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Erschienen in:
01.07.2010 | Head and Neck
Predictive value of diffusion-weighted magnetic resonance imaging during chemoradiotherapy for head and neck squamous cell carcinoma
Erschienen in: European Radiology | Ausgabe 7/2010
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Objective
To evaluate diffusion-weighted (DWI) magnetic resonance imaging (MRI) for treatment prediction during chemoradiotherapy (CRT) of head and neck squamous cell carcinoma (HNC).
Methods
Thirty patients with HNC underwent echo-planar DWI and anatomical MRI before and 2 and 4 weeks into CRT. Patient follow-up lasted 2 years post-CRT. Tumour ADC (ΔADC) and volume changes (ΔV) between baseline, and 2 and 4 weeks’ follow-up were compared for lesions with recurrence versus complete remission (CR) using a Mann-Whitney U test. The predictive value of the ΔADC and ΔV for locoregional control (LRC) was examined with the Kaplan-Meier method. The study was approved by the local ethics committee. All patients gave written informed consent.
Results
The ΔADC in primary tumours and nodal metastases, 2 and 4 weeks after the start of CRT, was significantly lower in lesions with post-CRT recurrence than in lesions with CR (ΔADC2 weeks and ΔADC4 weeks for primary tumours, relative to nodal metastases: p < 0.0001). The ΔV only showed a significant difference for primary tumours at 2 weeks (ΔV2 weeks: p = 0.03). The ΔADC correlated significantly with 2-year LRC (p < 0.001); the ΔV did not (p > 0.05).
Conclusion
DWI during CRT for HNC allows more accurate response prediction than anatomical imaging, correlating significantly with 2-year LRC.