, Hidetake; Shioyama, Yoshiyuki; Matsuo, Yoshio; Kamitani, Takeshi; Yonezawa, Masato; Yamada, Takashi; Nakashima, Torahiko; Mori, Mitsuru; Honda, Hiroshi

doi:10.1007/s11604-013-0272-y

Cited by 25 publications

(23 citation statements)

References 27 publications

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“…Pretreatment tumor ADC values have been shown to be predictors of treatment response in head and neck cancers. Previous head and neck squamous cell carcinoma studies have found significantly higher tumor ADC values in patients with LF, [5][6][7]10 nodal failure, 4 or poor treatment response, [8][9] while other studies have shown a similar trend in the ADC values that did not reach statistical significance. [17][18][19] It has been postulated that poor outcomes of some squamous cell carcinomas are due to tumor factors that are known to increase ADC values, such as micronecrosis, lower cellularity, and, more recently, negative human papillomavirus status and high stromal content.…”

Section: Discussionmentioning

confidence: 92%

“…It has been shown subsequently that more advanced nonGaussian models for ADC analysis influence the ADC in NPC. 41 In head and neck squamous cell carcinoma, the choice of b-values may also influence the accuracy of ADC for the prediction of treatment response, and some authors have proposed using ADCs calculated from the mid/high b-range (300/500-1000 s/mm 2 ) 9,10 to predict locoregional response.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, reports of head and neck squamous cell carcinoma suggest a significant association between high pretreatment ADC and poor treatment outcome. [4][5][6][7][8][9][10] However, for NPC, a smaller number of pretreatment predictive DWI studies have been reported. This is probably because local tumor relapse is less com-mon in NPC than in squamous cell carcinoma and is spread out during a longer posttreatment period.…”

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confidence: 99%

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Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

Law

King

Bhatia

et al. 2016

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Pretreatment prediction of patients with nasopharyngeal carcinoma who will fail conventional treatment would potentially allow these patients to undergo more intensive treatment or closer posttreatment monitoring. The aim of the study was to determine the ability of pretreatment DWI to predict local failure in patients with nasopharyngeal carcinoma based on long-term clinical outcome.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

Law

King

Bhatia

et al. 2016

AJNR Am J Neuroradiol

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“…Merging evidence suggests that diffusion-weighted magnetic resonance imaging (DWI-MRI) improves tissue characterization, staging, and response to treatment in HNSSC. 6–10 Conventional diffusion-weighted imaging (DWI), with a mono-exponential model, could not separate perfusion and true diffusion-related effect. This could be resolved in intra-voxel incoherent motion (IVIM) with a bi-exponential model.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment Intra-Voxel Incoherent Motion Diffusion-Weighted Imaging (IVIM-DWI) in Predicting Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma

Guo

Luo²,

Meng³

et al. 2016

Medicine

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The aim of this study was to predict response to induction chemotherapy in patients with locally advanced hypopharyngeal carcinoma by IVIM values.Twenty-eight patients with locally advanced hypopharyngeal carcinoma underwent IVIM studies using 12 different b values (b = 0, 10, 20, 30, 50, 70 100, 150, 200, 400, 800, and 1000 s/ mm2). All patients underwent 2 MRI studies: a baseline exam before any treatment and a mid-treatment exam 3 weeks after induction chemotherapy. In the IVIM approach, D∗, f, and D were extracted from a bi-exponential fit. For comparison, the ADC map were extracted from a mono-exponential fit. At the end of induction chemotherapy, patients were classified as responders or nonresponders group according to the Response Evaluation Criteria in Solid Tumors criteria (RECIST), based on their MRI measurement. The patients were classified into high grade group (G1), moderate grade group (G2), and low grade group (G3) according to the tumor pathological grading. The predictive value of IVIM parameters were examined with Student's t test, analysis of variance (ANOVA), and receiver operating characteristic (ROC) curves.After 2 cycles of induction chemotherapy, 18 patients were categorized into the responder group whereas the other 10 patients were considered nonresponders. Compared with the pretreatment value, the post-treatment ADC value and D value was significantly higher and the posttreatment D∗ value was significantly lower (all P < 0.05). In contrast, post-treatment f parameter only changed slightly (P > 0.05). Compared with nonresponders, a notably lower pretreatment ADC value, D value, posttreatment D∗ value, and higher posttreatment ADC value, D value, ΔADC, ΔD, and ΔD∗ were observed in responders (all P < 0.05), but no significant change in Δ f among the 2 group (P > 0.05). The ROC curve analysis indicated that the cutoff of pretreatment D value in best predicting tumor's chemotherapeutic response was 0.847 × 10−3 mm2/s, and the corresponding AUC, sensitivity, and specificity were 0.806, 75.0%, and 88.9%, respectively. Although pretreatment IVIM-derived parameters had no significant differences between high grade, moderate grade, and low grade group, a trend towards lower D∗ was observed with increasing tumor grading from G3 to G1.IVIM-DWI can potentially predict the treatment response to induction chemotherapy for hypopharyngeal carcinoma.

