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Research ArticleHEAD & NECK

Pretreatment DWI with Histogram Analysis of the ADC in Predicting the Outcome of Advanced Oropharyngeal Cancer with Known Human Papillomavirus Status Treated with Chemoradiation

M. Ravanelli, A. Grammatica, M. Maddalo, M. Ramanzin, G.M. Agazzi, E. Tononcelli, S. Battocchio, P. Bossi, M. Vezzoli, R. Maroldi and D. Farina
American Journal of Neuroradiology July 2020, DOI: https://doi.org/10.3174/ajnr.A6695
M. Ravanelli
aFrom the Departments of Radiology (M. Ravanelli, M. Ramanzin, G.M.A., E.T., R.M., D.F.)
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A. Grammatica
bOtorhinolaryngology (A.G.)
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M. Maddalo
cRadiation Oncology (M.M.)
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M. Ramanzin
aFrom the Departments of Radiology (M. Ravanelli, M. Ramanzin, G.M.A., E.T., R.M., D.F.)
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G.M. Agazzi
aFrom the Departments of Radiology (M. Ravanelli, M. Ramanzin, G.M.A., E.T., R.M., D.F.)
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E. Tononcelli
aFrom the Departments of Radiology (M. Ravanelli, M. Ramanzin, G.M.A., E.T., R.M., D.F.)
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S. Battocchio
dPathological Anatomy (S.B.)
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P. Bossi
eMedical Oncology (P.B.)
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M. Vezzoli
fMolecular and Translational Medicine (M.V.), University of Brescia, Brescia, Italy.
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R. Maroldi
aFrom the Departments of Radiology (M. Ravanelli, M. Ramanzin, G.M.A., E.T., R.M., D.F.)
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D. Farina
aFrom the Departments of Radiology (M. Ravanelli, M. Ramanzin, G.M.A., E.T., R.M., D.F.)
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Abstract

BACKGROUND AND PURPOSE: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has increased in the period from the 1970s to 2004, due to increase of infection with human papilloma virus (HPV). This study aimed to examine the role of histogram analysis of the ADC in treatment response and survival prediction of patients with oropharyngeal squamous cell carcinoma and known human papillomavirus status.

MATERIALS AND METHODS: This was a retrospective single-center study. Following inclusion and exclusion criteria, data for 59 patients affected by T2–T4 (according to the 8th edition of the AJCC Cancer Staging Manual) oropharyngeal squamous cell carcinoma were retrieved. Twenty-eight had human papillomavirus–positive oropharyngeal squamous cell carcinoma, while 31 had human papillomavirus–negative oropharyngeal squamous cell carcinoma. All patients underwent a pretreatment MR imaging. Histogram analysis of ADC maps obtained by DWI (b = 0–1000 mm/s2) was performed on the central section of all of tumors. The minimum follow-up period was 2 years. Histogram ADC parameters were associated with progression-free survival and overall survival. Univariable and multivariable Cox models were applied to the data; P values were corrected using the Benjamini-Hochberg method.

RESULTS: At univariable analysis, both human papillomavirus status and mean ADC were associated with progression-free survival (hazard ratio = 0.267, P < .05, and hazard ratio  = 1.0028, P ≤ .05, respectively), while only human papillomavirus status was associated with overall survival (hazard ratio  = 0.213, P ≤ .05) before correction. At multivariable analysis, no parameter was included (in fact, human papillomavirus status lost significance after correction). If we separated the patients into 2 subgroups according to human papillomavirus status, ADC entropy was associated with overall survival in the human papillomavirus–negative group (hazard ratio  = 4.846, P = .01).

CONCLUSIONS: ADC and human papillomavirus status are related to progression-free survival in patients treated with chemoradiation for advanced oropharyngeal squamous cell carcinoma; however, this association seems to result from the strong association between ADC and human papillomavirus status.

ABBREVIATIONS:

HPV
human papillomavirus
OPSCC
oropharyngeal squamous cell carcinoma
OS
overall survival
PFS
progression-free survival
TNM
Tumor, Node, Metastasis

Footnotes

  • Disclosures: Marco Ravanelli—RELATED: Payment for Writing or Reviewing the Manuscript: Linguistic Editing; UNRELATED: Payment for Manuscript Preparation: Linguistic Editing. Paolo Bossi—RELATED: Consulting Fee or Honorarium; UNRELATED: Consultancy: Galera Therapeutics, Comments: less than ϵ1500. Davide Farina—UNRELATED: Payment for Lectures Including Service on Speakers Bureaus: Marco Ravanelli 2019, Comments: around ϵ1000; Payment for Development of Educational Presentations: Bracco 2020, Comments: around ϵ1000.

  • © 2020 by American Journal of Neuroradiology
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Pretreatment DWI with Histogram Analysis of the ADC in Predicting the Outcome of Advanced Oropharyngeal Cancer with Known Human Papillomavirus Status Treated with Chemoradiation
M. Ravanelli, A. Grammatica, M. Maddalo, M. Ramanzin, G.M. Agazzi, E. Tononcelli, S. Battocchio, P. Bossi, M. Vezzoli, R. Maroldi, D. Farina
American Journal of Neuroradiology Jul 2020, DOI: 10.3174/ajnr.A6695

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Pretreatment DWI with Histogram Analysis of the ADC in Predicting the Outcome of Advanced Oropharyngeal Cancer with Known Human Papillomavirus Status Treated with Chemoradiation
M. Ravanelli, A. Grammatica, M. Maddalo, M. Ramanzin, G.M. Agazzi, E. Tononcelli, S. Battocchio, P. Bossi, M. Vezzoli, R. Maroldi, D. Farina
American Journal of Neuroradiology Jul 2020, DOI: 10.3174/ajnr.A6695
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