Differentiation of Recurrent Tumor and Posttreatment Changes in Head and Neck Squamous Cell Carcinoma: Application of High b-Value Diffusion-Weighted Imaging

Hwang, In-Kyeong; Choi, Seung Hong; Kim, Y.-J.; Kim, K.G.; Lee, A.L.; Tie, Yun; Kim, J.-h.; Sohn, Chul Ho

doi:10.3174/ajnr.a3603

Cited by 46 publications

(43 citation statements)

References 26 publications

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“…One potential explanation for these conflicting results is that our b-values are partly lower than previously reported in the literature (800 vs. 1,000-2,000). It is known that the ADC value decreases when the b-value increases beyond 1,000 s/ mm2 [30]. The decrease in the observed ADC with an increasing b-value is explained by the decay of biexponential signal intensity [30].…”

Section: Malignant and Non-malignant Lesionsmentioning

confidence: 92%

“…In head and neck cancer single-modality MRI, DWI is often performed for tumor detection and characterization, to monitor treatment response, and for the differentiation of recurrence from post-radiation changes [11,29,30]. However, the quality of the DWI sequence can be severely distorted by susceptibility artifacts, particularly in the head and neck area due to dental implants, and has a relatively low specificity [29][30][31].…”

Section: General Aspectsmentioning

confidence: 99%

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Use of diffusion-weighted imaging (DWI) in PET/MRI for head and neck cancer evaluation

Queiroz

Hüllner

Kuhn

et al. 2014

Eur J Nucl Med Mol Imaging

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Section: Malignant and Non-malignant Lesionsmentioning

confidence: 92%

Section: General Aspectsmentioning

confidence: 99%

Use of diffusion-weighted imaging (DWI) in PET/MRI for head and neck cancer evaluation

Queiroz

Hüllner

Kuhn

et al. 2014

Eur J Nucl Med Mol Imaging

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“…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. 25,[28][29][30] Histogram analysis is considered to represent tumor heterogeneity, which is well known to affect tumor response to chemoradiation therapy.…”

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

et al. 2015

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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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“…Many studies have shown the advantages of DW-MRI or PET/CT for distinguishing recurrent tumors from post-treatment changes in head and neck cancers (1,2,4,9). However, few studies have investigated the diagnostic performence of DW-MRI and PET-CT in the same patients with head and neck cancers (8,11).…”

Section: Resultsmentioning

confidence: 99%

“…The median delay times between radiotherapy and MRI and between MRI and FDG PET/CT were 71 days (range: 43-98 days) and 75 days (range: 44-103 days), respectively. Diffusion-weighted single-shot echo planar imaging was performed before contrast injection at b values of 0 and 1000 s/ mm 2 . PET/CT images were acquired after the administration of 3.7 MBq/kg of fluorine-18-fluorodeoxyglucose, and the images were acquired 1 h later.…”

Section: Sonuçmentioning

confidence: 99%

Diagnostic Performance of Diffusion-Weighted MRI and FDG PET/CT for Detecting the Local Recurrence of Head and Neck Squamous Cell Carcinoma

Öz¹,

Şerifoğlu²,

Salihoğlu³

et al. 2016

Istanbul Med J

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IntroductionFor patients with head and neck squamous cell carcinoma (HNSCC), multidisciplinary treatment involving surgery, radiotherapy, and/or chemotherapy improves survival and quality of life (1, 2). Despite aggressive combined management, locoregional recurrence is observed in approximately 40% of patients (3). Physical examination after treatment can be compromised by post-treatment changes, as surgical intervention can change the normal anatomy and radiotherapy can cause edema, inflammation, fibrosis, and necrosis (4). Particularly in the early stages of treatment, posttreatment follow-up imaging is also a challenge. Differentiation of post-treatment changes from a recurrence of HNSCC is generally not possible on computed tomography (CT) or magnetic resonance imaging (MRI); recurrent tumors and post-treatment changes may show similar appearances on routine MRI. After contrast administration, mass-like enhancement of post-treatment changes may mimic recurrence (1). Conversely, some recurrent tumors do not show enhancements, and thus, they cannot be distinguished from post-treatment changes (5).Diffusion-weighted MRI (DW-MRI) is sensitive to the randomized (Brownian) motion of water molecules. This imaging technique uses two opposite gradients of similar strength along a particular diffusion direction. The first gradient stimulates dephasing, and the second gradient will completely rephase all stationary molecules. Consequently, the movement of protons in living tissues results in incomplete rephrasing and is then converted into a decrease in the signal intensity on the resulting image (6, 7). The apparent diffusion coefficient ( Bulgular: Nüks saptanan hastalarda ADC ortalama değerleri saptanmayan hastalarla karşılaştırıldığında istatistiksel olarak anlamlı derecede düşük bulunmuştur (0,773'e karşı 1,588 x10-3/mm 2 sırasıyla, p<0,001). Nüks saptanan hastalarda SUV max değerleri saptanmaya hastalara göre istatistiksel olarak anlamlı derecede yüksek bulundu (15,642' karşı 4,508 sırasıyla; p<0,001). Nüks saptanan hastalarda ADC ortalama ve SUV max değerleri arasında anlamlı bir korelasyon izlenmedi (p=0,278, r=0,341). Nüks saptanmayan hastalarda ADC ortalama ve SUV max değerleri arasında negatif korelasyon saptandı (p=0,019, r=-0,691).Sonuç: PET/BT ve DAG-MRG baş-boyun SCC hastalarında tedavi sonrası nüksü saptamada etkin yöntemlerdir. Baş-Boyun SCC hastaları tedavi sonrası DAG-MRG ile takip edilebilir ve nüks şüphesi olan hastalarda PET-BT takip protokolüne eklenebilir.Anahtar Kelimeler: Baş ve boyun kanseri; difüzyon ağırlıklı görüntüleme, görünür difüzyon katsayısı, pozitron emisyon tomografisi/bilgisayarlı tomografi, standardize tutulum değeri Objective: To compare the efficacy between diffusion-weighted magnetic resonance imaging (DW-MRI) and positron emission tomography/computed tomography (PET/CT) in detecting the local recurrence of head and neck squamous cell carcinoma (HNSCC) following treatment in the same patient group. Methods: Twenty-three patients who had biopsy-proven HNSCC were enrolled. All ...

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Differentiation of Recurrent Tumor and Posttreatment Changes in Head and Neck Squamous Cell Carcinoma: Application of High b-Value Diffusion-Weighted Imaging

Abstract: BACKGROUND AND PURPOSE: High b-value DWI has been expected to have an additional diagnostic role and demonstrated some promising results in head and neck cancer. The aim of this study was to evaluate the diagnostic performance of DWI at a high b-value (bϭ2000 s/mm

Cited by 46 publications

References 26 publications

Use of diffusion-weighted imaging (DWI) in PET/MRI for head and neck cancer evaluation

Use of diffusion-weighted imaging (DWI) in PET/MRI for head and neck cancer evaluation

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

Diagnostic Performance of Diffusion-Weighted MRI and FDG PET/CT for Detecting the Local Recurrence of Head and Neck Squamous Cell Carcinoma

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