Correlations between DW‐MRI and ¹⁸F‐FDG PET/CT parameters in head and neck squamous cell carcinoma following definitive chemo‐radiotherapy

Abstract

Background: Posttreatment diffusion-weighted magnetic resonance imaging (DW-MRI) and 18F-fluorodeoxygluocose ( 18 F-FDG) positron emission tomography (PET) with computed tomography (PET/CT) have potential prognostic value following chemo-radiotherapy (CRT) for head and neck squamous cell carcinoma (HNSCC). Correlations between these PET/CT (standardized uptake value or SUV) and DW-MRI (apparent diffusion coefficient or ADC) parameters have only been previously explored in the pretreatment setting.Aim: To evaluate stage III and IV HNSCC at 12-weeks post-CRT for the correlation between SUV max and ADC values and their interval changes from pretreatment imaging.Methods: Fifty-six patients (45 male, 11 female, mean age 59.9 + − 7.38) with stage 3 and 4 HNSCC patients underwent 12-week posttreatment DW-MRI and 18 F-FDG PET/CT studies in this prospective study. There were 41/56 patients in the cohort with human papilloma virus-related oropharyngeal cancer (HPV OPC). DW-MRI (ADC max and ADC min) and 18 F-FDG PET/CT (SUV max and SUV max ratio to liver) parameters were measured at the site of primary tumors (n = 48) and the largest lymph nodes (n = 52). Kendall's tau evaluated the correlation between DW-MRI and 18 F-FDG PET/CT parameters. Mann-Whitney test compared the post-CRT PET/CT and DW-MRI parameters between those participants with and without 2-year disease-free survival (DFS).Results: There was no correlation between DW-MRI and 18 F-FDG PET/CT parameters on 12-week posttreatment imaging (P = .455-.794; tau = −0.075-0.25) or their interval changes from pretreatment to 12-week posttreatment imaging (P = .1-.946; tau = −0.194-0.044). The primary tumor ADC mean (P = .03) and the interval change in nodal ADC min (P = .05) predicted 2-year DFS but none of the 18 F-FDG PET/CT parameters were associated with 2-year DFS.

MRI for Differentiation between HPV-Positive and HPV-Negative Oropharyngeal Squamous Cell Carcinoma: A Systematic Review

“…Overall, low risk of bias was selected most often in all assessment categories, except for the reference standard, for which high risk was most prevalent. For the reference standard, the main concern was the use of different HPV determination methods for different patients or the exclusive use of p16 immunohistochemistry for HPV determination [ 20 , 21 , 22 , 23 , 26 , 31 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. The main concern for patient selection was the lack of information on consecutive or random patient selection and the exclusion of patients with lower-stage OPSCC [ 20 , 25 , 27 , 35 , 36 , 37 , 38 , 39 , 45 , 46 , 47 ].…”

“…For the reference standard, the main concern was the use of different HPV determination methods for different patients or the exclusive use of p16 immunohistochemistry for HPV determination [ 20 , 21 , 22 , 23 , 26 , 31 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. The main concern for patient selection was the lack of information on consecutive or random patient selection and the exclusion of patients with lower-stage OPSCC [ 20 , 25 , 27 , 35 , 36 , 37 , 38 , 39 , 45 , 46 , 47 ]. Regarding the index test, the main concern was the lack of pre-specification of thresholds or independent validation [ 21 , 25 , 26 , 27 , 31 , 39 , 40 , 41 , 46 , 47 , 48 ].…”

“…Regarding the index test, the main concern was the lack of pre-specification of thresholds or independent validation [ 21 , 25 , 26 , 27 , 31 , 39 , 40 , 41 , 46 , 47 , 48 ]. The main concern for flow and timing was the fact that not all patients received the same reference standard or index test [ 21 , 31 , 32 , 36 , 37 , 39 , 40 , 43 , 48 ]. The QUADAS-2 assessment for each study can be found in Supplementary Data S2 .…”

“…Twenty-one studies had a retrospective cohort study design [ 2 , 19 , 20 , 21 , 22 , 25 , 26 , 28 , 29 , 31 , 32 , 35 , 37 , 38 , 39 , 42 , 44 , 45 , 47 , 48 , 49 ], and seven studies had a prospective cohort study design [ 23 , 27 , 40 , 41 , 43 , 46 , 50 ]. Of the twenty-eight included papers, five papers focused on structural MRI sequences that were used in routine clinical examinations [ 19 , 20 , 21 , 22 , 23 ], nineteen focused on DWI sequences [ 2 , 25 , 27 , 28 , 29 , 31 , 32 , 35 , 36 , 38 , 39 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 ], and se...…”

“…Nineteen studies made use of DW-MRI to study differences in HPV status [ 2 , 25 , 27 , 28 , 29 , 31 , 32 , 35 , 36 , 38 , 39 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 ]. The diffusion weighting used for DWI, referred to as b-values, can be found in Table 4 .…”