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“…Therefore, in recent years, DWI has been considered a good candidate as a noninvasive biomarker for predicting and monitoring treatment responses. Consequently, many studies have assessed DWI parameters (ADC values) with tumor response to chemoradiation therapy, [16][17][18][19][20][21][22][23][24] 2 ) has been applied successfully to HNSCC for tumor grading and work-up for recurrence following treatment. [25][26][27] In addition, a histogram-based approach with ADC maps has been used in neuro-oncologic imaging to differentiate tumor progression from pseudoprogession and to evaluate tumor grades and even gene mutations.…”

Section: Introductionmentioning

confidence: 99%

Squamous Cell Carcinoma of the Head and Neck: Comparison of Diffusion-weighted MRI at b-values of 1,000 and 2,000 s/mm<sup>2</sup> to Predict Response to Induction Chemotherapy

Ryoo

Kim

Choi

et al. 2015

MRMS

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Purpose: Recent publications have reported contradictory results of pretreatment diffusion-weighted magnetic resonance imaging (DWI) for the prediction of chemoradiotherapeutic response in primary squamous cell carcinomas of the head and neck (HNSCC). Therefore, we evaluated the diagnostic performance of DWI obtained with both standard (b = 0 and 1,000 s/mm 2 ) and high (b = 0 and 2,000 s/mm 2 ) b-values for predicting response to induction chemotherapy in HNSCCs.Methods: For 25 patients with primary HNSCC who underwent DWI with both standard and high b-values prior to treatment, we calculated corresponding apparent diffusion coefficient (ADC) maps. Regions of interest containing the tumor were drawn on every section of ADC maps and summated to make volume-based data of the entire tumor. Histogram parameters (mean ADC, kurtosis, and skewness) were correlated with treatment response using unpaired Student t test. Univariate and multivariate analysis of the ADC parameters, patient age, sex, whole tumor volume, and T stage were also performed to predict tumor response to induction chemotherapy.Results: Response to induction chemotherapy was good in 13 of the 25 patients and poor in 12. The mean ADC values of good responders at standard b-value (ADC 1000 ), 1.23 « 0.34 (© 10 ¹3 mm 2 /s), and high b-value (ADC 2000 ), 0.62 « 0.14 (© 10 ¹3 mm 2 /s), were lower than those of poor responders (ADC 1000 , 1.32 « 0.28 [© 10 ¹3 mm 2 /s]; ADC 2000 , 0.76 « 0.15 [© 10 ¹3 mm 2 /s]), but significant difference was achieved only at the ADC 2000 map (P = 0.02). In addition, mean tumor volume prior to treatment of good responders was smaller than that of poor responders. However, at multiple logistic regression analysis, only the mean ADC 2000 value remained as a significant predictor of response to induction chemotherapy.Conclusion: DWI with high b-values (b = 0 and 2,000 s/mm 2 ) as an assessment of ADC values may help predict tumor response to neoadjuvant chemotherapy for primary HNSCCs.

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Apparent diffusion coefficient is a prognostic factor of head and neck squamous cell carcinoma treated with radiotherapy

Abstract: ADC is an independent predictor of prognosis in HNSCC treated with radiotherapy.

Cited by 25 publications

References 27 publications

Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

Pretreatment Intra-Voxel Incoherent Motion Diffusion-Weighted Imaging (IVIM-DWI) in Predicting Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma

Squamous Cell Carcinoma of the Head and Neck: Comparison of Diffusion-weighted MRI at b-values of 1,000 and 2,000 s/mm<sup>2</sup> to Predict Response to Induction Chemotherapy

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